A new grafting technique is set to add extra ammunition to the fight against ageing skin.
Injecting small amounts of fat has long been used by cosmetic surgeons to make faces look younger - but the process isn't always successful.
This week New Zealand and Australian plastic surgeons are being shown a new technique that dramatically improves the chances of taking fat from other parts of a patient's body without damaging it.
Fat in certain parts of the face is a sign of youthful beauty. Too little can reduce perceived facial attractiveness in some young people, while loss of facial volume is a common component of an ageing face.
Fat grafting involves taking fat, usually from the patient's backside or abdomen, then pumping it into their faces.
Until now fat has usually been taken using a suction technique. A syringe is inserted and the fat is sucked out.
But that kills some of the fat cells which, when reimplanted, are useless.
American aesthetic plastic surgery expert Bahman Guyuron will explain his "coring" method at the Australasian Aesthetic Plastic Surgeons conference in Arrowtown today.
It involves a thin, modified syringe, which has had its needle bevelled, being slowly inserted into the chosen area of fat, Dr Guyuron told the Herald yesterday.
The syringe is carefully twisted around as it is pressed in deeper. The result is a long string of fat, much like an apple peel, which has not gone through the trauma of suction.
That fat is then washed and inserted in the chin, cheeks, lips, or anywhere else facial volume has been lost.
While fat grafting is not new - it has been performed in New Zealand for 10 years - Dr Guyuron's method makes considerable improvements.
Success depends on the fat's survival. If it survives, it will operate in the area where it is implanted like normal fat, adding volume.
But fat grafting has generally only offered a 50 per cent or less success rate. The new method, which Dr Guyuron has performed for three years in the United States, has posted success rates of between 75 and 80 per cent.
Operating times were shorter, complications fewer, and recovery times far less, Dr Guyuron said.
He expected the method would be practised in New Zealand soon.
While 25 years ago a facelift involved tightening and stretching the skin, today it was more focused on the loss of volume in the right places.
"Part of the ageing process is depleting facial volume. There are patients, and we do the best facelifts on them, that still don't look good because they've lost volume."
While a young person usually has fat high in their cheeks, by old age that fat could have sunken, either through gravity or a genetic predisposition, to their jowls, he said.
NEW BREASTS FROM OLD FAT
Fat could be used to construct entire breasts within the next 30 years, according to Auckland plastic surgeon Glenn Bartlett.
Fat grafting to add volume to people's faces was now a common technique, practised widely in New Zealand, he said.
It required just a few millilitres of fat being taken from a patient's bottom or abdomen.
Already some surgeons overseas were using the technique to add volume to breasts, he said.
That application of fat grafting was still in its infancy, was extremely expensive, time consuming and presently offered no evidence of benefits over traditional implants.
But it was a rapidly advancing field which, it was hoped, could lead to breast cancer victims whose breast had been removed having them replaced by new breasts, filled with their own fat. Such a procedure would require hundreds of millilitres of fat.
That fat could be grown through the harvesting of stem cells or, depending on scientific advancements, sourced from other people.