While a veritable media frenzy was sparked in the aftermath of an article published by New York Magazine about Madonna having gotten a volumetric face lift that was achieved with fat grafting and how it represents a new era of facelifts, Make Me Heal and some industry insiders are yawning. Why? Because we already reported the Madonna news over a year ago and this plastic surgery trend of volumetric facelifts dates back nearly a decade.
Back at the 2007 Oscars, Make Me Heal already “outed” Madonna about the facelift she must have gotten in advance of the Oscars (see the full story on Madonna’s Facelift), along with other plastic surgery procedures we speculated about, including Botox injections, eyelid surgery (see the full story on Madonna’s Eyelid Surgery), laser treatments like Fraxel and Active Fx, and a potential breast augmentation and lift.
The fat grafting approach for facial rejuvenation involves harvesting the fat from the body and then using fat grafting to volumize the face.
Make Me Heal has also broken out interviews with the pioneer of the volumetric facelift himself, Dr. Richard Ellenbogen, who already 25 years ago went against the industry convention of tightening inner facial layers and realized that the key to achieving most natural-looking face lift entails adding fat to areas that have lost volume, not tightening the face (read the interview on Dr. Ellenbogen and the Volumetric Fat Grafting Facelift).
In the words of Dr. Ellenbogen, the concept of the volumetric facelift and using fat grafting to restore volume has to do with the simple fact that the face deflates as you get older.
“Fat is lost and descends in the face and if this fat is not replaced someone will simply look pulled because that is all the alternative facelift is,“ said Dr. Ellenbogen.
“So what I have been doing for the past fifteen years is adding fat to the various areas that have lost fat and not tightening the inner layers at all because in certain studies with MRI’s these inner layers have been proven not to have fallen at all. Consequently, my operations look very realistic and this is why I have had such a healthy facelift practice with every patient bringing in another patient. I can actually tell my patients nowadays that you will look even younger, whereas fifteen years ago I could say only that you will look more rested. Adding fat and understanding the addition of fat in the amount and how to make it last has been the greatest innovation in facelifts in the past 31 years and I am glad that this is something that I am responsible for and many other plastic surgeons are now following my lead.“
Another plastic surgeon we recently interviewed, Dr. Babak Azizzadeh combines multilevel fat grafting with facelifts, eyelid rejuvenation, and brow lifts (forehead lifts) to achieve three dimensional facial rejuvenation that avoids the plastic pulled look of old-school facelifts entirely.
“In my current approach, I proceed with harvesting of the fat from the abdomen, flank inner or outer thigh region,“ said Dr. Azizzadeh in an article written by him in the Make Me Heal Magazine (read the full interview on Dr. Azizzadeh’s Facelift With Volume Restoration).
“The fat is then processed gently to avoid rupture of the fat cells. We try to maintain some of the serum that comes out as there has been research showing that there are stem cells present in the serum. We next proceed with endoscopic brow lift, conservative blepharoplasty (eyelift) and/ or short scar facelift procedures depending on the patient’s need to address the excess laxity and create structural support for the face. At the conclusion of the procedures, fat grafting is utilized to volumize the face in a three-dimensional format in the brow area, in the teartrough, cheek and the region around the mouth.“
Getting back to Madonna, the before and after pictures of Madonna made the conclusion of her facelift quite obvious to Make Me Heal well over a year ago when noting the disappearing lines that once perched themselves a little below her eyes, the absence of her once prominent nasolabial folds (that emanate from the corner of her nose), the lack of wrinkles on her forehead, and the lack of slack skin on her clean and taut neck line. Only a few years ago, Madonna started exhibiting some serious lines around her nose and a softer jawline with looser skin. With this aging pattern, one would expect Madonna to have some jowls, furrows (forehead lines) and drooping around the neck. The lack of these normal age-related facial changes signal a small facelift which involved both tightening of skin and fat grafting in strategic areas of the face. Moreover, the plumpiness of Madonna’s cheeks defies logic, considering that she has been losing more and more weight over the years which would normally lead to a hollowing of the cheek pads. The cheeks were likely plumped by fat grafting, facial implants, or as Dr. Anthony Youn suggested Sculptra injections.
“So why do I think Madonna has had Sculptra and not facial fat grafting? Since it appears the fat in the rest of her body has all but disappeared, I would expect the same to occur in her face,” wrote Dr. Youn in his blog. “However, even with an extremely thin body, her cheeks remain full. Sculptra-enhanced cheeks should not deflate quite as much as fat-enhanced cheeks,“ he adds.
In the final analysis, Madonna looks unbelievable and natural and had she not fallen to the scrutiny of the media she would have continued to enjoy her beauty secret. Now that the jig is up, it’s only a matter of seconds before half of the world’s Madonna-age women will rush in to the nearest plastic surgeon to ask for a volumetric facelift.
Ultimately, the New York Magazine piece did a lot of good in making the uninformed public of the new generation of facelifts. But one should know that not all plastic surgeons subscribe to the new approach, as many of them continue to use a two-dimensional technique that involves only tightening, cutting, and redraping. Let the buyer beware.
Read the complete plastic surgery profile of Madonna on Plasticopedia, the largest online celebrity plastic surgery encyclopedia.none