Fat proponents rarely discuss the problems this natural filler can cause in inexperienced hands. In his presentation, “Fat is unpredictable, overrated, has significant complications, can grow and even distort the face,” Dr. Lambros emphasized and demonstrated issues that frequently arise with fat.
First, he pointed out, fat is unpredictable. On one hand, fat may
not “take” and completely disappear. On the other, it can multiply and create an
undesirable result. For example, a rookie mistake might be to overgraft fat into
the face to smooth away wrinkles. But if that fat grows over time, it can make
the face unnaturally big, thereby masking the natural contours. Thus, the
wrinkles may be gone, but patients tend not to be happy when they no longer look
like themselves, Dr. Lambros said.
Second, if fat is used in a younger person, acceptable results
today may not be so in the years to come. We gain weight as we grow older, and
fat behaves in the face as it did in the area in which it was harvested from, he
said. Whether it was taken from the tummy, thighs or other area that tends to be
more prone to weight gain, it will likely multiply with age and can negatively
affect the appearance of injected portions of the face. This, Dr. Lambros said,
can be particularly devastating under the eyes.
His take-home message today was this: Fat is a valuable tool in
the plastic surgeon’s armamentarium. However, use it cautiously. Take the time
to build experience and get comfortable with fat behavior and the various
complications that potentially come with this natural filler.
