Holger G. Gassner, M.D., Board Certified Facial Plastic Surgeon (USA)


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LIPOSCULPTURE

The injection of fat in order to fill wrinkles and to rejuvenate the face with additional volume is called lipostructure, liposculpture or lipofilling.  The principle behind the method is to harvest fat cells typically from the thigh or from the waist with a special method of liposuction.  The harvested cells are then treated in a special way so that only the highest quality cells are selected.  These are then injected into those areas of the face that benefit from volume augmentation.  One advantage of the method is that once the volume augmentation has taken place, this remains with pretty good longevity.  Moreover, the risk of allergic reactions or foreign body reactions to the body’s own fat is not relevant.  Only a certain proportion of the fat cells that are injected do survive.  Therefore during the treatment a slight degree of overcorrection is intended.  Often more than one surgical procedure maybe required to achieve the intended result.

Beside the loss of elasticity and the redundancy of the external skin, additional changes of the face contribute to visible ageing.  These changes include loss of volume of the bony facial skeleton, more importantly, loss of volume of the deeper connective tissues and of the facial fat.  Loss of volume may result in a hollow appearance of the cheeks or in a thin appearance of the lips.  The most important factor in these changes is the loss of subcutaneous fat in the face.

The decision whether or not to perform a Face Lift or a lipostructure or a combination of the two techniques that is best suited for you requires an in-depth analysis of the condition of your anatomical structures, and your wishes and expectations.

When loss of volume is an important factor in the facial aging process, autologous fat transfer (lipostructure) is an excellent option to reverse these changes.  The rate of fat survival may be variable. Therefore, this treatment sometimes requires repitition.

The Liposculpture technique was popularized in the USA by Prof. Coleman.

In this technique, an incision approximately the size of a buttonhole is placed on the thigh or the waist and a small amount of fat is harvested by a small liposuction cannula.  The harvested cells are then treated in a special way so that only the highest quality cells are selected.  These are then injected into those areas of the face that benefit from volume augmentation with the smallest needle possible.

One advantage of the method is that once the volume augmentation has taken place, this remains with pretty good longevity.  Moreover, the risk of allergic reactions or foreign body reactions to the body’s own fat is not relevant.  Only a certain proportion of the fat cells that are injected do survive.  Therefore during the treatment a slight degree of overcorrection is intended.  Often more than one surgical procedure maybe required to achieve the intended result.

Lipostructure can be used to treat cheeks, areas around the eyes and deep wrinkles.  Sometimes a second procedure may be required in order to receive the desired result, because generally a certain portion of hte fat cells injected does not survive.  During the treatment, a slight decree of overcorrection is intended.

Lipostructure isn’t regularly performed with a Face Lift simultaneously.

Techniques required for a Face Lift are designed to correct the skin’s loss of elasticity and the redundancy of the external skin.
Lipostructure, on the other hand, creates more volume in the deeper connective tissues under the skin (the subcutaneous fat tissue).  Depending upon the results desired, a combination of the two techniques could, however, possibly make sense and be necessary.

A fundamental modification of surgical techniques involved in a Face Lift are not necessary  Eine grundlegende Modifikation der chirurgischen Technik des Face Lifts ist nicht erforderlich, um eine gleichzeitige Volumenunterfütterung durch Lipostructure zu erzielen.

Lipostructure varies from patient to patient and would be customized especially for each individual.  Therefore, the post-operative guidelines will also be based on an individual’s specific needs.  The following instructions are of course, only intended for patients under the care of Dr. Gassner and the recommendations only be followed after an in-depth consultation with same.

Prof. Gassner has experience performing over 100 Lipostructure procedures.

He lectures about these topics at international courses and meetings.  There is also an important chapter on Lipostructure in his recent textbook, “The Art and Craft of Facial Plastic Surgery”, which he co-authored with facial plastic surgeon Dr. Wayne Larrabee of Seattle and the surgical artist William Walsh of Minneapolis.