During the aging process, a "fat tissue distribution disorder" occurs on our face. The medical name of this condition is "Senile Facial Lipodystrophy".
When you put a photo of a person in his forties and a photo of him in his 20s side by side, one of the changes that attracts your attention the most will be the extent to which the total volume in the face has decreased. During the aging process, the fatty tissue of the face gradually decreases. This decrease is so regular and so slow that you cannot notice the change even though you see your face in the mirror every day. More interestingly, while some areas of the face lose volume, the volume of fat tissues in some areas (e.g. bags under the eyes, fat pad under the chin, etc.) increases.
One of the most effective methods we have in the treatment of volume loss during the aging process is fat tissue. transfer. Fat tissue transfer, as the name suggests, requires taking fat tissue from one part of the body and transferring it to another part. In this process, fat is removed from a part of the body with special cannulas (a kind of liposuction) and then it is processed through various processes and delivered to the desired area through small cannulas. You can think of what we call a cannula as a needle with a blunt tip. For this reason, fat tissue transfer is likened to an injection process and is also known as "fat injection".
Since the fats removed during the fat tissue transfer process are removed from their natural environment, a significant part of the cells die during fat removal. The cells that are still alive after the injection will survive if they can find a vessel that will nourish them in their new home and attach to it, and those that cannot find it will die. Therefore, a significant part of the transferred volume in fat tissue transfer will melt and only a small part will remain. How much of the transferred fat tissue will survive depends on many factors. The survival percentage varies depending on the internal structure and diameter of the cannulas used when taking and giving fat, the area where the fat is taken, the area where the fat is given, the drugs used, the intermediate steps used when separating the fat (filtering, centrifuge, nanofilter, etc.) and the injection technique.
In fat tissue transfers, as the size of the transferred fat particles decreases, the survival percentage decreases. For example, structure While survival in red fat grafts is 25-50%, this rate decreases to 10-30% in micro fat transfer and 5-10% in nano fat transfer. Despite this decrease in survival percentage, we prefer small particle transfer in some special cases. For example, in areas where the skin is very thin, such as around the eyes, or where the injection will be applied superficially, small particles are preferred because they create a smoother contour.
Another issue is the application technique. In fat tissue transfer, the cannula acts like a sewing machine inside the tissue. We obtain a three-dimensional pattern by leaving a very small volume inside a thin tunnel with each pass, as if we were making a braid. It is essential that the cannulas constantly enter and exit the tissue and be in motion. This type of procedure inevitably creates significant edema and bruising in the tissue. In other words, even if we do not lose any fat and only insert and remove the cannulas, it will be inevitable for swelling to occur that will continue for a few weeks.
For the reasons I mentioned above, the volume that emerges in the early period after tissue transfer is perhaps close to 10 times the targeted final volume. Patients are generally uncomfortable with swelling in the early stages, and the swelling of this procedure is not unbearable. Around 10-14 days after the procedure, swelling due to tissue trauma decreases considerably and the volume of injected fat remains. The volume we see between 10-14 days will decrease significantly in the following 6 weeks as the dead fat is removed by the body and the remaining edema regresses, and the final volume will appear. It is important that you know these because the fat tissue transferred and this Our patients, who are not sufficiently informed on these issues, are upset by saying "the fat has disappeared, I could not achieve the result I wanted." They may also be reluctant about subsequent sessions because they are disappointed. However, we can typically reach the targeted volume in 3-4 sessions. If we give high volumes to reach the target volume in one go, the patient stays away from social life for weeks due to excessive swelling and bruising in the early stages. Applying high volumes at once has other risks. Because this fatty tissue is a “living thing” and has a unique habit. Sometimes the applied oil can last much more than expected. may. That's when the problems start.
It is better to keep less fat than too much, because if there is too little, it can be added later, but if there is too much and irregularities occur due to the injected fat, even a surgery may be required to remove this fat. The best example of this is fat tissue transfers around the eyes. If a large amount of fat tissue is transferred around the eye, especially with large particles, and if the fat in that person survives at a higher percentage than expected, new bags and visible oil cysts may form under the thin eyelid skin. When this situation is permanent, these fats can only be removed by surgery.
One of the problems encountered in fat tissue transfers is that the fat is given to a single area and cannot be distributed well enough. In this case, a swelling or bump occurs in the given area and an abnormal, unnatural contour may occur. In order to prevent this, as I mentioned at the beginning, the cannulas must penetrate the fat cells into the tissue in many passes.
Fat tissue transfer is one of the most powerful applications of modern plastic surgery. One of the key applications of facial rejuvenation. However, this procedure, like every medical procedure, has its own limitations and limits. Be sure to talk to your doctor before the procedure about the estimated number of sessions it will take to reach your goals, the cost and total cost of each session, the technique to be used, and how to deal with possible complications.
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