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Aesthetic facial surgery - Liposuction & Lipofilling

Liposuction
Removing fat tissue volume from the neck or/and face.
A ‘double chin’ is a common feature and may be treated separately or as adjuvant surgery during orthognathic treatment (osteotomies). Liposuction of the neck may be carried out through three stab incisions (under the chin and R & L under the ear, each 2mm). The removal of fatty tissue is carried out using a suction device. Sometimes, the same procedure is extended higher up to the face.
Lipofilling 
Adding soft tissue volume to the face.
Lipofilling is the opposite of liposuction. When used in subtle ways it is a marvellous adjunct in our aesthetic armentorium. Lipofilling has become more and more widely accepted and standard in our use.

Lipofilling, also referred to as free fat transfer or fat grafting, is a procedure to fill up facial features with the patient’s own body fat instead of using a chemical filling or an implant. This is a highly efficient procedure. It is not very invasive and the results are, above all, natural and youthful. Another advantage is that the procedure can easily be repeated.

Fat cells can be reaped from another region of the body, i.e. belly and outer or inner thighs. The fat is then infiltrated with the "Maftgun" device into the soft tissues of the face after careful filtering. The device is enable us to bringing the fat in small spherical units what enhance by far the survival of the fat transplant. Specific anatomic areas may be: the cheeks, the paranasal area’s, the lips (nice and lasting volume), the high and lower cheek regions, the temporal areas. The results are amazing and extremely well received by patients.
Nano fat
The texture of the skin can be further enhanced with nano-fat. Nano-fat is a rather new concept in the facial rejuvenation story, and is processed from micro-fat. Nano-fat contains only the stem cells present in the reaped micro fat. The fat cells themselves are removed. In fat tissue there is certainly a huge reservoir of stem cells. The nano-fat is injected with a sharp needle, most superficially in the dermis. It is known to enhance the texture and quality of the skin.
The result
Facial Sculpture Clinic - Dr Joël Defrancq - Jaw surgery and implant reconstructive surgery The fat used for fat transfer can be reaped from any part of your body such as the abdomen or thighs by liposuction, and it can be injected where needed. This cosmetic procedure can be used to rejuvenate the face, augment the cheeks or lips, or correct problems such as hollowness around the eyes or scars.

Fat grafting is usually performed under local anaesthesia if done as solitary procedure. The technique used is the Coleman technique, the application is with the "Maftgun".
Liposuction: The donor place of the fat can be taken from any part of the body with sufficient fat deposits. In most cases fat is harvested from the abdomen or the upper legs. First a local anaesthetic with vasoconstrictor is infiltrated in the area of the harvest through a very small stab incision and fat is aspirated using a blunt needle that has multiple perforations. A special aspirator is used for this purpose. The small incision is closed with one little stitch.
Filtration: This fat is filtered to remove blood, broken cells, and oil from the harvest. Only healthy fat cells with some stem cells are further used.

Liposuction can be done the same way in neck and face to reduce volume and produce more clear neck and facial features. This fat is then usually disregarded. Smaller canules are then used.
Fat injection: The place where we want more volume are injected with the prepared fat cells, injected with very fine cannulas and the "Maftgun". The art of fat transfer is to inject only a very small amount of fat with each pass of the cannula. This way each little island of injected fat drop is in direct contact with surrounding tissues and receives nutrition from all around. This technique maximises the chances of fat survival. The smaller the island drops of fat the better, the more tissue surrounding each droplet the better. About 60% of the fat stays, so some initial overcorrection is commonly performed. To enhance the results, we used the "Maftgun".
Postoperative instructions & frequently asked questions

How long does the fat stay in place?

In general, 60% of the fat survives the tract from the donor site to the host location. This 60% will stay forever. Therefore, some overcorrection is most often performed. There are many factors that determine how long fat grafting lasts in a specific location, but what we do know is that the fat that is still in place after six months will stay forever. Furthermore, after six months, if necessary, the procedure can be repeated until the desired effect is reached. And so, it is wise to have a second intervention in mind. Please don’t see this as a something negative. The results are often gorgeous, and simply impossible to obtain with any other type of material or intervention.

Can I have an idea of the outcome through computer simulation?

The effects of liposuction / lipofilling / liposculpture may be simulated via computer technology at the time of your consultation in Antwerp (3d Vectra).

What about Swelling?

Immediately after the surgery the cheek will be quite swollen and bruised. In about 3 weeks time approximately 80% of the bruising and swelling will have disappeared. About a week to ten days after surgery you will feel confident going outdoors, and be back at work. If any bruises have developed, they might remain visible for a little longer but you can hide them reasonably well with a good concealer. After 3 months you can get a good impression of what the final result after 6 months will be.

What about overcorrection?

In the beginning the correction may look rather exaggerated. We usually over-correct, which means injecting more fat than is actually needed. We do that because 40% of the transplanted fat cells do not survive. The final result is there after 6 months. Then it will stay as it is. It is best to foresee a second intervention months later to top up any shortfall in volume. Indeed some fat is reabsorbed by the body and sometimes only a certain percentage is permanent although newer techniques harvesting smaller fat drops show remarkably better results.

Can the fat also grow in the area where it has been added?

Yes it is possible! If you gain weight in the area where the fat was taken, this also may show up in the area where the fat was injected. The fat follows the cycle of life pattern from where it initially came from, and is still hormone dependent from that donor area. Nature is amazing!

Does the procedure need repeating?

After six months, if necessary, the procedure can be repeated until the desired effect has been obtained. Repetition is needed in +/- 50% of patients.