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Plastic Surgeon Beirut Lebanon
Fillers - Lipofilling


Fat, or adipose tissue, provides the structural support to the skin. This is crucial in providing a healthy and youthful appearance to the skin. The next time you observe a young child, look at his/her cheeks, and then compare to an older individual around you. You will find that with a few exceptions, facial aging is associated with flatter cheeks, and sunken folds around the mouth. This occurs because with time, some of the fat is lost, and some droops with gravity to form the jowls. What is left is not enough to support the skin over the cheeks, and therefore one sees the folds around the mouth and the eyes, and flattening of the face. Similarly, the fat of the hands is lost with time, making the veins and tendons very visible. Lipofilling can help restore the fullness and the appearance of more youthful hands


Traditionally, collagen and hylauronic injections are used to correct the folds around the mouth and other lines on the face. These are very useful in the beginning of the aging process, but may not be enough as more fat is lost. Many people seek a facelift to trim the excess skin, but end up with a hollow face. When there is a loss of volume of the face, volume replacement is ideal to help restore a natural appearance. Think of a balloon that is deflating over time. The treatment is not trimming the balloon, but filling it with air again!  

Before & 1 month after lipofilling of the cheek. Note fuller appearance. (Dany Touma, M.D.)

  The concept of lipofilling

While most people gradually lose the fatty layers that provide the structural support for facial skin, they retain ample amounts of fatty stores in other areas, such as the hips, outer thighs and buttocks.

The idea is simple: One of these areas as well as the face is numbed using local anesthesia. Fat is suctioned using a small syringe and a gentle needle. This is like a micro-liposuction procedure (in fact many of my patients that undergo liposuction chose to have some fat re-injected into areas that need correction). The suctioned fat is gently transferred into the face or hands  in a sterile, non-traumatic and artful way to recreate the lost contour.

  Results and expectations

Like any other transplanted tissue, it is somewhat unpredictable how much of the transferred fat will survive. Most studies have shown a "take" of about 40%. Individual results vary though. In my own experience, while some patients have had superb results that were sustained over years after a single treatment, a few others have had less impressive results. In order to maximize results, I recommend re-injecting at three and six months. This serial injection approach is needed to provide the maximum chance of a long lasting result.   

Before and aftre lipofilling of the cheeks. The result was the equivalent of gaining several Kgs in weight. (Dany Touma, M.D.)

  How to prepare for surgery


The procedure takes about 90 minutes. No sutures are placed. Oral antibiotics are started the night before the procedure and help decrease the risk of infection. Mild bruising or swelling might develop, but most people are able to resume normal activities the same or next day. Bruising is minimized by avoiding aspirin, aspirin-like products, vitamin E, alcohol and herbal medicines for ten days pre-operatively.

  The art of lipofilling

It is useful to bring an old picture of your early adulthood. This will help in achieving individualized recontouring of your face. Areas usually corrected are the cheeks, lower eyelids, folds around the mouth, the lips and the hands. Occasionnally, defects left after liposuction are also corrected with lipofilling.  The result is beautiful and natural rejuvenation of the face.

Aging hands before and after lipofilling. Dany Touma, M.D.

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