This section of the forum is dedicated to discussions on various surgical techniques for facial rejuvenation, including fat transfer/fat grafting, browlift, blepharoplasty (cosmetic eyelid surgery), facelift, etc. Also, this category includes questions on hand rejuvenation via fat grafting. (Of note, Dr. Lam does not perform body rejuvenation except for hand fat grafting)
What is the difference in the longevity of regualr fat grafting versus "pearl fat" being grafted. It seems that the larger size of the pearl fat would do better in areas that require more volume, but does it "take" as well in moving areas?
Thanks for you opinion and sharing your knowledge.
First, let me clarify. There are many ways to skin a cat. In other words, it is not my responsibility or right to condemn another surgeon for his or her technique. However, let's think about logically what you proposed, namely that pearl fat would work better for areas of volume. Pearl fat technique, according to my understanding, is taking a lump of fat out (albeit not very large) that is surgically inserted. My method uses no "surgery", i.e, no physical incision and very tiny, tiny microdroplets of fat dispersed over a wide tissue range. Which do you think would have better blood supply to hold a larger lump of fat inserted through a surgical incision in which the tissue planes and blood supply are disrupted? Or, tiny tiny drops of fat suspended in the surrounding tissue with no disruption of blood supply since not even a needle or knife that can lacerate or disturb the tissue is used but instead a blunt cannula to distribute the fat evenly over the wide plane?
Remember for blood supply to hold, the surrounding blood supply should not be disturbed through surgical incisions and second should have tremendous contact to the fat particle transplanted. Let me make this clearer, let's say you have a basketball sitting in a swimming pool and a grape sitting in a swimming pool. The basketball and grape represent the fat particle transplanted and the swimming pool the surrounding blood supply. Let's assume the blood supply is not disrupted with either technique (although it really should be significantly more disturbed with pearl placement). How much blood supply gets to the center of the basketball compared with the grape? Of course, 100 grapes that are in the swimming pool inherently have more blood supply contact than one large basketball. Now, think of it another way. Why do tumors "necrose" or die in the center? Because as they grow very fast, the center of the tumor loses blood supply and dies. In conclusion, smaller tiny grafts atraumatically (that is non-traumatically) inserted should in theory hold significantly better than a larger lump of fat traumatically inserted through disturbed tissue planes.
Now, theory is all well and good but what is practice? I can't speak on the longevity of the pearl method since I have no clinical experience with it but mine holds tremendously well everywhere on the face, as shown in my successive photographs with long-term results. And supporting patient video testimonials accounting to how long they are out from a single session of fat transfer. Anyway, i can only state my longevity but had to answer in detail the response you made about how a pearl fat grafting logically would hold better for volume. That is extremely illogical unless you can explain to me logically why it would, as I have done. best, sml