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    Rethinking facial rejuvenation with fat

    Dr. CohenA long-time inventor of medical procedures and devices, San Diego, Calif.-based plastic surgeon Steven R. Cohen, M.D., has refined the fat grafting procedure to where it appears to measurably reverse tissue decay to regenerate the face.

    His presentation on the approach, called Injectable Tissue Replacement (ITR), won the Tiffany award for the best scientific presentation at the American Society of Aesthetic Plastic Surgery’s 2017 annual meeting. It involves using fat grafting and the stem cells in fat to do more than make the face look more youthful. Rather, he says, Injectable Tissue Replacement helps to increase tissue mass, rebuilding volume where there have been losses in specific areas of the face of an individual patient — in essence, to potentially alter cellular aging.

    Dissecting Facial Aging

    There are important factors that lead to tissue decay, or aging: photo damage, volume loss and laxity. These three phenotypic changes are superimposed on genetics and facilitated by facial expression and environment, according to Dr. Cohen.

    By the time people reach about age 22, they’re fully grown and the process of tissue decay kicks in. The rate of tissue decay, which is impacted by those three factors, varies among individuals.

    “But you can monitor decay,” Dr. Cohen says.

    For example in younger patients, the physician can look back at college pictures, provided patients liked how they looked and haven’t gained or lost significant weight, and almost gauge patients’ aging trajectory.

    “For volume, if you now take that patient and put back precisely not only the size and shape of the fat, but in the exact compartments where the fat was lost, you seem to change the trajectory of aging and reduce tissue decay,” he says.

    Dr. Cohen says there is no other procedure he is aware of that addresses how to reverse facial tissue decay.

    “Injectable Tissue Replacement is not really fat grafting. It’s using fat — because that is the tissue that has been lost — in a proper size, based on the patient’s individualized aging pattern,” he says.

    NEXT: Where Filler Use Fails and Fat Wins

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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