Given the difference between body tissues of young and old and middle age people, any surgery or cosmetic operation on the elderly should consider some other factors in addition to those considered for younger people.
We know that fat transfer can be performed in young and old people, but there are differences between these two age groups. Here we only discuss three differences between young and old patients when it comes to fat transfer.
A touch on the abdomen of a teenager or youngster shows that the fat at this part is relatively stiff and consistent while older people have soft sloppy fat. This is why we see sagging in fatty tissues of older individuals.
Fat cells in older individuals are quite vulnerable, and some of these cells may be destroyed or become turgid during transfer. A turgid cell is a dead cell and, if injected to a patient body, will certainly have undesirable effect on fat transfer. This is why calculation of the amount of fat required for transfer as well as transfer technique is different in young individuals from the elderly.
Clearly, any cosmetic operation should address the needs of the patient. Most young people looking for fat transfer want this to augment a part of their face (for example, cheeks). Although this may also be the case for older individuals, most of the older patients seek facial rejuvenation. Therefore, specific attention must be paid to removing the signs of aging when considering fat transfer for these individuals.
Fat transfer for younger individuals is different from the procedure for the elderly and one reason why middle age or old patients are not satisfied with fat transfer results is that signs of aging have not been well examined prior to surgery and transfer technique has not been properly chosen to remove these signs.
Aging signs often appear at deep tissues of the face in two different forms: sagging and sloppy subcutaneous tissues and reduce volume of tissues especially adipose tissue in the face. Individuals may be classified into three groups based on these changes.
The first group consists of individuals who experience sagging skin as they age (the figure below; right). On the other hand, there are people who have no sagging on their facial skin but suffer from reduce volume of fat (left). The third group includes individuals with both problems. Most people fall into this third group.
No certain age can be determined as the age at which a young individual becomes middle age and fat cells start to behave differently compared to these cells in young people. Such an age is different from one individual to another. In some cases, a quality of fat adipose tissues in a 50-year-old individual is as good as a young person while a 40-year-old person may have turgid cells and aging signs. In general, however, fat tissues are young prior to the age of 45 at which they start to show the signs of aging.
Even when the quality of fat is not the same, older people with thin faces get a better result from fat transfer. Good results are also obtained for individuals who do not suffer from severe cardiovascular diseases, uncontrolled diabetes, liver failure, or renal insufficiency.