I apologize if this question is redundant to anything else posted on the forums, but I couldn't find anyone asking exactly this. I have two questions. First, how long would you wait after a patient finished taking Accutane before performing 1. a cheek or chin implant or 2. fat grafting. I realize the primary concern is with skin scarring, which is why you would not perform laser surgery before 18 months off Accutane, but does the drug interfere with bone healing after, say, a cheek implant as well?
Second, most of your gallery pictures appear to be of people at least in their late 20s, more often in their 30s and beyond. Is fat grafting reserved for older people who are experiencing fat loss and consequent facial thinning, or is this procedure sometimes appropriate for a young person in their late teens/early twenties who has a small, narrow face with flat cheekbones and very little natural fat, causing her to look â€˜agedâ€™, even when actual aging has not begun to occur. So in other words, the person is not losing facial volume, but never had it to begin with. You have mentioned that many women gain weight in their 20s, but if someone has a genetically thin face, often their faces seem to just get thinner from the teen years onwards. Would you be more likely to perform cheek/chin implants on such a patient to correct the underlying weak bone structure, or use fat grafting to provide more volume and a softer look? Do you ever use both, or do you prefer simply not to operate on patients in their early 20s?
Thanks very much for your time.