Category Archives: fat grafting

Applying art to facial rejuvenation is key to making a face appear optimally youthful and at the same time completely natural. I have spent my lifetime studying faces to determine what are the qualities that make a face look younger or older. I particularly like to look at mother and daughters’ photos on social media […]

Glass of Water Emptying:  The Way I Explain the Aging of the Face When people ask me whether fat grafting is permanent, I say yes and no.  Yes, it is permanent because if done well by an expert injector (which I consider myself one) then once the graft gains formal blood supply over a period […]

Breaking down the Cheek into Aesthetic Subunits: Avoiding Chipmunk Cheeks There is nothing uglier than big, chipmunk cheeks other than perhaps a devil looking arched brow or a duck-like lip.  How do you avoid this problem?  Should one not fill the cheeks at all then?  The answer is no since the cheek is one of […]

Type 1 and Type 2 Eyelids One of my colleagues came up with the distinction between two types of youthful eyelids.  Type 1 is a very full upper eyelid that hangs almost over the eyeball itself (not quite).  Type 2 eyelid is an eyelid that is much hollower but at the same time still distinguishes […]

Breaking the Brow into Subunits: Designing a Brow for Cosmetic Improvement In a previous blog we discussed why low, full brows are sexy, youthful and attractive. In this blog, we will delve into the exact subcomponents of a brow that need to be filled to achieve that look.  I break the brow into multiple points depending […]

When Do I Do an Upper-Eyelid Blepharoplasty and How? But should we always just add fillers or fat to the upper frame of the eyelid and never remove any tissues?  The answer is no.  If the eyelid skin is above the eyelash margin, I rarely if ever remove skin.  Filling fat or fillers into the […]

When Do I Do a Lower-Eyelid Blepharoplasty and How? Like the upper eyelid, I find myself performing many more fat transfers to correct the aging process than traditional eyelid surgery.  Further, if I perform a traditional lower-eyelid procedure I will almost always use some fat transferred to improve the result.  In fact, I look at […]

Recently, I had a lady who at the age of 57 started modeling for the first time in her life thanks in large part to the syringes I have put into her face to make her look better.  Her new boyfriend remarked that she looked better than she had when he saw her 7 years […]

Correcting Fat Loss in IPL Damage: My Thoughts Unfortunately, I have heard a lot on the Internet about facial fat loss following a laser treatment like intense pulsed light therapy, or IPL.  Fortunately, I have never seen a patient of mine with this outcome.  I think partly because this phenomenon is rare and partly because […]

Recovery and Cost of Fillers vs. Fat Grafting I would like to focus on two specific pros and cons with fillers and fat transfer: cost and recovery. In the younger patient (under 35 years of age), fillers typically are the most affordable way to make a face look more youthful. The reason for this is […]

Top 10 Things People Worry about After a Fat Transfer (During the Recovery Period) When I call one of my patients the night following a fat transfer procedure, I usually mention the top few things that can make them alarmed that will resolve over the period of the next couple of weeks.  Here is that […]

High or Low Brows?:  What is Sexier for Men and for Women? I am reading a book called Survival of the Prettiest by Nancy Etcoff in which she says studies have shown that a higher brow actually looks less attractive to subjects who viewed various individuals with different brow heights.  A low brow was considered […]

The Outer Face:  Converting Double Concavities into Convexities The one thing that I cannot stand is seeing a face that appears disjointed, i.e., part of the face has been over augmented relative to another.  Perhaps the two biggest problem areas that I see are the lips and the cheeks.  In fact, I have come up […]

Cosmetic Facial Enhancement:  A Mechanic vs. an Artist I had a lady come to my office a few months ago who said that she went somewhere else for a facial fat transfer because it was a couple of thousand dollars less than what I charged.  She then came to me to touch up the work […]

Fat Grafting:  A Little Everywhere Good taste with clothing means that the items one wears are in harmony, possess style, cut well, and made of good material.  Good cosmetic facial surgery is very similar.  The products (materials) one uses can determine the outcome and certain fillers, e.g., fat, Restylane, and Juvederm, work better in certain […]

Hollywood’s Pillow Face is a Problem As many of you know, I love facial volumization in which lost soft tissue of the face from aging is restored using fat grafting and/or injectable fillers.  The word that has dominated the media is a “pillow face” to describe this facial fullness.  I am very adverse to this […]

Fill vs. Lift in Facial Cosmetic Enhancement This article is a corollary to my other article called the “Two-Finger Rule”. In the article on the “Two-Finger Rule”, I argued that taking two fingers and gently pulling up on the skin would not be achievable with any type of cosmetic procedure since it cannot be exactly […]

Understanding the Brow as a Balloon:  The Role of Fat Grafting to the Brow One of the most confusing things that I do is to inflate a brow/upper eyelid with fat or filler when someone instinctively thinks that her brow is already too heavy and sagging.  If someone really does not get it, all I […]

Understanding the Role of Artistry in Cosmetic Surgery and Enhancement One of the greatest compliments that I received was from an Italian plastic surgeon who flew from Italy trusting me to work on his wife’s face, which I performed in front of him.  I undertook a fat transfer on her face to make her look […]

Kenny Rogers and Bad Blepharoplasty and Browlift Surgery Obviously, there is quite a bit of brouhaha about Kenny Rogers’ facial work. His alien appearance has clearly become the poster child for bad facial plastic surgery. If you are wondering what I see as far as his bad work is concerned, I can break it down […]

Avoiding Bad Eyelid Surgery: Preserve the Canthus At All Costs I oftentimes hear a patient come to me to say, “I don’t want to look like celebrity…” who has had too much surgery done or a friend that has been subject to similar bad work.  If the surgery has to do with the eyes, there […]

Eyebags, Shorelines, and Rocks When we talk about eyebags, we are focused on the obvious, which is that there is a protuberant bag of tissue. However, is this really the case in the majority of situations? My answer is no. What I oftentimes see is that the lower orbital bony rim becomes exposed over time […]

How I use Permanent Facial Fillers: Fat Transfer, Silicone, Bellafill(Artefill) In my clinical practice I use both temporary and permanent facial fillers depending on a mixture of budget, desires, and safety. Although permanent fillers carry the risk that they are indeed permanent, I believe that it is important to delineate safety guidelines and also to […]

Differentiating Type 1 from Type 2 Eyes When Considering Fat Transfer to the Upper Eyelid/Brow Complex A colleague of mine really got it right when he created a new perspective on seeing youthful eyes.  He called them Type 1 and Type 2 eyes.  I cannot recall which one was which, which is not important.  Suffice […]

Runner’s Face News Story Featured on 33 News Tonight I was featured on 33 News tonight at 9 pm on a segment entitled “Runner’s Face” for those hyper athletic individuals who prematurely age due to volume loss.  Melinda Arai goes through multiple syringes of fillers to help plump her face back naturally into a more […]

Leveraging the Hardness of Products in Cosmetic Injectable Fillers How hard an injectable product is can be a very good thing or a not so good thing. In any case, I try to use products based on its hardness factors for differing effects on the face. One of the softest materials that I use is […]

Exploring the Recovery Period after Plastic Surgery:  The Concept of Personal Time Many times during a recovery following plastic surgery we imbue that time with heavily negative connotations.  We reflect on everything that we could otherwise be doing. We think about the lost wages or time away from work.  We contemplate the time that we […]

Depression After Plastic Surgery The goal of these blog articles is to discuss the good, the bad, and the ugly with regard to facial cosmetic surgery. Depression is an ugly word but it is important to mention it to understand when someone experiences it after plastic surgery. Depression may arise during the first week or […]

Fat Processing for Fat Grafting: Does It Matter? One of the most common questions that I get on the forum is “How do you process your fat?” This question pertains to how fat, once harvested from the body, is treated before injection into the face and/or hands. I know the intent of the question is […]

I gave this Master’s Seminar on Fat Grafting in Las Vegas on June 22, 2011, at the Vegas Cosmetic Surgery 2011 conference.

Fillers Versus Fat: Shifting Sand Concept Many of my patients try to weigh the merits of fat grafting versus fillers since they both seem to be equally beneficial to fill in the hollows of an aging face.  However, I would disagree.  For younger faces still replete with enough fat and in whom I worry about […]

Understanding the Aging Process Using Fat Grafting:  A Glass of Water Emptying The face undergoes significantly less gravitational descent than was once thought.  Although everyone oftentimes takes two fingers to lift up what appears to be sagging, this maneuver does not truly represent what can be accomplished with a lifting procedure nor does it reflect […]

Understanding The Anterior Chin: The Upside Down U Aging of the chin area is one of the most confusing areas because people I believe focus on the wrong thing. Most oftentimes the concern is about a jowl or about a sagging puppet line. Alternatively, it is about the fine lines that can circumscribe the lips, […]

Dismissing Fat Grafting Myths After speaking with patients who are vaguely familiar with fat grafting I have encountered a lot of misunderstanding about how fat grafting works and a lot of this misunderstanding comes from other surgeons who do not understand it.  Here are some of the top myths on fat grafting that I would like […]

Blink Effect:  How We Perceive Beauty and the Role of Cosmetic Surgery Enhancement One of the most important things that a woman typically wants fixed is the fine lines around her mouth.  I have found this to be the case no matter if she is 33 years old or 85 years old.  Why is this […]

Fat Grafting Recovery: Things You Need To Know Following Your Procedure One of the biggest concerns in our busy workaday America is “What is my recovery like after fat grafting?”  This is something that I will try to explore in this brief article to help prepare a prospective patient who is interested in having this […]

Stem Cells and Fat Grafting: My Thoughts Perhaps the hottest topic that we have today in cosmetic surgery is stem cells.  Do they exist?  How do we use them?  What are they good for?  Are there risks?  Unfortunately, even the most dogged proponents or detractors do not have clear answers to the above points.  I […]

Fat Grafting Eyelid Series Part 2 of 2:  Rethinking the Lower Eyelid This second article in the series focuses on techniques for lower eyelid rejuvenation.  The traditional way to manage the lower-eyelid aging was through a cutting procedure that involved either a skin cut or involved taking fat out from inside the eyelid without an […]

Fat Grafting Eyelid Series Part 1 of 2:  Rethinking Aging of the Upper Eyelid and Brow Traditionally, we have looked at the aging of the upper eyelid and brow through a gravitational model, i.e., we believe that the aging of the upper eyelid and brow sag over time.  This is not always the case.  In […]

The Importance of the Buccal Zone: Joining the Mid to Lower Face The buccal area is defined as the part of the face where if you sucked in your cheeks they would suck inward.  It is the area that in a very skinny person can make one look gaunt, and the buccal area resides in […]

Recent Fat Grafting Video Testimonials I have had several recent video testimonials by patients who have had my fat grafting services that I thought I would post here in this blog in addition to putting them in the video testimonial section of this Web site. I would truly like to thank my patients for their […]

Fat Grafting Using a Hair Transplant Model for Understanding Part 3: Donor Dominance A new concept that really did not mature fully until I was preparing for my Vegas lecture in mid-2010 and then refined further as I was finishing my prep work for my St. Louis lecture in November 2010 was the concept of […]

Fat Grafting Using a Hair Transplant Model for Understanding Part 2: The Dip The early swelling of fat grafting that dominates the first 1 to 3 weeks after a procedure can be misconstrued as a result when it in fact is a mixture of engorged fat cells and postoperative swelling. Sometimes the stretched out appearance […]

Fat Grafting Using a Hair Transplant Model for Understanding Part 1:  Graft Growth Looking at my fat grafting results I was puzzled initially as to why I saw results continue to improve in patients somewhere between 6 months to 2 years after a procedure.  Being a very careful student of my own work by photographing […]

Balance vs. Symmetry We have all heard that symmetry is one of the cardinal signs of a beautiful face.  Studies in the animal kingdom have led us to believe that symmetry truly makes all the difference when selecting an ideal mate.  However, I would like to propose that symmetry is not as important as we […]

Rethinking Facial Implants When considering a cheek augmentation, consider truly what would benefit you most.  In many young individuals with weak bone structure, a cheek implant made of silicone or other material can be an ideal choice since it is reversible, easily inserted and can provide a better, more attractive structure to the face.  However, cheek […]

Fat Grafting: Rethinking Aging of the Face A revolution is upon us today in how we see aging of the face and how we understand the aging process. In the past, the gravitational model held that all things fall including the brows, the eyelids, the cheeks, and the jawline. Using rigorous computer modeling and matching […]