Facing Fat Facts

Whether it's your own fat, synthetic fillers, or both for your facial rejuvenation goals, the same adage applies: One size does not fit all

Despite the aesthetic industry’s evolving attitude toward fat as functional facial filler over the past several years—from cynical to skeptical to accepting—Dr. Few has been fat grafting for more than 12 years. Today, no doubt about it, fat is fabulous. (Who’d have predicted that?)

Fat, says Dr. Few, may be uniquely “green” (a great way to recycle that unwanted collection from the waistline, no doubt), and offer a nice, long-term facial result, but, he points out, it isn’t a filler that completely transcends the overall filler category. In other words, just as certain synthetic fillers are indicated for specific components of facial rejuvenation, (ie, hyaluronic acids are used to fill lines, plump lips, put the apple back in your cheek), fat too has it’s strengths. Unfortunately, that doesn’t include filling fine lines.

“Fat is only good for volume, not superficial wrinkles,” says Dr. Few, a fact he often points out to counter the misconception among his filler patients.

While fat is routinely used for cheeks, chin and jawline, if you’ve got fine lines to fill, those are best left to the HA fillers (Restylane, Juvéderm, Perlane). In Dr. Few's hands, it's Restylane. And if fat just isn't your thing (or if you simply don't have the tissue to spare—ahem, nice problem to have!), Dr. Few says you can opt for Restylane all the way.

Side by side, here's generally how fat and Restylane stack up (all that's left is to decide is, which one is right for you?):

Fat vs Restylane

	Procedure Time, min	Cost	Longevity
Fat	45	$4000	Indefinitely*
Restylane	15	$1500 (2 syringes)	up to 18 months

*75% patients won’t need another filler for several years; 25% patients will need another round of fat in 3 to 12 months.

Lip Service

When it comes to the perfect pout, what do your lips say?

While we used to frequently encounter that so-called "trout pout" of the last decade, today there’s definitely a backlash against any enhancement that looks obvious and “overdone.”

“It’s about enhancing your natural lip contours,” says Dr. Few. “If you try to change the shape, you could have a very unnatural-looking result.”

But how do you know? Dr. Few offers up 5 lip tips that will wipe the pout off your lips and leave you all smiles:

1. The upper lip shouldn’t be larger than the lower lip.
   “Although Julia Roberts has a larger upper lip [and pulls it off!], it’s generally an unnatural proportion and will result in an unnatural looking lip,” says Dr. Few.
2. Enhance your natural lip definition.
   “Don’t just make your lips bigger. This is a common mistake that creates those unnaturally protruding ‘duck lips’.”
3. Don’t expect to erase all your lip and mouth ridges and folds.
   “If you inject too much filler, the skin will stretch and create what we call ‘sausage lips’.”
4. Maintain your filler. (Restylane lasts approximately 6 months.)
   “Regular maintenance of your lips will create a more natural look, so don’t wait until it disappears to get a refill.”
5. Avoid permanent fillers in the lips.
   “While the idea of a permanent filler is appealing, if you don’t like your result, you’ll have to have it surgically removed. As we like to say in the industry, permanent fillers, permanent problems.”