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.
1. Soft sloppy fat in middle age and elderly patients
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.
2. Aged-related differences in quality of adipose (fatty) tissue
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.
3. Younger and older patients have different needs
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.
Note:
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.
Effects of fat in removing signs of aging
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.
This classification is particularly helpful in choosing rejuvenation technique as briefly discussed below.
Group 1 (patients with soft sloppy tissues in the face)
Facelift is particularly helpful in face rejuvenation for individuals in this group. Given the overconcentration of fat at some spots on the face and neck, some of these patients will also need liposuction or surgery at their chin, smile line, etc.
Group 2 (patients with reduced adipose tissue)
Reduced volume of fat, muscles, and connective tissue in these individuals gives them an older look. Fat transfer can properly compensate for this reduced fat. The best result for these patients can be achieved through an inexpensive procedure of fat transfer without any facelift. In such cases, subcutaneous fat injection gives the patient a younger look.
Individuals in this group who do not like fat transfer may opt for filler injection or prosthetic face parts
Group 3 (patients with soft sloppy tissues and reduced facial fat)
Most people fall into this group since they experience a combination of soft tissues and reduced fat as they age. However, these changes are not necessarily the same in all individuals as in some people one type of these changes is more apparent than the other. In these cases, desirable results are often achievable through a combination of facelift and fat augmentation (fat transfer, filler injection, or prosthesis).
Proper age for fat transfer
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.
Who, among older patients, get a better result from fat transfer?
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.
