A well recognized component of facial aging is loss of fat volume. This loss results in a sunken, hollow appearance to the face, which may be difficult to describe, but is easy to recognize. The face looses its round contours and sharp demarcations develop between different regions of the face. Volume augmentation is a large component of comprehensive facial rejuvenation.

Facial volume restoration can be achieved in several ways. There are many commercially available injectible fillers to augment the face. Products such as Restylane, Juvederm, Scupltra, and Radiesse are now a part of the popular culture lexicon. Although these fillers are easy to administer, they lack permanency. Fat grafting is a permanent technique for restoration of facial volume, and an attractive alternative to the commercially available facial fillers.

Dr. Khosh performs fat grafting in Manhattan, as an office based procedure. Small amounts of fat is gently harvested from the lower body, prepared carefully, and then meticulously injected into appropriately chosen areas of the face. Fat transfer can be used to enhance the appearance of the cheeks, brow, temple, and the orbital regions. Patients notice not only improved facial contours, but also more vibrant and healthier skin. A secondary benefit that has been postulated to be due to growth factors or stem cells present in the fat graft.

Facial aging

A new study by Dr. Howard Lanstein at the University of Rochester confirms long standing plastic surgeons’ assumption that changes in the shape of facial bones, specially the mandible, has a significant impact on facial aging.

In this study, CT scans of the facial bones were obtained in nearly 120 patients. The patients were then divided into three groups: young (ages 20-36), middle (ages 41-64), and old (65 and older). There were equal numbers of male and female patients in each group. Comparison of these groups showed that with aging, there is a significant reduction in length and height of the jaw. This leads to reduced chin projection, and loss of jaw-line definition.

The study findings confirm our updated understanding of facial aging, where multiple factors including loss of skin elasticity, soft tissue volume loss, and bony loss are responsible for changes that occur in the face. In regards to bony loss in the jaw, new treatments for tooth loss such as dental implants could help maintain more bony volume. Otherwise, chin implants have a long standing history as an adjunct to facelift surgery, and neck liposuction to enhance lower face and neck appearance.