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Facial Fat Transfer

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Facial Fat Transfer

Facial Fat Transfer before and after photos by Sherber and Rad in Washington, DC

Facial Fat Transfer before and after photos by Sherber and Rad in Washington, DC

Facial Fat Transfer before and after photos by Sherber and Rad in Washington, DC

Facial Fat Transfer before and after photos by Sherber and Rad in Washington, DC

Facial Fat Transfer before and after photos by Sherber and Rad in Washington, DC

Facial Fat Transfer before and after photos by Sherber and Rad in Washington, DC

Facial Fat Transfer

Scarless Lower Blepharoplasty + Fat Grafting to Midface/Tear Trough

Read About Facial Fat Transfer

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dr ariel rad

@drarielrad

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Lower blepharoplasty fat repositioning is one of my favorite procedures because of its unrivaled power to refresh the eyes.👁️ Lower eyelid bags are caused by bulging orbital fat and while most surgeons remove them, I choose to move them instead. For this gentleman, I used a hidden incision inside the lower eyelid to access the bulging orbital fat. Instead of cutting it out, I transposed the fat into the tear trough—like moving a hill into a valley—to smooth the under-eye contour and soften the transition between the lid and the cheek. Although his eyesocket bone is quite set back (called negative vector) and implants could have enhanced his results further, he and I decided to optimize with tissue sculpting techniques. Orbital fat pads have their own blood supply and so can reliably volumize deficient tear troughs especially in negative vector anatomy like his.
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💉 I also brightened his eyes with a subtle endoscopic brow lift through the temples and fat grafting to blend the lower eyelid into the midface, outer cheekbone, and temple—creating a smooth, natural transition without sharp shadows or hollows. Recovery is straightforward, with only mild discomfort and bruising which requires a couple of weeks to wait out. At 1 year postop his eyes now reflect his energy and warm personality. 💫
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#faceops #lowerblepharoplasty #fatgrafting #faceoptimization #beforeandafter #aesthetics #sherberandrad

Facelift scars are a common concern amongst patients but generally shouldn’t be. The key to minimizing scars is assessment of skin excess which determines scar length and placement, and tensionless incision closures which requires total skin flap release through a deep plane lift.💯
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Younger patients who have minimal excess skin in spite of neck fullness usually can avoid long scars because their problem is more about sculpting deep structures rather than removing excess skin. However for most folks, facelifting involves ligament release, lifting and redraping of excess skin in an upward diagonal direction. Since we cannot have skin bunching around the ears, for those with excess, the extra skin must be removed in front of, and behind the ears.
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Meticulous incision placement is key and involves following the natural curves, hills and valleys of the ear, starting at the top from the helical root and curving around to the tragus where I place the incision behind the little tragus cartilage so that it is well hidden from view, then extends around the earlobe, along the post auricular crease, and then fading into the back neck hair.
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Facelift in men can be challenging due to wearing short hair and sideburns which often require a more vertical lift, rather than diagonal lift as in women. Although scars can be quite long, length is the least important factor. Rather, a tensionless skin redraping and incision closure are crucial which is why high level facelift involves muscle-lifting, so called deep plane surgery. These techniques demand the highest level of skill and artistry. 🎯
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#aesthetics #facelift #deepplanefacelift #deepnecksculpting #deepplanenecklift #facelift #necklift #sherberandrad

FaceOps Part II: Her beauty is striking before and after, though what prompted her to seek surgery was a surgery was feeling self conscious about her facial proportions, nose and eyes. After 2 prior open rhinoplasties done elsewhere she had persistent breathing issues and she wanted a more lifted tip. 👃 While her jaw structure wasn’t outside of the realm of natural, she wanted a slimmer lower face to take a more heart shape. I treated with V-line jaw and chin slimming which created a gentle and slim curvature and accentuated a heart shaped lower facial frame. Reducing her jaw and chin made her eyes and lips appear larger by proportion effects. 👁️
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For her rhinoplasty I used rib cartilage to lift and shape her nasal tip, open her internal airway and also bring her upper lip contour more forward by augmenting her central maxilla, the bone structure just above the upper teeth and behind the base of her nose. This was needed because the space between her upper lip and nose, called the columella-labial angle, was very acute and sunken inwards due to the set back maxilla. By bringing her nasal base And upper lip slightly forward and up, her tip appears more lifted and lip aesthetics are more beautiful. 👄
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Finally, to counteract loose under-jaw and deep neck tissues, I did deep plane face and neck lift with deep neck sculpting which sharpened her jaw and neck lines, and with buccal fat reduction slimmed her lower face even further. Now her beauty is truly optimized while preserving her ethnic identify to show off her stunning beauty, and I’m thrilled that she’s happy with her results and grateful to have her trust to take care of her. 🎯🔥🫶🏻
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#faceops #deepplanenecklift #deepnecksculpting #faceoptimization #vlinejawsurgery #rhinoplasty #beforeandafter #aesthetics #sherberandrad

🫶🏻Loving these 6 month results for my lovely patient after deep plane face and neck lift, deep neck sculpting (gland reduction), endoscopic brow lift, and chin augmentation. Her lower face and neck were more aged appearing due to retusive (set back) chin — proves how important bone structure is in supporting soft tissues. Chin augmentation combined with deep sculpting and platysmaplasty defined her jaw and neck. With the endoscopic lateral brow lift and gentle canthoplasty, now her eyes are warm and inviting.
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Face lifting is all about smoothing and repositioning lax tissues in the most natural ways. Her surgery also combined elements of face optimization with a more almond eye shape and chin enhancement which she never had before. By artfully combining these techniques we can optimize aesthetic harmony, and oftentimes more is more, rewinding the clock 15-20 years or more. All of my lifts are in the “deep plane,” the muscle/fascia layers of the neck (platysma), face (SMAS), and forehead (TPF), that connect muscles of animation to overlying skin. The reasons these tissue layers are so important are because of their tensile strength and also their role in suspending deep fat compartments. Artfully lifting the deep plane not only refreshes naturally, but also youthfully resets facial anatomy lasting many years.
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I’m grateful for her and all patients’ trust in me to give her this beautiful restoration.💯
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#deepplanefacelift #deepnecksculpting #faceops #faceoptimization #deepplanenecklift #necklift #chinaugmentation #facelift #beforeandafter #sherberandrad

🎯 There are many rhinoplasty techniques to create a beautifully balanced nose, and which one is best varies with anatomy, goals and the surgeon’s preference. My approach always focuses on hidden scars (“closed” approach) and minimizing invasiveness, i.e. as little surgical dissection as possible, to achieve the results. This philosophy informs all of my operations, and closed preservation rhinoplasty is a modern form of this. “Preservation” refers to two elements: one, retaining or preserving the cartilage and bone structure, rather than removing them, and two, shaping the structures with minimally invasive methods via hidden internal nostril incisions. I often use this technique to correct a dorsal hump, very droopy and bulbous tip, expanding the airway if collapsed and narrowing the upper bony pyramid.
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Closed technique entails hidden incisions within the nostrils. A common misconception is that closed approach is “blind” — while difficult for observers to see what the surgeon sees, operating in small tunnels is customary with enough visibility of the necessary structures. Importantly we are able to see the outside nasal contour.
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While there are different rhinoplasty techniques, I use the spectrum of “preservation” methods to optimize my patients’ results while minimizing operative dissection, time under anesthesia and overall risk.👃💯
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#rhinoplasty #closedrhinoplasty #nosejob #faceops #faceoptimization #beforeandafter #sherberandrad

FaceOps Part II: Meet Kacy, a beautiful young lady in her mid-30s who sought facial rejuvenation and facial optimization (and a perfect example of the Wall Street Journal article in which I was featured). She started to be bothered by early signs of aging. Fillers stopped giving her the improvements she wanted, and instead started to distort her features, not to mention their temporary effects. She didn’t need or want an overhaul, but instead she wanted to nip in the bud these early changes so that every tine she looked in the mirror she wouldn’t be reminded of the fact that it will only progress and get worse. The specific issues that she and I discussed were neck and under jaw looseness and fullness, nasolabial folds, heaviness of the tissues above her eyes, and irregular perioral mounds. She was also bothered by the dorsal hump on her nose bridge.
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Endoscopic brow lift and gentle canthoplasty fox eye lift opened and framed her eyes more beautifully. 👁️ Deep plane face and neck lift with gland reduction and platysmaplasty defined her neck and jaw line, fat grafting added subtle volume for smoothing transitions at the temple-forehead, lid-cheek and modiolus-prejowl junctions, as well as subtly plumping her lips. 👄 Finally, closed rhinoplasty👃 with composite dorsal hump reduction, osteotomy and tip shaping gave her a more balanced nose shape and lifted tip.
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You might think that she didn’t “need” anything, and you’re right. She had a lot of natural beauty and by the fact that she feels lifted, lighter and her beauty shines more brightly, I’m grateful to have her trust to give her these results which she’ll enjoy for many years. 💯
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#facialrejuvenation #faceoptimization #facelift #rhinoplasty #endoscopicbrowlift #aesthetics #deepplanefacelift #plasticsurgery #beforeandafter #sherberandrad

🫶🏻This lovely young lady came to me wanting to optimize her natural beauty. In her mid-30s she was bothered by early aging signs that gave her a feeling of heaviness weighing down her eyes, mouth and neck. She felt self conscious about the dorsal hump on her nose bridge and a droopy tip, and she also didn’t like the perioral mounds that appeared as shadowy bumps beneath her lip corners.
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From our consultation, her goals and my aesthetic were aligned in that she wanted subtle optimization without a dramatic transformation. Surgically my primary goals were deep layer structural lifts from forehead to clavicles, specifically the TPF (forehead/brow layer), SMAS (midface deep layer), platysma (neck deep layer). Endoscopic brow lift and gentle canthoplasty fox eye lift opened and framed her eyes more beautifully. 👁️ Deep plane face and neck lift with gland reduction and platysmaplasty defined her neck and jaw line. The power of deep neck sculpting is that it offloads the platysma allowing tissues to drape upwards more effectively. Fat grafting added subtle volume for smoothing transitions at the temple-forehead, lid-cheek and modiolus-prejowl junctions, as well as subtly plumping her lips. 👄 Finally, closed rhinoplasty 👃 with composite dorsal hump reduction, osteotomy and tip shaping gave her a more balanced nose shape and lifted tip.
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As always, I’m careful to advise nuance and subtlety in multiple areas for plausible deniability. I’m so happy that her beauty shines a bit more brightly and she’s found greater confidence in her appearance. And I’m grateful to have her trust to give her these results which she’ll enjoy for many years. 💯
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#facialrejuvenation #faceoptimization #facelift #rhinoplasty #endoscopicbrowlift #aesthetics #deepplanefacelift #plasticsurgery #beforeandafter #sherberandrad

🫶🏻Love this early result a few months after deep plane facelift result for my lovely patient who was bothered for years by drooping jowls, neck laxity and fullness, drooping brows and hooded eyes, all of which gave her face a aged, bottom heavy appearance.
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I did deep plane face and neck lift which naturally lifted and smoothed her lower face to the base of her neck, deep neck sculpting (gland reduction) which offloaded her platysma and allowed tissues to drape upwards more effectively. This also facilitated a tension-free pre-auricular incision line for optimal healing. I removed about 3 inches of excess skin from her face and neck and with meticulous technique and favorable healing, the scars fade nicely. 👁️ Endoscopic brow lift and gentle canthoplasty “fox eye” lift opened her eyes subtly, and finally fat grafting restored natural volume in her midface, temples, forehead and lips. This combination of procedures is the most common and powerful to rewind the clock naturally with maximum longevity as results typically last 15+ years before another refresh may be needed.💯
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Before surgery she lacked confidence in every circle of her life and I’m so happy for her that she has the refreshed appearance that now matches her vibrant energy. I’ve thoroughly enjoyed providing her care and look forward to additional improvement as healing progresses through the months and years.🎯
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#facialrejuvenation #faceoptimization #facelift #aesthetics #deepplanefacelift #plasticsurgery #beforeandafter #sherberandrad

Facelifting in the modern age is incredibly powerful and versatile to help patients of all ages. Here’s my breakdown of techniques that I use routinely to give patients optimized results:
1️⃣ “Endoscopic” methods involve small, hidden incisions in the temple, scalp, post-auricular (behind the ears) and sometimes under the chin through which I lift, sculpt and shape SMAS and platysma without removal of skin. This stealth facelift technique is optimal for patients 20s to 30s who have minimal or no skin laxity.
2️⃣ “Deep plane” techniques involve removal of some skin in front and behind the ears and under the chin through which I lift the SMAS and platysma. Ideal for patients in their 40s and 50s, I often combine this with deep neck sculpting, i.e. gland reduction for optimized jaw and neck lines and endo brow lift.
3️⃣ “SMAS plication or “High SMAS” techniques for patients in their later years who have severely lax tissues and significant skin redraping is important. A top to bottom refresh is often needed for harmony.
4️⃣ One other technique I didn’t discuss but that adds to my armamentarium is the subperiosteal midface lift. This involves lifting the midface “en bloc” on the cheekbone surface through hidden internal upper lip and lower eyelid incisions, ideal for patients with early midface descent but without much skin laxity and who need a more vertical lift. I can also place orbital rim implants if needed for an ultimate result.💯
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With all of these techniques, commonly I will combine with other procedures for a top to bottom refresh including endoscopic brow lift, canthoplasty fox eye lift, fat grafting, upper and lower blepharoplasty, forehead reduction, rhinoplasty and porous polyethylene implants. As every patient’s needs and goals are unique, I listen carefully and advise towards the ultimate aim of creating the most naturally refreshed and beautiful version of a face. Offering the complete spectrum of facelift techniques gives me the ability to truly optimize each patient’s results. 🎯
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#faceoptimization #faceops #facelift #aesthetics #deepplanefacelift #plasticsurgery #beforeandafter #sherberandrad

🎯What is the “best facelift” technique? Many patients are focused on finding a specific method, such as the “deep plane” or endo “ponytail” lift. But fundamentally this is the wrong question to ask because it’s the surgeon behind the scalpel, rather than the specific method he or she uses. This was proven in the famous 10 year twin study where 4 of the world’s best surgeons at the time performed a uniquely different facelift technique, and over 10 years results were compared. Surprisingly there was no discernible difference in quality or longevity of results regardless of technique, thus proving the point that it’s the surgeon and not the specific technique.
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As Goose said to Maverick in Top Gun, “it’s the plane…not the pilot,” before Maverick, flying an older jet, out maneuvered a less skilled pilot flying a high tech 5th generation fighter jet. ✈️ Similarly, surgeons’ skill and experience vary widely and so patients should seek out the right surgeon to meet their needs. Focus on track record of producing exceptional results, maintaining the highest level of safety, and whether you get the sense that the surgeon cares about the person beyond just doing a decent operation and moving on. When you consult with a surgeon, gain a sense of how they think about aesthetics, how they explain harmony and natural enhancement for your unique face, the nuances of technique, recovery and risks, and then ultimately shepherd you through surgery safely. There’s no formula, just doing your due diligence to research surgeons and usually your gut instinct is right.💯
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Daily I am reminded about why I went into the practice of medicine, and that is to care for my fellow humans. Achieving exceptionally beautiful and safe results for each patient is what motivates me every day me always to do better for patients.🎯🫶🏻
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#faceoptimization #faceops #facialimplants #aesthetics #deepplanefacelift #plasticsurgery #beforeandafter #sherberandrad

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