Dermal Fillers


Can Sculptra buttock augmentation provide the same results as the Brazilian butt lift? This is arguably the most common question of patients who want to reshape their backside but have very low body fat percentage to make butt augmentation via fat transfer a viable option.

 

While Sculptra and other lab-made fillers can add volume to almost any part of the body, leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that Brazilian butt lift remains the gold standard because it gives the surgeon more control over the projection, shape, and size of the buttocks.

 

sculptra buttock augmentation

In essence, Brazilian butt lift is a buttock augmentation via fat grafting in which excess fats are removed from various donor sites (usually the lower back, hip-flank region, back rolls, and frontal abdomen) and later re-injected into the patient’s backside.

 

The celebrity plastic surgeon regularly posts Snapchat videos showing how the Brazilian butt lift is accomplished and thus may help viewers (or would-be patients) form “reasonable” expectations and goals.

 

The problem with Sculptra, he says, is one will need multiple procedures performed several weeks apart just to achieve a “conservative” amount of augmentation; hence, patients seeking for more drastic results will have to adjust their expectations. Furthermore, it may cost as high as $30,000 on top of the fact that the results can only last an average of five years, says Dr. Smiley.

 

The average cost of Brazilian butt lift, meanwhile, is between $5,000 and $9,000; its highly variable pricing is due to factors such as liposuction or donor sites, clinic location, doctor’s fee, and operating room fee.

 

With blood supply ingrowth within and around the fat grafts, the results of Brazilian butt lift are near permanent, Dr. Smiley further explains.

 

Sculptra and other traditional fillers are best reserved for treating small areas such as the laugh lines, deep tear trough, flat or gaunt cheeks, and thinning lips, says Dr. Smiley.

 

Should the patient elect to have Sculptra buttock augmentation, Dr. Smiley says that while the filler is FDA-approved for facial volume loss, injecting it into the backside is an off-label procedure.

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Dermal fillers or fat transfer: Which one provides better results?

 

These two treatments (both are injected into the soft tissue) are also referred to as volumizers as they replace facial volume loss that results in nasolabial folds (laugh lines), flat cheeks, deep tear trough, and thinning lips.

 

dermal fillers or fat transfer

Photo Credit: Ambro at FreeDigitalPhotos.net

In order to answer which one provides better results, dermal fillers or fat transfer, several factors are taken into account such as the treatment site, cosmetic goals, and use of ancillary procedures such as facelift, if there is any.

 

Leading Los Angeles plastic surgeon Dr. Tarick Smiley says that despite of the more natural effects of fat transfer, under certain circumstances the use of dermal fillers might be a better option.

 

For instance, the thinning lips are best treated by dermal fillers, particularly hyaluronic acid-based products like Restylane. Because the “site” constantly moves (while eating, speaking, yawning, etc.), the fat grafts may not settle properly or gain their new blood supply to become a permanent fixture.

 

And since the effects of dermal fillers are just temporary, usually 4-6 months, they are ideal for patients who want to see first the effects of volumizers before resorting to more permanent treatments like fat transfer or even facial implants.

 

Nonetheless, most patients with facial volume loss are good candidates for fat transfer in which a small amount of fats, not more than a few teaspoons, is collected from the donor sites, usually the tummy and hips, says Dr. Smiley.

 

The celebrity plastic surgeon even treats fat transfer as an integral part of facelift surgery. With a multifaceted approach in which the sagging skin and gaunt appearance are treated simultaneously, he believes that the results look more natural and are more “stable.”

 

“Stable” results mean that the face is less susceptible to the effects of continuous aging. Dr. Smiley warns that failure to address the loss of volume in the lower eyelid could lead to an abrupt transition between the lid and upper cheek, which can present itself right after surgery or years down the road.

 

Fat transfer and facelift are best performed simultaneously so the patient will only experience recovery once, he explains.

 

Because the results of fat transfer are near permanent (studies have suggested that on average they can last 8-10 years), in the long run they are cheaper than having regular dermal fillers injections.

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African American facelift involves a unique set of challenges due to the patient’s susceptibility to keloids or aggressive scarring. For this reason, a more proactive scar treatment approach in the first few weeks becomes particularly important to prevent any reminder of plastic surgery.

 

Scar placement is the first step to hide any surgical stigmata. Fortunately, this is possible for the vast majority of patients who can choose from different incision techniques to produce their aesthetic results.

 

African American facelift

Before-and-After Photos of African American Facelift Patient

 

While shorter incisions might be perceived as better than longer incision techniques, patients who need extensive corrections—i.e., their mid and lower face has a significant skin and tissue laxity—may have to accept the standard facelift method in which the scar typically starts from the temple (in front or behind the hairline) that goes around the inside edge of the ears and then reaches the earlobe.

 

Sometimes, the scar is even extended into the nape still concealed by the patient’s natural hairline for optimal concealment.

 

Regardless of one’s race or gender, the vast majority of facelift patients will require some type of internal reinforcement in which the soft tissue and muscle are reshaped as well, as opposed to relying solely on skin, which over times settles and droops due to the effects of gravity.

 

Simply put, most facelifts today are not a skin-only operation. To achieve stable results that can last for many years, experts at the California Surgical Institute suggest that all soft tissue must be taken into account during surgery.

 

In the past, facelifts relied on excising and tightening the loose skin, without giving much thought about the facial volume loss. This approach resulted in gaunt cheeks, upper cheek crescent, and/or hollowed lower eyelids, which could present themselves immediately or years after the surgery.

 

To avoid these aforementioned reminders of plastic surgery, surgeons at the California Surgical Institute address facial volume loss at the same time; this is either performed through fat transfer or dermal fillers.

 

Fat transfer uses the patients’ own fat cells, usually collected from their tummy, to smooth out their laugh lines, correct the deep tear troughs, and plump up their hollowed cheeks. Typically, this is performed simultaneously with facelift.

 

Dermal fillers such as Restylane and Juvederm, meanwhile, also work like fat transfer, although their results can only last between four and six months.

 

Whether fat transfer or dermal filler is used at the time of surgery, addressing soft tissue shrinkage during African American facelift means the surgeon relies less on skin pulling, thereby possibly obviating the need for longer scars.

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Restylane vs fat transfer injection: This is arguably the most common dilemma of patients seeking facial rejuvenation procedure, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.

 

Both materials are also referred to as volumizers since they fill in hollowed facial regions (e.g., flat cheeks and gaunt lower lids) and certain types of deep creases.

 

restylane vs fat transfer

Photo Credit: Restylane.com

Restylane is a hyaluronic acid-based dermal filler, a naturally occurring material that gives the skin its youthful “plump” and glow, hence there is almost no risk of allergic reaction.

 

In essence, Restylane is derived from tissue cultivated in a laboratory, with its entire DNA removed to further eliminate risk of allergic reaction. A few comprehensive clinical studies have demonstrated its impressive safety profile, making hyaluronic acid-based volumizers more popular than collagen and other filler materials.

 

Fat transfer, meanwhile, also boasts impressive safety profile in the hands of a skilled injector. But compared to Restylane or any other type of dermal fillers, the technique has a higher technical difficulty due to the processes involved.

 

In this technique, donor fats are collected, then processed to eliminate impurities, and injected back into the body. As of this writing, there is no standardized procedure thus the survival rate of grafts may differ from doctor to doctor.

 

Proponents of fat transfer suggest that it provides more natural and softer results than most types of fillers because it adheres to the principle of replacing “likes with likes.” For this reason, it has become a common routine to combine this technique with facelift surgery.

 

The effects of fat transfer are expected to be near permanent, or at least 8-10 years, while Restylane or most types of hyaluronic acid-based fillers can only last 4-6 months. Simply put, the patient who resorts to dermal fillers must take into account the cost of maintenance.

 

However, fat transfer has its own caveat such as longer downtime—i.e., it will take about two weeks for most of the swelling to subside. As a result some doctors recommend dermal fillers to most of their patients unless they will have a simultaneous facelift surgery.

 

Dermal fillers, particularly hyaluronic acid-based products, are also ideal for first-time patients who are contemplating about the possibility of more permanent solutions like fat transfer or facial implants.

 

Hyaluronic acid-based products are reversible should the patient is not happy with the results. They can be immediately broken down by an injectable enzyme; however, this is not an option in fat transfer.

 

The issues involving Restylane vs fat transfer can be resolved by honest and transparent communication between a patient and her doctor.

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Restylane Vs Facelift. The truth is, they are two different things, although when combined they can provide the most natural effects as they address the two main contributors of facial aging: sagging skin and soft tissue atrophy (shrinkage).

 

Restylane is just one of the many dermal filler injections used to “fill in” deep creases and gaunt facial regions caused by loss of volume/fat that comes with aging. But due to its impressive safety profile and highly predictable results, leading Beverly Hills plastic surgeon Dr. Tarick Smiley says it is one of the most popular brands to date.

 

Restylane Vs Facelift

Restylane is a gel consisting of laboratory-made hyaluronic acid, which is naturally found in the body, particularly in the youthful skin. To further eliminate risk of allergic reaction, the product contains no animal or human DNA.

 

As a stand-alone procedure, Restylane and other similar dermal fillers are suitable for “younger” patients or those whose main concern is the appearance of laugh lines (nasolabial folds) and other deep creases caused by loss of fat, flat cheeks, and gaunt jawline.

 

In the hands of a skilled injector, Restylane can also “conceal” the under eye-bags by creating a smooth lower lid-cheek junction, and the appearance of “pre-jowl” by plumping up its “border.”

 

Despite the rejuvenating effects of Restylane, Dr. Smiley says no amount of volumizers can address sagging skin. This is where facelift comes practical as it provides more lasting results—i.e., five to 10 years, as suggested by medical literature.

 

Generally, the standard facelift focuses on tightening the jaw line and eliminating the “fleshy” neck appearance. And if needed, it will also involve elevating the entire muscle mass supporting the mid face, hence giving back the youthful plumpness of the lower lid and cheek.

 

If there is an indication that warrants the use of Restylane, a simultaneous facelift is not always necessary. But when the patient is deemed as a good candidate for surgical dissection, usually a simultaneous Restylane or any other form of volume restoration is ideal to achieve more natural, stable results.

 

Compared with other fillers in the market, the effects of Restylane and other hyaluronic acid-based products can only last for a shorter period of time, about 4-6 months.

 

For patients who want longer lasting results, fat transfer might be a good option. This involves collecting donor fats usually from the tummy area, purifying them to increase their survival rate, and re-injecting them to the recipient area.

 

The issues involving Restylane vs facelift can be solved by examining the patient’s underlying anatomies and knowing her cosmetic goals and personal preference, explains Dr. Smiley.

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Facelift or fillers? — This is one of the most common issues facing individuals who want to minimize the signs of facial aging.

 

While facelift and fillers (e.g., hyaluronic acid based products and fat transfer, which are both injected) both provide rejuvenating effects, they work differently. Thus when performed simultaneously, leading Los Angeles plastic surgeon Dr. Tarick Smiley said they provide more impressive results.

facelift or fillers

Facelift is a surgical dissection to tighten the skin and facial muscle/fascia to eliminate or at least soften the appearance of jowling, cheek “crescent” or descent, sagging lower eyelid, and “fleshy” neck. However, Dr. Smiley said the procedure fails to address one critical aspect of an aging face: loss of volume.

 

Fillers, which are also referred to as volumizers, plump up the skin to correct the flat-looking cheeks, “bony” eye socket, and thinning lips. They are also used to fill in the deep creases such as the nasolabial folds or “laugh lines, and to “conceal” under eye bags by creating a smooth eyelid-cheek junction, said Dr. Smiley.

 

Patients in their thirties and early forties can benefit from “stand-alone” fillers and other non-surgical alternatives to facelift. However, “older” individuals, particularly those who exhibit significant amounts of loose skin, may only achieve impressive rejuvenating effects from a surgical dissection, Dr. Smiley added.

 

Nevertheless, the renowned Los Angeles plastic surgeon said that even potential facelift candidates may choose fillers and other non-invasive treatments, as opposed to an actual surgery, provided that they have realistic goals and expectations.

 

Should the patient ask for facelift and fillers via fat transfer, a technique in which their own fat cells are used to plump up their gaunt face, the consensus is to perform them simultaneously, as opposed to staging them, to lower the cost and to experience recovery just once.

 

Dr. Smiley said the combo procedure might even make it easier to assess the ideal depth of fat grafts, leading to increased survival rate and natural-looking results.

 

With a combo approach, reminders of facelift such as hollow eye and cheek crescent—which could present themselves immediately or years after the surgery—can be avoided, thus allowing the face to age more gracefully and more naturally, Dr. Smiley explained.

 

Simply put, the issue involving facelift or fillers boils down the patient’s underlying anatomies, personal preference, and cosmetic goals, he said.

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