Facial fat transfer vs. filler: which is better? [Kiya Movassaghi, MD, Eugene]

Welcome to the podcast Where Before Meets After. Submit your questions for our experts at wherebeforemeetsafter.com. I'm your host, Eva Sheie.

I am Kiya Movassaghi. I am a plastic surgeon and currently the President-Elect of the Aesthetics Society and I practice in Eugene, Oregon.

Can you speak to how you use fat and how we should think about it in terms of its use in aesthetics?

Absolutely. I'm actually giving a talk next week at the night campus at University of Oregon is a research building and they invited me as a keynote speaker to talk about the challenges that we face in regenerative medicine because that's the future, and fat plays a great role. Now we're at the infancy stages of use of fat when you think of pre-juvenation or rejuvenation. But right now we have fat that we use for structural support, for volume augmentation, and then there are fats that we use for rejuvenation. So we call it, we have the macro fat, micro fat, and nano fat. When you get to the micro fat is, for instance, what I use for a lot of my facelift patients is I'm trying to augment the deficient areas in the face because that's one of the aging process is a lot of folks lose volume in their face. So that's micro fat injection. In contrast, nano fat injection is you actually break up all those fat cells and you want to use the goodies within the fat cells, the products in the fat cells. So you're not using it as a structural support, you're not using it as augmentation, you're not getting volume out of it, but you're trying to rejuvenate it. So we are using that for skin rejuvenation.

Which is better fat or filler.

It depends on what you're trying to accomplish. If I'm doing a surgery for a patient and I'm tightening and I'm lifting the tissue, I think fat, there's no question, their own fat is better. If I'm not doing the surgery, I think you have to be very cautious with fat injections in younger patients. Because we now see a lot of results of these patients who had fat in the younger age, the fat doesn't age well. They get heavier, you get droopier. So now you've injected fat in the cheeks earlier, but now that cheek becomes droopy as they age and now that you have a big chunk of jowl fat that wasn't there before. So the fat injection at a younger age, you have to be very cautious how you're doing it, judiciously, small amounts, yes. Large amount like we do in the facelift, no, not a good idea.

(02:34)
Now filler has this lifespan. It's not the answer to everything. So if I'm taking somebody to the operating room, fat injection is my option. The other thing you have to consider also is not all fat is the same fat. It's the age of the patient also is their age of their fat. If I take that same patient, clone him at age 40 or 50, do a facelift on him with fat injection and then do same patient, same genetics at age 70, the fat is not going to be the same. Their level of take of the fat won't be the same.

Has anyone looked into why the fat isn't aging well? Is it the location? Is it the person? Do we have any idea why that's happening?

Well, the fat cells, like any other cells in the body, cells do age. And the DNA part of the DNA gets shorter and shorter. That's how we age. And fat is not an exemption to that, so.

Did you see my mind get blown at that one? That's the first time I've heard that. It's very interesting. If we are listening today and we want to find out more about you or come see you for a consultation, where should we look for you online?

So you can go to my website, KiyaMovassaghi.com. You can go to my Instagram, Dr. Kiya Movassaghi.

Thank you for your wisdom today.

Thank you very much for inviting me again.

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