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Board Certifications: American Board of Facial Plastic and
Reconstructive Surgery American Board of Otolaryngology - ABO

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Why Fat Is The Key To Youth

The older we get the more fat we want in the face, and those who are a bit chubby may not have to worry as much about an aged appearance. Dr. Sam Rizk is not suggesting you should be chubby. Instead, stem cell autogenous fat transfer can turn the clock back in a natural look instead of over pulling face with too many facelifts. Dr. Rizk focuses on lower face (ie jowls) and neck for his facelifts and focuses the fat transfer to cheeks, temples, periorbital area, and forehead, nasolabial folds and lips. Fat, it seems like your worst enemy but in the war against aging, the right amount of it is actually the secret to looking youthful. Fat is what gives the face volume, and volume is the hallmark of youth. Before age 40, facial fat begins to deplete, and once this fat is lost, the face as a whole begins to descend and deflate, losing fullness and volume and creating a hollow, aged appearance. Therefore, restoring this right amount of fat is fundamental to reversing the aging process. Dr. Sam Rizk uses stem cell fat transfer as a compliment to facelift surgery at the same time. Dr. Rizk also believes a laser to rejuvenate the skin completes the youthful appearance since youthful definition from a facelift and fullness from fat transfer can be detracted by poor quality skin.

The loss and descent of facial fat is a phenomenon that can be traced from birth. At birth, the face is round and full because of an abundance of fat that is evenly distributed. In the mid to late 20's facial fat starts to degrade, but not enough of it is lost that there is a significant difference. Around the early 30's more fat is lost, causing the face to take on a heart or oval shape. There's more fullness in the bottom part of the face near the chin and jowl area than the upper part of the face. In the 40's fat is lost in the cheeks, which causes the midface to start to droop, producing more pronounced jowling. By age 50, a good amount of fat has been lost and the face resembles more of an inverted triangle or square shape-the upper face tapers outward at the cheeks, and the bottom portion begins to widen, which both result in an aged appearance.

Fat has many benefits in the face. Dr. Sam Rizk explains that fat has three main functions in addition to providing fullness-to protect the underlying muscles and tissues, to provide cushion and support, and to serve as a gliding mechanism for the muscles.

The New Facelift

Harper's Bazaar - "The New Facelift" stem cell by Dr. Rizk

procedures for aging lower eyelids

Dr. Rizk discusses procedures for aging lower eyelids

Three main factors cause volume loss-age, hormonal shifts and weight loss-can cause significant amounts of fat to be lost, since each of us is genetically programmed differently, the rate at which fat is lost in the face varies from one person to the next. As hormonal levels drop, fat thins out. When estrogen levels become prevalent around puberty is when there is the most adequate amount of fat in the face and fullness is ideal. Changes in levels of the hormone cortisol and growth factors are related to changes in the face, but we don't know the exact role they play in fat loss. The aging process is a primary cause of fat loss. While there is little that can be done to mitigate the effects, keeping a steady weight may help to make the signs of aging less prominent. Weight loss is another cause of facial wasting. The goal of dieting is to lose weight. But the key to doing it correctly is to do it steadily. Shedding pounds too quickly results in too much fat loss, accelerating the signs of aging. Weight is definitely a factor in fat loss. Dr. Rizk explains that losing weight has an effect on fat within the body, especially in the face and a patient cannot choose where the fat will selectively be lost as this is genetically programmed. Massive weight loss in the face accelerates aging because fat is lost in the central parts of the face, the deep parts of the cheek and the storage compartments. When this fat is gone, there is no foundation, and the structure begins to collapse. With Minimal weight loss (20lb or less) , there is usually not a big difference in the face because the underlying fat areas that are important for definition remain intact. Dr. Sam Rizk recommends if a person wants to lose weight to do it in a certain way so as not to lose facial fat and there is a certain way to do so-he recommends avoiding excessively restrictive diets, exercising to conserve and improve muscle tone, pacing yourself to do it gradually, loading up on orange fruits and vegetables, going raw and eating plenty of omega-3 fatty acids (doing this will add the needed nutrients to support and restore needed nutrients for facial fat cells)

Fat grafting involves surgically removing fat from one area of the body with micro-liposuctioning methods and transplanting it to another. Even though some of the fat will absorb, much of it will last for a long time. However, fat is not totally predictable and may not take as much as one desires, and absorption of fat varies individually. In general, according to Dr. Rizk and his data, 30-50 percent of transplanted fat will survive about 3-5 years. The procedure may need to be repeated. More importantly, our understanding of stem cells within the fat has led us to purify the fat to expose stem cells to the surface of the fat cell which results in greater longevity and significant rejuvenating benefits on facial skin. The cytori puregraft system has allowed such purification process. The transplanted fat is best for the cheeks, smile lines, temples, forehead, lips and in certain cases the under-eye area. Since your own fat and stem cells are used, there is no risk of an allergic reaction like exogenous fillers.

Dr. Sam Rizk, a board certified NY facial plastic surgeon, explains the following about fat transfer.

  1. Since its your own fat, allergic reactions do not occur.
  2. Fat has the potential to be semi-permanent and is scientifically proven to have long-lasting effects in the face. You may require a secondary procedure years later to add more fat.
  3. The patient may be bruised and swollen for a week after the surgery or even longer.
  4. The stem cells used in aesthetic procedures are fat-derived from the patient's own body and not extracted from an embryo and there is no increased risk from using a person's own stem cells in their own fat. The cytori puregraft system for stem cell fat transfer was FDA approved 2 years ago.
  5. Facial implants are another option that is discussed with patients-to achieve a similar result to fat transfer but they are not without risk such as movement, infection or underlying bony resorption over time. However, they are particularly good for the chin and cheeks. Besides providing volume, facial implants can also define facial features since they build up the bone structure. Dr. Sam Rizk believes it is important to select patients for cheek implants carefully since they don't always provide a natural result in the cheeks.

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