Lipofilling of the face
The strong points
We perform facial lipofilling under local anesthesia or general anesthesia.
Lipofilling, also known as facial lipomodeling, is a recent technique that has revolutionized facial rejuvenation. It offers a natural and stable alternative to injections of synthetic and resorbable products (Hyaluronic acid, Radiesse...).
The lifespan of facial lipofilling is long-lasting.
The price of a facial lipofilling varies from 3500 to 5500 euros depending on the difficulty of the case.
Description of a facial lipofilling
It is a transplant of purified fatty tissue. Using a syringe, fat is sucked from an area rich in adipose tissue (stomach, hips, etc.). The fat is then purified using a specific single-use filter(Puregraft 50 or Lipogems) in order to separate blood and water from the pure fat (adipocytes). This fat is then injected in a very precise way by means of fine cannulas in the face in order to :
filling of certain very pronounced wrinkles, in particular the nasolabial folds
increase in volume of certain areas of the face that have melted due to the loss of tissue associated with aging (cheekbones)
A discreet over-correction is performed because the injected fat usually takes only 60%.
The final result is obtained at 1 month and is totally stable over time.
Facial lipofilling in practice
The procedure is most often performed under pure local anesthesia but can be performed under general anesthesia or simple sedation. It is not more painful than a hyaluronic acid injection. You can also opt for a neuroleptanalgesia (local anesthesia deepened by sedatives administered intravenously). This requires a pre-anesthetic consultation at least 48 hours before the procedure. The after-effects are simple and a normal social life can be envisaged 48 hours after the lipofilling. Modern techniques of fat purification make it possible to avoid bruising on the face, however a slight edema is present for 48 hours due to the over-correction.
Bruising can be seen in the areas where the fat has been suctioned for 10 to 15 days.
The specificities of our facial lipofilling
We no longer use the classic method of fat purification by centrifugation. We believe that it is too aggressive for the fat and that it gives a fat that is too compact to be injected by a fine cannula. We now only use single-use filters (Puregraft and Lipogems) which have many advantages:
- they are closed systems that allow the handling of grease without bacterial contamination
- the purification is done by filtration and washing which allows to totally eliminate the blood and the oil responsible for bruises and inflammation on the face
- The fat obtained is very fluid, which allows it to be injected with very fine cannulas (21 or 23 gauges), making this procedure possible under pure local anesthesia.
- the fat being thinner, there is less risk of having unsightly fat balls after injection
Questions / Answers
What are the differences between facial lipofilling and hyaluronic acid injection?
The fundamental difference is the stability of the effects of facial lipofilling over time. Once the fat is taken, the volume will not decrease and no injection renewal is necessary. Moreover, it is an autologous product, that is to say, it comes from your own body. No long term inflammatory reaction is possible as we can see with the injection of foreign products such as hyaluronic acid which, even if it is purified, contains chemical stabilizers such as BDDE.
However, fat has some disadvantages. It is injected in larger quantities than hyaluronic acid depending on the size of the fat lobules.
It is therefore not suitable for the correction of fine wrinkles or areas where the skin is very thin such as dark circles.
Nevertheless, it tends to spread better than some very dense fillers (Juverderm Voluma® or Radiesse®), thus allowing for better projection and a more precise modification of the face's volumetry (particularly in the treatment of the tear valley wrinkle).
Thus, we use lipofilling as a first-line treatment for the correction of deep wrinkles (nasolabial folds, tear troughs, bitterness folds) and to increase the volume of the cheeks. Similarly, lipofilling of the cheeks before and after gives excellent results because it is a large area where the fat grafting allows a natural result respecting the anatomical composition of the cheek.
We prefer to use low-concentrated hyaluronic acid (Restylane Eye®, Juvederm®) in the treatment of fine lines (forehead or lips).
Is the result of facial lipofilling stable over time?
Yes, once the graft has undergone partial resorption (it is estimated that the injected volume is reduced by 40 to 50% in the 15 days following the procedure), the result is perfectly stable over time.
What are the possible complications of facial lipofilling?
A rigorous technique is necessary in this very delicate procedure. It is a graft, so the percentage of tissue uptake can be variable.
Heavy smoking, for example, greatly reduces the graft take. Nevertheless, it can be considered that in trained hands, a percentage of 50 to 60% take is usual. By integrating, the fat can create small clusters or balls of fat after lipofilling. In order to avoid this phenomenon, which sometimes cannot be seen but can be felt to the touch, we inject deep into the body in a continuous tract with cannulas. Finally, due to the necessary over-correction, the face is oedematous for 2 to 4 days after the procedure.
Are there any lipofillings covered by the health insurance?
Yes, as part of reconstruction after trauma or accident or if you suffer from lipodystrophy related to antiretroviral treatment against the HIV virus.
Your case will be reviewed by the medical officer of the health insurance company before a possible agreement is obtained.
The health insurance coverage of your lipofilling does not cover additional surgical fees. Our estimate of fees must be sent to your mutual insurance company to know the amount of your coverage.
How much does facial lipofilling cost?
The price of facial lipofilling varies between 3500 € (cheekbone lipofilling) and 5500 € (full facial lipofilling) depending on the areas injected and the type of anesthesia (local or sedation).
Have a question? Please contact us!
Docteur Yaël Berdah and Docteur Marc-David Benjoar
Plastic surgeons in Paris France