The old saying goes that at a certain age women have to choose between their face and their figure. Indeed, recent studies show that women over 40 appear younger if they are heavier.
That’s bad news for those who spend hours honing their abs in the gym only for the results to be shown in a thin and less youthful face.
But a new type of facelift claims to prove you can have the holy grail: a plump face and a smaller behind – but at a price.
During the so-called ‘organic facelift’, fat is harvested from bulky stomachs, thighs and bottoms via laser liposuction.
This is purified, and re-injected into the face as a natural volume-enhancing filler. Patients are reported to have the two-in-one benefit of a slimmer frame and fewer lines without the aid of synthetic fillers (hence the ‘organic’ moniker).
As we age, men and women lose volume from the face, particularly around the temples, under the eyes and from the apples of the cheeks.
This gaunt effect is caused by a loss of bone density, collagen and, most of all, fat.
As the face loses its roundness – like a deflating balloon – the over-lying skin appears saggier, and jowls and folds start to appear. These are the tell-tale signs of ageing.
For years, the gold standard for reversing this effect were ‘liquid facelifts’, procedures that used fillers made from hyaluronic acid, a synthetic version of a natural component of healthy, young skin.
These are safe, come in various thicknesses for use in different parts of the body, and are used to fill lined areas and to add volume to ageing faces. But these fillers have unpalatable downsides.
Because fillers are thicker and less fluid than natural fat, when they’re used to refill sagging faces they look convincing in repose, but ‘overstuffed’ when a patient talks or laughs.
This is the ubiquitous Hollywood ‘cat face’ with over-done, artificially plumped cheeks that don’t move.
The second downside is that these traditional fillers last only for a maximum of a year. Patients therefore start with bulky, inflexible pillow faces, which slowly deflate. Far from ideal.
In the U.S., where hyaluronic fillers were illegal for many years, celebrities wanting to look younger without going under the surgeon’s knife resorted to using the only alternative: their own fat.
Back then, most of the fat injected – up to 70 per cent – disappeared.
To ensure women had a lasting result, surgeons routinely ‘over-filled’ faces (when Meg Ryan appeared in public with a bloated face some years ago, it was speculated that she’d had an early fat facelift).
But within the past year, improvements in the technique mean nearly all the fat put into the face survives.
The fat transfer has therefore become a much more subtle and effective way to rejuvenate the face.
Plus, there’s no risk of rejection as it’s your own fat. Results can last for ten years or longer – compared to the usual six to 12 months for normal fillers.
‘As we age, we naturally lose fat from our faces, so it’s perfect to plump things back up again.
Women may think they need a surgical facelift, but simply replacing lost fat can easily restore a youthful look. Stem cells found in fat rejuvenate the skin, making it thicker, smoother and brighter – like young skin.’
At £2,500, it’s not cheap, but still significantly less than you’d pay for a decade of filler injections at around £400 to £1,000 a pop.
Patients are even booking the procedure alongside a standard liposuction treatment – sucking out fat from unwanted areas and re-injecting it where it’s most needed. It’s one of the fastest-growing treatments.
For sagging, a traditional facelift is best, but often needs to be combined with volume replacement for the best result. So, as with most things aesthetic, this procedure works best in combination. It’s also unpredictable how long the fat injections will last – for some people it’s years, and for others only months.’
Married mother of three Rosetta Citton, 57, who works in the jewellery business, decided to try the procedure.
‘I saw it as an investment in myself,’ she says. ‘My appearance has always been important to me, but recently I’ve been unhappy with the way my face was ageing. I’m naturally slim and as I’ve got older, it has become increasingly gaunt.
‘I work with luxury products and the saying is: “They don’t just buy jewellery, they have to buy you first.” In my line of work, I’m competing with women in their 20s and 30s, so it’s important for me to stay looking as good as I can.
‘I’d been having fillers and Botox, but I didn’t like having such regular top-ups. I asked for something safe but more permanent. When the organic facelift was mentioned I was very excited and wanted to sign up for it straightaway.
‘Yes, this is more expensive than one treatment with fillers, but I hoped it would save me money in the long run.’
During the 90-minute procedure – which is done under local anaesthetic – a surgeon makes four or five 1mm to 2 mm incisions on each side of the face, and using a fine, blunt-ended needle, creates tiny tunnels deep in the muscles.
The harvested fat is deposited into these tunnels, filling out gaunt cheeks, hollows under the eye and at the temple. It can also help to restore volume to the jawline.
The key to this treatment is the careful layering of mini-droplets of fat deep in the face’s muscle layer, which has lots of nearby blood vessels. This means the fat can easily develop its own blood supply, which it needs to survive.
This technique is why the treatment is such an improvement on the old fat-injection procedures. Previously, surgeons used to dump a huge volume of fat into the face and only the surface layers were able to connect to a blood supply. The rest would die and be re-absorbed by the body.
The new procedure means only 20 per cent of the fat might die, so the result is more stable and predictable.
‘I didn’t have much body fat to start with, so I didn’t need liposuction,’ says Rosetta. ‘Surgeons simply removed a little fat taken from each of my thighs under local anaesthetic, which was purified and injected into my face.
‘I had two doctors working on me, Dr Di Giuseppe and my regular cosmetic doctor, Dr Wolf, who injected one side of my face each.
‘After the treatment, my face was swollen. I had no stitches, just tiny plasters on the four incisions on my temples and at the sides of my cheeks.
‘I had to sleep with my head raised on pillows for a week, and wasn’t allowed to rub my face in case I disturbed the fat.
‘I had the procedure on a Friday and went back to work on Tuesday. The effect is subtle and more natural looking than my previous filler injections. Colleagues who didn’t know what I’d had done simply said I looked well rested.
‘I’m thrilled with the results. My skin looks brighter and smoother. I’d say it’s taken five to ten years off my looks.’
However, there can be disadvantages to the procedure. Unlike hyaluronic fillers, your own fat isn’t dissolvable, so if you don’t like the effect you can’t reverse it.
The organic facelift also involves surgery, which always carries risks of infection and complications, and you will usually need to wear an elastic corset or compression leggings for weeks on the areas where significant amounts of fat have been removed to prevent lumpiness and reduce swelling.
The procedure is not suitable for women with lots of sagging skin, especially on the neck. You will also need to maintain a steady size – if you gain weight your face can bloat, and if you lose it, the fat can disappear. But Dr Di Giuseppe says: ‘Done in an operating theatre, with experienced surgeons, this is usually a straightforward treatment with very low risk.’
Perhaps it’s time to have another slice of cake after all…