As we age, the skin and supporting structures lose collagen and elastin, the things that give it strength and elasticity.  Gravity and the muscles that are attached to the skin in the face stretch the skin and cause it to wrinkle.  Additionally, we lose subcutaneous tissue.  The result depends on which of these changes predominate.  If stretch is the largest component, then surgical removal of the excess skin with a facelift, blepharoplasty, etc. is required.  However, if volume loss and wrinkling are most prominent, then re-filling the area using Today’s Liquid Lift™, a nonsurgical, noninvasive procedure, is all that is needed. This works equally well for both men and women.

Non-Invasive Liquid Lift™ Procedure

This approach uses a combination of skin care, Botox®, and a filler, either off the shelf or your own fat, to reverse the signs of aging.  What is used, depends on the particular problem.

The most important step in treating wrinkles is beginning the use of tretinoin (Retin-A, to stimulate collagen) and Obagi®’s patented ELASTIderm® (to stimulate elastic tissue) along with basic skincare consisting of a cleanser, a pH balancer, an exfoliant, and a good zinc oxide sunblock. If the wrinkle is caused by underlying muscle action, and the muscle is not necessary for normal function, then we use Botox® to stop the muscle action on the skin.  This is all that is necessary for fine wrinkles.  For deeper wrinkles, we add micro-needling to increase dermal (the support layer of the skin) production of collagen to reduce the wrinkles. If the wrinkles are quite deep, we then fill the wrinkle using Juvéderm Volbella™, a filler that generally does not cause the Tyndall effect (a blue line where the filler is injected close to the surface).  Previously for these deeper wrinkles, we used either a leveling peel or laser to remove the top layer of the skin to the bottom of the wrinkle allowing the skin to regrow smoothly.  This, however, has a 2-3 week downtime, as opposed to the no downtime of what we do now.

Botox® can also be used to improve facial features if removing a certain muscle function allows opposing muscles to achieve the result that you desire.  The most dramatic result is to open the eyes when the muscles below the brow are pulling the brow downward and removing those muscles allows the muscle in the forehead to elevate the brow and open the eye.

If the problem is related to loss of volume, then refilling that area with either your own fat or a filler corrects it. The choice of which depends on how much fill is needed, where the filler is needed, and other factors, including cost. Initially, if you wished a long-lasting result the only choice was fat.  However, the newer fillers are now much longer-lasting, (one Juvéderm® Voluma) up to five years or longer. Fat is still excellent for filling large areas and is quite long-lasting.  For small areas, an off-the-shelf filler is excellent, exceptionally convenient, and cost-effective.

Filler Choices Other Than Fat

You will frequently see these called “dermal” fillers.  However, we have almost never used them intradermally and, even now, there are only a few that work well placed in the dermis without causing a Tyndall effect. Some are intended for only subcutaneous and deep subcutaneous placement but still get labeled as “dermal” fillers by many people. There are a variety of off-the-shelf fillers used. The basic types of these include:

• Hyaluronic acid, the most common with many brands.
• Polymethylmethacrylate beads, Bellafill®, an essentially permanent filler but with frequent problems.
• Calcium hydroxylapatite, Radiesse®, still a good filler for deep filling, but not as long-lasting as Voluma®, a hyaluronic acid filler.
• Poly-L-lactic acid, Sculptra®, a stimulant filler requiring multiple injections to achieve the desired result with less longevity than some of the hyaluronic acid ones and calcium hydroxyapatite

Today’s Liquid Lift™ Filler Used

Dr. Buchanan prefers the Juvéderm® family of hyaluronic acid fillers because of their excellent performance, safety, and because they are more long-lasting than any other comparable filler on the market.

These include:

• Juvéderm Ultra™, excellent for most superficial applications including the lips and when increased volume above what is injected is desired.  Lasts about a year
• Juvéderm Voluma™, excellent for volume filling when the filler can be placed directly on bone or muscle.  We have had it last over five years, though it is supposed to last only about two years.
• Juvéderm Volbella™, excellent for superficial filling, particularly the lips, for finessing, and filling lines and wrinkles. It lasts at least a year.
• Juvéderm Vollure™, excellent for lips and volume filling where we need to fill the superficial or deep fat compartments not overlying bone. Lasts at least 18 months.

Using the latest techniques, it is our goal to provide the desired outcome with a procedure offering the quickest recovery and optimal results. We listen to you and strive to provide a natural result with the least invasive means.

Where reasonable, before injection, we use either a local or regional anesthetic before Botox or filler injection. Other than that, there may be only a mild stinging sensation. The procedure takes about 15 minutes to an hour, depending upon what is done with essentially no downtime.

Regain Your Vibrance with a Liquid Lift

Give yourself the gift of youthful vibrance with Today’s Liquid Lift™. Also, ask about repair using the techniques for aged hands. Contact the Center for Plastic Surgery serving Highlands, NC and the surrounding community, by calling 828-526-3783 to schedule your consultation with Dr. Robert Buchanan.

The signs of aging are a frustrating concern for many adults. We know certain changes will occur, and we know why. Still, we’d prefer to sidestep them if we can. As facial structure transforms over time, we need more profound correction. Is it possible to achieve this without surgery? It may be! To help patients address their cosmetic concerns, Dr. Buchanan has developed Today’s Liquid Lift™. We’ll discuss how this process works and why it is popular among our patients.

What Is A Liquid Facelift?

Just by the name alone, you can probably guess that a Liquid Facelift utilizes various injectables to correct the signs of aging. Fillers, either off the shelf or your own fat, are injected to improve volume. Botox is used in certain areas to relax muscle contractions that pull on the skin. Today’s Liquid Lift addresses the signs of aging using Botox, hyaluronic acid fillers and fat injections. This technique, developed by Dr. Buchanan to address the aging that naturally occurs after facial plastic surgery, corrects the natural deflation of the face that occurs over time.

Facial aging continues regardless of surgery or fillers and Botox. As it does, the loose skin that results from volume loss droops downward. The opposing actions of sagging skin and supportive ligaments deep beneath the skin result in cosmetic problems like undereye bags and the loss of youthful cheek contour. Nasolabial folds and marionette lines also deepen around the nose and mouth as tissue descends further. Fillers may soften the appearance of these lines but they do not correct the original problem, the loss of volume.

The purpose of Today’s Liquid Lift is to artistically restore the triangular shape of the youthful face. This technique increases the width at the top areas of the face, tapering incrementally to narrow at the jawline and chin. Treatment focuses on restoring volume in the mid-face, across the cheeks. Filling out this area naturally elevates the skin and tissue that have descended downward toward the jawline. Targeting the upper malar area near the tear trough, Dr. Buchanan can also smooth the transition from the cheek to the lower eyelid, camouflaging puffiness.

Experience the benefits of a Liquid Facelift. Contact our Highlands, NC office at Call (828) 526-3783 to schedule your consultation.

Microneedling is one of several technologies that markedly rejuvenates the skin and reduces wrinkling.  Here we will discuss those technologies and other things that you can do to improve the quality and appearance of your skin.

Retinol/Retin-A

The cornerstone of skin care to prevent wrinkles has been, for many years, the use of a retinol or tretinoin (Retin-A) after the age of 30.  This is because the skin stops continually making collagen, the substance that thickens the skin, at around 30 years of age.  If the skin is not stimulated to continue the process of collagen production, the dermis, the support layer of the skin, thins and multiple crinkles and wrinkles result.  If you have failed to use these in the past and have developed significant crinkles and wrinkles, then use of the more potent tretinoin is still the mainstay of skin rejuvenation.

Peels & Laser Resurfacing

Once you had developed aged appearing skin, the only treatment that could correct the wrinkling/crinkling was a leveling peel or laser resurfacing that removed the surface of the skin between the wrinkles to the level of the bottom of the wrinkles and allowed the skin to grow a new surface epithelium over a smoother dermal base.  The problem with this is that, because of limitation of the body’s ability to resurface the skin, they became the procedures with the longest downtime of any of the modern plastic surgical procedures.  Although we could push the body some, the minimum downtime where the skin is somewhat raw and oozing with either of these technologies is about 1 ½ to 2 weeks.

Intradermal Filling

Although fillers have been called “dermal fillers” for many years, until recently no one actually injected the filler into the dermis, the support layer of the skin.  If they did, frequently a greenish or bluish line would appear when light reflected off the injected filler.  Only in the last 10 years have we had fillers that did not cause this blue line, the Tindal effect.  Belotero Balance® introduced in 2011 was the 1^st.  Juvederm Volbella®, equally as good if not better, was approved in 2016.  These allowed us to actually inject fillers into the dermis elevating the surface of the wrinkle to reduce or eliminate it.  We have also discovered that if the product is placed just at the bottom or under the dermis perpendicular to the wrinkles, it can prevent further wrinkling of the skin and allow the tretinoin to use some of the product to thicken and stiffen the skin.  Other than some mild swelling and occasionally minimal bruising that could be covered with camouflage makeup, there is essentially no down time with this technique.

Microneedling/Fraxel Laser

The one thing that leveling peels and laser did was markedly stimulate the dermis to build significant new collagen at a faster rate than it did with just the use of tretinoin.  The 1^st improvement to markedly improve the rate of the skin’s collagen production was development of the Fraxel Laser, a laser that, instead of removing the surface of the skin, simply poked holes in it.  Since injury to the dermis is the one thing that causes the skin to markedly produce collagen, this significantly turned on the body’s healing processes.  This laser, however, is quite expensive and uncomfortable.  Microneedling was developed to answer these problems.  It does the same thing by using small needles that create holes in the dermis and also turns on the body’s healing processes, markedly stimulating collagen production.

The procedure, done in a physician’s office, uses a device that pushes the needles absolutely perpendicular so that there is only a very minute entry point.  Because of the marked success of this process, “Microneedling” rollers are now being sold for home use.  The problem is that they do not produce uniform holes to the proper depth in the dermis and, instead of entering and leaving absolutely perpendicular, they enter and exit at an angle actually tearing the skin.

Who is a Good Candidate for Microneedling?

Because it works by stimulating collagen productionin the dermis, the support layer of the skin, microneedling is an excellent treatment option for a wide variety of concerns. You should be a good candidate for microneedling whether your goal is to correct a cosmetic concern or simply to support your naturally aging skin that stops making collagen naturally around 25 years of age. Microneedling is efficient at reducing enlarged pores, softening lines and wrinkles, and reducing the appearance of scars and stretch marks. Since the skin loses collagen over time  mictoneedling is advantageous in the fight against sun damage and tissue laxity.

What Are the Benefits of Microneedling?

There are several reasons why microneedling is such a popular cosmetic treatment. The process takes only about an hour in most cases and it incurs essentially no downtime. Your skin may look red for a few hours after your treatment, but not so much so that you have to rearrange your schedule for several days. You may return to work or other activities immediately after you’ve had microneedling done. Another benefit of microneedling is that the treatment works naturally to rejuvenate your skin from the inside out. There are no incisions, no products, no “foreign substances.” It does, however, work better if you are on regular tretinoin (Retin-A) or, if you are younger than 45-50, retinol.

How Does Microneedling Work?

Microneedling is a form of collagen induction therapy that has been around far longer than most people realize. Ancient civilizations used this technique, though not in the same fashion we do today. The microneedling treatment that professionals perform is done with an automated instrument rather than a hand held needle or a needle-clad drum. The benefit of this is that the needles pass into the skin in a completely perpendicular pattern and penetrates only a specific depth. This significantly reduces the risk of tiny skin tears and the potential for scarring. During a microneedling session, the automated device quickly creates hundreds of micro-injuries in the dermis of your skin. Micro-injuries take very little time to heal. Their sole purpose is to trick the body into believing repair is needed. Repair comes in the form of increased collagen and elastin production, which the body makes for a prolonged period of time in response to the treatment. The increase in the body’s regenerative system works to rejuvenate the skin.

When Will I See Results from Microneedling?

You might notice some of your microneedling results the same day you have your treatment! Many people report feeling like their skin has a new vibrancy to it right after their appointment. This early improvement expands into others as your body begins to flood the treatment area with an ongoing supply of collagen and elastin. The results of a single treatment occur over time with multiple sessions being cummulative. If you are trying to reduce significant wrinkling, however, it may take a year or more to see the final results/

Is any Numbing Cream Applied Before?

Yes! Comfort is an important aspect of our treatment process. To minimize the sensation of this process, we’ll apply a topical anesthetic to the target area. This medication does not cause complete numbness like injections of lidocaine do. However, it achieves sufficient desensitization to make microneedling easily tolerable.

Can I Combine Microneedling with Other Treatments?

You can combine microneedling with other treatments to acheive more profound tissue rejuvenation. As previously said, we recommend everyone receiving microneedling be on either retinol or tretinoin. For significant wrinkling in the past we used leveling peels or ablative lasers. Their problem is that they have a 2-3 week down time. Instead, we now use microneedling after filling the worst wrinkles with one of the newer fillers that works well when injected in the dermis itself. (Although many people call them “dermal fillers,” we previously never actually injected the dermis with them since the old fillers caused a blue or green line, the tyndall effect.) We will discuss what you’d like to achieve and what concerns you have and will recommend a treatment plan using that information. To get the best results with the fewest risks and side effects, microneedling may be scheduled as a standalone procedure within your broader course of treatment.

No Downtime Skin Rejuvenation

These latter two developments have allowed us to now achieve skin rejuvenation comparable to leveling peels and laser but without the significant downtime.  Our present protocol for rejuvenation of sun damaged, wrinkled, crinkled skin is beginning tretinoin, injection of the wrinkles to reduce as much as we can using Volbella®, and then doing a series of Microneedling procedures, all with minimal to no downtime.

If you are interested in rejuvenating your skin, schedule a consultation with Dr. Buchanan at our Highlands, NC office. Call (828) 526-3783 today.

Botox has been used for around 30 years for cosmetic purposes. After the FDA approved this drug for cosmetic rejuvenation, the first of its kind, in 2002, adults interested in looking younger have relied on Botox to achieve anti-aging goals of reduced wrinkles. While Botox is not magic, it does accomplish amazing results when treating dynamic wrinkles. We consider it a valuable adjunct to good skin care and maintaining a youthful appearance. If you have been on the sidelines and are ready to give Botox a try, you may be wondering what it will be like to get this injectable treatment. Here, we walk you through the process.

Your Botox Consultation

Because Botox has been around for so long, new patients tend to schedule visits with this treatment in mind. Regardless, an experienced provider will begin the appointment with a brief consultation. To know if Botox is right for you, we have to know what concerns you have and what you would like to achieve. Botox is a great treatment for crow’s feet, forehead lines, frown lines, and a droopy brow line. If you have concerns beyond these, such as depressed mouth corners or creases around your nose and mouth, we can discuss how to address those, as well.

Treatment

If you so choose, we can perform your Botox treatment right after your consultation. We usually use a topical anesthetic to make the injection as painless as possible. Also the injections are administered with a very small needle. You may feel tiny pinching sensations with each injection, though this is not painful. Each sensation lasts only a moment. Depending on the purpose of treatment, several injections may be given.

Recovery and Results

Botox is well-known for its convenience and safety. After treatment, most people experience nothing more than slight swelling and redness where injections have been given. Adverse side effects are rare. The most common is a slight bruising. A rare patient may develop a slight headache that may last a few hours or body aches that feel like the flu that generally disappear within 24 hours.

Full effects from the injections usually occur form about 6 hours to 6-7 days. Improvement typically lasts from 3 to 6 months. Touch-ups can be scheduled as needed.

If you’re new to Botox, you will appreciate our conservative, gentle approach. To schedule a consultation at our Highlands, NC office, call | (828) 526-3783.

Many people associate the signs of aging with the skin, but that is only part of the story. Facial aging is a matter of degradation of not only the skin but the structures that support it. Sure, the skin becomes thin and loose over time, but there are also changes happening beneath the  surface. One of them is the loss of fatty tissue. This happens generally but is significantly noticeable in the midface. Previously, the solution was to tighten the skin via a facelift. Today, one of the primary strategies is to refill the mid-face with fillers. Even more progressive, though, is the use of fat from your own body to smooth wrinkles and restore volume and normal contours. Even with facelifts, the procedure is no longer simply to remove the excess skin but is also to replace fat to its normal position and fill.

Fat transfer has become one of the most popular approaches to nonsurgical facial rejuvenation. There are several reasons why. Fat injections are conservative, do not require general anesthesia, and they achieve results that outlast almost all off the shelf fillers. They also transfer stem cells that can further rejuvenate the overlying skin and surrounding tissues. They essentially replace exactly what has been lost.

The Procedure:

The two-step process is simple: Dr. Buchanan performs a minor liposuction procedure on an area of the body where there is extra fat. The fat is washed, removing the anesthetic fluid, tissue, and blood, leaving only viable, live fat  and stem cells. These are then injected into the areas of the face that need more volume. There is much skepticism about fat grafting, mainly because most physicians who have tried it have approached it like regular liposuction and injecting fillers, neither of which you can do and obtain good results. All three of the above steps are very important in keeping the fat cells alive and obtaining a good result. The removal of the fat has to be done with fine, very smooth canulas at a reduced pressure to keep from injuring the cells. Injection is the most important, as the live cells have to be placed in very thin rows next to tissue with excellent blood supply to keep them from dying. If placed like a filler, the cells in the center of the masses just die and produce lumps. When done correctly, greater than 75% of the fat injected survives and there are no lumps.

What you can expect after Fat Transfer:

During the first week after fat injections, you can expect some bruising and swelling. This happens both where fat has been removed and where fat cells have been injected, though bruising is usually minimal on the face. Cold compresses may be used to soothe mild discomfort and also reduce swelling. In spite of this, most people can return to normal light activities by the next day and vigorous activities by a week. Swelling often resolves more quickly than bruising but the latter can be covered with camouflage make-up.

We slightly overfill the area if the tissues will allow it to try and reduce the need for a second procedure. However, if your tissues do not allow this, a second lesser graft almost always provides excellent cosmetic contours.

Facial rejuvenation is something that helps a lot of people feel like themselves again. You may not need surgery to accomplish that. For more information about fat injections, contact our Highlands, NC office at (828) 526-3783.

Recently, we’ve seen the meteoric rise in filler use among adults of all ages. Soft tissue fillers like those in the Juvéderm family are known for achieving consistent results whether the goal is to smooth wrinkles and folds or plump areas of the face that have lost their volume and normal contour. The cheeks and area below the eyes are prime areas where this happens, and treatment using Juvéderm Voluma XC is one of the best ways to correct these problems.

What is Juvéderm Voluma?

Several products make up the Juvéderm family of fillers. All of them are made of varying compilations and consistencies of hyaluronic acid (HA). This chemical is a naturally-occurring sugar compound that the body uses to keep the skin, joints, and eyes lubricated and to produce new collagen, which thickens the skin and supports the surrounding tissues. The Juvéderm products also contain lidocaine, an anesthetic that reduces discomfort during injections. Juvéderm Voluma has been developed with a heavier consistency to achieve specific results. There is, in fact, only one other filler nearly as thick as Voluma.

Having a denser consistency, Voluma XC can build more structure beneath the skin. The name of the product, Voluma, indicates its purpose, to restore structural volume of the tissues. This filler was the first to be FDA-approved for cheek enhancement. As we age, this part of the face loses its shape. The fat pads that overlay the cheekbones and make them look more pronounced decrease in volume over time. As the face loses volume, the tissues descended as far as the next ligament and folds resultat teh ligament and depressions occur above. By midlife, the mid-face looks rather flat and, as a result, the lower face looks wider, fuller and saggy. Occasionally a similar appearance occurs from congenital anatomic variations and younger individuals look older than their actual age. When Voluma XC is placed on the bony of the cheek, it elevates, rounds, and firms the overlying tissues.

What to Expect During and After Voluma Treatment

Filler treatments are very popular but that does not make them right for everyone. We conduct a consultation and brief assessment of the skin, underlying muscle and bone structure, and facial volume to make sure that an injectable can achieve the desired outcome. The treatment itself takes only a few minutes. Injection is done using a very thin cannula through the absolute minimum of skin punctures. The Voluma is carefully placed on the underlying bone under where extra volume is needed. This technique not only is safer than use of a sharp needle, it is more controlled and gives superior results. Thanks to the lidocaine and tiny cannula, there is minimal discomfort.

Results are visible as soon as the Voluma treatment is complete,. You may experience short-lived firmness and swelling for a day or so. Except occasionally at the point of entry through the skin, there is almost never any bruising. To reduce the risk of bruising further you should avoid strenuous exercise for the first 8 hours after injections.

We can help if you have a congenital volume deficit or believe you are aging. Call our Highlands, NC office at (828) 526-3783 to explore what Juvéderm Voluma can do for you.

Natural facial aging is something we cannot avoid because several factors impact this process. Over time, particularly after about age 25, the skin stops regularly producing collagen and elastin, its thickness and elasticity decrease, and the muscles acting on it become more active. Together they markedly increase skin wrinkling. The hours we’ve spent without daily sunblock finally catch up to us in the form of further collagen breakdown, sun spots, abnormal blood vessels, and other damage. Loss of skeletal structure and fat may cause the eyes or cheeks to look hollow. These changes  lead to ever-deepening lines and creases on the forehead, around the eyes, in the cheeks, and mouth. The neck may also show signs of aging such as thin skin, excess fat, horizontal lines, and sagging. None of these changes to appearance sound particularly exciting. At the same time, neither may surgery.

If you are interested in looking your best but do not like the idea of a major surgical procedure, you have options. In our Highland, NC office, we’ve helped many patients restore a friendlier, more youthful appearance using nonsurgical treatments. Dr. Buchanan has named this anti-aging approach Today’s Liquid Facelift and uses it regularly to achieve the optimal reversal without surgery of age-related cosmetic concerns, including those that affect the neck and hands. In many cases, ti provides improvement that not even surgery can achieve.

How We Can Help You Look Younger and More Vibrant

Wrinkle Reduction

Three treatments are commonly used to reduce the appearance of wrinkles:

• Botox is the injectable treatment that is applied to dynamic wrinkles. Dynamic wrinkles are those that originate in the muscle. Though these lines can occur anywhere effected by the facial muscles and thinning, less elastic skin, the muscles on the upper face and around the eyes and some on the neck and chin can be treated without causing problems to eliminate the muscular component of the wrinkles. Botox is a neuromodulator that decreases muscle contractions so overlying skin can lie flat and smooth.
• Thin fillers are injectables that can be placed within the dermis to elevate fine to medium wrinkles. These products are different than Botox because they actually reduce or eliminate permanent wrinkles by adding volume to the skin layer just below the surface, pushing the wrinkle up. Though fillers have been called “dermal fillers,” since their development, this is the only time now that they are actually used intradermal. Either that or a slightly heavier filler is then placed just under the dermis perpendicular to the wrinkles to essentially thicken it and support it, reducing its tendency to wrinkle. This also supplies a scaffolding for the body to use when properly stimulated to build its own collagen to permanently eliminate the wrinkles.
• Adding tretinoin (Retin-A) or a good retinol and Obagi’s ELASTIderm to regular skin care for everyone 25-30 years old or older is the mainstay of wrinkle prevention or reversal. The tretinoin or retinol stimulates the skin to continue making collagen to maintain or recreate collagen and and prevent or reverse thinning. ELASTIderm is now the only product presently available that stimulates the production of elastic tissue in the skin to allow it to contract rather than wrinkling. Other modalities like Fraxel Laser or in office microneedling can also help stimulate collagen, but the retinols are still the mainstay.
• A leveling peel or laser can also significantly reduce wrinkling, but their 2 week down time make them less desirable than the above.

Restoring Volume

Lines and wrinkles are just part of the overall problem with facial aging. The loss of volume results in folds, depressions and loss of youthful contours. Although, if there is also too much extra skin, surgery may be the best answer, restoring volume deficits with filler or fat can frequently restore a youthful appearance alone. This is especially true in the mid-face where volume loss is frequently the worst.

Skin Rejuvenation

Aging and sun damage can also result in spots, dullness, and red vascular collections. To restore vibrancy, and reduce these problems we use the Obagi Nu-Derm System to restore normal skin appearance and an IPL (a laser like machine) to treat the vascular problems and, occasionally the brown spots. Microdermabrasion and micro peels can also assist in the improvement. These are preferred techniques because they do not require much downtime if any at all.

Look more vibrant and youthful. Call (828) 526-3783 to schedule your visit with us.

We recently discussed how facial fat transfer works and what to expect after treatment. With more people considering a move away from off the shelf fillers and toward a more permanent solution to facial volume loss, we understand many questions need to be answered. Here, we discuss some of the top reasons why people choose facial fat transfer over fillers, and why you may want to do the same.

Two Benefits in One Treatment

When we use fillers to restore facial volume, the product we inject is provided by a manufacturer. When we perform fat transfer, the substance that supplies volume is your own body fat. To obtain fat cells for transfer, it is necessary to perform minor liposuction. Patients often choose small areas that are troublesome, such as the hips, flanks, or abdomen, to harvest fat. Liposuction performed under local anesthetic sculpts one area of the body while fat transfer rejuvenates another. All in all, the combination of treatments can refresh both the face and body.

Treatment is Customized

Fat transfer is developed around the needs of each patient. Some patients prefer that more fatty tissue is removed for better body contours. Some need or have very little fat available, so liposuction takes only what is absolutely necessary for contouring the face. As long as sufficient fatty tissue is present, patients may choose to harvest from a variety of areas, but, most commonly, the midsection. It may also be possible to remove fat from under the chin to sculpt the face even more.

As with liposuction, fat injections are also administered based on the areas of concern. Some patients wish to have only one area treated like their lips or cheeks, where others prefer full-face rejuvenation that smoothes and rounds everywhere there is volume loss with properly-layered fat cells.

Results are Natural and Long-Lasting

Though there are several benefits to facial fat transfer, the permanent results that can be achieved with treatment are among the best. It takes approximately 4 months to fully see how much of the transferred fat has survived. After this point, though, new cells are expected to remain indefinitely. As fat cells do, those that are transferred to the face may grow and shrink with weight changes. The overall results will also naturally change as age changes the structure of the skin and underlying bone and fat is further lost naturally. A benefit, however, of fat grafting is transfer of stem cells that can further rejuvenate the area and skin.

Fat transfer is facial rejuvenation with an added bonus of slight body contouring. To learn more about his treatment, call our Highlands, NC office at (828) 526-3783.

Part of the aging process, we have learned, is the loss of volume across the mid-face. Volume loss also occurs at the temples and on the lips. This is one of the reasons why the lower face starts to look wider and saggy as we get older. In recent years, research has discovered that the best way to rejuvenate the face may not be to perform facelift surgery (at least not on its own) but to restore volume using some type of biocompatible substance. Off the shelf fillers do this with temporary ingredients like hyaluronic acid. Facial fat transfer is the technique patients choose when they want permanent results or need significant volume added.

What is facial fat transfer?

Facial fat transfer is the minimally-invasive procedure in which cosmetic concerns are corrected using fat from your own body. Skilled surgeons now also use fat transfer techniques to add or restore volume to areas of the body such as the buttocks and the breasts. More commonly, fat cells are used to give the face a better contour, to fill deflated or thin lips, and to smooth deep creases around the nose and mouth and under the eyes

The treatment is performed in the office using local anesthetic and mild sedation, when needed. There are three parts to the technique:

• Harvesting fat from a part of the body where you have an excess using liposuction. Common areas include the abdomen and the thighs. If desired, donor area can also be contoured.
• Purifying fat cells. To add volume to the face, we want pure fat cells. To get them, we wash what is obtained via liposuction. The fat cells are then transferred to a syringe.
• Transferring fat. The face is treated with local anesthesia before we begin injections. Then, a tiny cannula is inserted under the skin and moved back and forth. With each pass, a line of fat cells is deposited. This technique layers fat cells in a way that achieves natural-looking results.

The visit may last approximately two hours, after which you may return home to recuperate. Most people can return to normal activities by the next day.

What can you expect after increasing facial volume with fat?

After fat transfer, you may experience some swelling and bruising. Discomfort is typically minimal, although both the liposuctioned area and the facial areas treated may feel sore and somewhat tender. This is usually mild enough to manage with over-the-counter medication.

What is important to know about facial fat grafting is that 75 to 80% of the new fat cells introduced to the face are expected to survive. What is present at 4 months is permanent. Because of the loss of some of the fat cells we generally overfill the areas about 10%. Because the transferred fat cells contain stem cells, over time the overlying skin and surrounding tissue may actually improve in quality.

Dr. Buchanan performs facial fat transfer in a way that maximizes success. To learn more about this procedure, call our Highlands, NC office at (828) 526-3783.

There are several benefits of getting fillers injected in one or more areas of the face. This nonsurgical treatment is sought by younger patients who wish to enhance the shape of their lips or cheeks and by older adults who would like to reverse many of the changes of aging. Fillers are even used to improve the appearance of the nose and are an integral aspect of the nonsurgical facelift. Still, there is a very real chance that you could be let down by your treatment. There are several reason this happens.One is that there are a huge number of injectors with little or inadequate training. Another is that patients rarely know how much filler they need to achieve their desired result, but attempt to dictate how much filler is used.

How much is enough?

Several factors contribute to the outcome of filler treatment. For this reason, it can be difficult to estimate just how much filler one person will need compared to another. For example, some people visit their provider with an idea that they need 1 syringe of filler to correct the flattening of their cheeks. They believe this because their friend obtained amazing results with just that much. After receiving their 1 syringe, the patient may feel dissatisfied that their cheeks don’t look like their friend’s. Why might this be?

• Fillers don’t affect everyone the same way. This is because each person has unique bone and muscle structure. Even side-sleeping can affect how the face looks on one side versus the other. These small details contribute to the outcome of filler treatment and also determine, to some degree, how much filler is needed by each person.
• The amount of volume loss (of both fatty tissue and bone) will also impact how much filler is needed to plump the area.
• The area that needs filling also partially determines how much filler is required.

Expectations are Everything

One of the most significant factors that translates into patient satisfaction is expectation. It is important to approach filler treatment with an open mind about what is and is not possible:

• Fillers can, occasionally, make you look 10 years younger, but only in certain circumstances. If done improperly, they can also make you look older.
• Filler treatment can round out cheeks and plump lips, but it will not tighten loose skin. In some cases, a slight lifting effect may occur, but this is not guaranteed.
• Results may last longer for some people. This is a matter of simple biology and how quickly the body will metabolize the inserted product.

See what fillers can do for you. Schedule an appointment to learn more in our Highlands, NC office at (828) 526-3783.