Dr. Brent

LiveFill® Fat Transfer Beverly Hills, Los Angeles, Santa Barbara

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LiveFill® Overview
Aging is generally a result of what is technically known as “soft tissue deflation.” This is a slow process in which the tissue that gives your face its supple feel loses its elasticity and collapses giving a wrinkled, hard texture instead. There is hope however. The traditional approach has been to use fat injections and in this procedure, the plastic surgeon takes your own body fat and injects it into the wrinkled area. The fat cells must go through a harvesting tube and centrifuge prior to being injected and this process kills most of the tissue. After being injected, patients often see swelling due to the over-injection necessary to compensate for the small amount of tissue that is actually healthy.

Unlike traditional fat injection, LiveFill® offers a permanent treatment for the facial wasting that occurs with age. LiveFill® uses grafts of 100 percent living tissue harvested, usually from the patient’s lower abdomen. Dr. Moelleken inserts these grafts resembling strings of pearls into the deflated regions of your face and they immediately adapt to the body. This process can literally wipe away wrinkles because fat is taken from your body and injected into your face.
Dr. Moelleken has performed experiments on the survival of traditional Coleman aspirated fat grafts. Through research, he believes the initial viability to be around 20-25% with final survival being even lower. The issue is how viability is assessed. If you look at cells grossly, the viability is high. If however, you use trypan blue exclusion techniques or metabolic studies, the number of live cells from fat injection is anywhere from 3% alive to 25% alive. That is the starting number and it goes down from there as cells either do or do not survive. Dr. Moelleken has presented his findings at the American Society for Aesthetic Plastic Surgery (ASAPS) and American Society of Plastic Surgeons (ASPS) meetings and he has published his work in the journal of Plastic and Reconstructive Surgery. The studies indicate that when 3-D CT scans are viewed before and after, 70+ percent of the grafted material survives and the long term histology supports a normal appearance of the grafts, with blood supply intact, normal cellular architecture, etc.

Dr. Moelleken is very excited and proud to have originated LiveFill® and the promising procedure has become a regular part of his practice. “As the baby boomer population ages, demand for fills is occurring in record numbers,” Dr. Moelleken explains. “For the first time, we can help patients achieve a more natural and youthful appearance with a safe procedure that is permanent.” For more information or to schedule a consultation, please call (310) 273-1001 or fill out the form on our contact page and we will get in touch with you.

LiveFill ® Introduction
Dr. Brent Moelleken, M.D., F.A.C.S., is one of the most respected plastic and reconstructive surgeons in the world. His philosophy that “beauty and facial harmony is the mirror to your soul” as well as his years of experience make him a professional you can depend on for precision cosmetic surgery with a personalized touch. You are living a longer and more active life than your parents and grandparents did and the day will come when you look in the mirror and wonder why the person staring back at you looks so old. Realizing you do not feel older, you decide it is time to regain confidence regarding your appearance by turning back the hands of time. Dr. Moelleken has a reputation for helping his patients achieve a renewed self-image and his innovative techniques produce superior results.

Dr. Moelleken has pioneered many signature procedures accepted by plastic surgeons internationally and one is known as LiveFill®. LiveFill® is a lip and facial augmentation technique invented by Dr. Moelleken that utilizes all natural facial fillers producing a dramatic return to a more youthful appearance. Through his groundbreaking work, Dr. Moelleken is changing the face of plastic surgery and he has received ongoing national and local media coverage on over 60 national television programs including Extreme Makeover, Discovery Health, Extra, CNN, The Doctors, Oprah, E, and numerous other print publications such as the New York Times, Los Angeles Times, and People Magazine among others. Dr. Moelleken is one of three surgeons in the world to complete the year long Aesthetic Surgery Fellowship at UCLA and he has been selected by Who’s Who in America’s “Top Plastic Surgeons”, “Top Doctors in Los Angeles”, “America’s Top Surgeons”, and by Vogue Magazine as one of the “Top 10 Plastic Surgeons in America”.

LiveFill ® Facts
Fat transfer, also known as fat grafting, fat autographs, autologous fat transplantation, fat injection, or microlipo- injections, plumps up facial features with your own fat and is a popular alternative to conventional wrinkle treatments. In traditional rejuvenation surgery, physicians were limited to repositioning or tightening your existing tissue and skin. Tightening and lifting the skin is not always the answer to facial rejuvenation however because many times, fuller offers better results than tightening. Fat Transfer has added a new dimension to cosmetic surgery and this revolutionary technique of replacing tissue is now being used in all facial areas. Once transferred, the result is usually permanent, although more than one session may be required to achieve your desired volume.

Human fat is actually a delicate and fragile substance. Basically, the fat transfer procedure harvests fat from one part of your body where excess exists, placing it in another part of your body where the additional bulk is used for cosmetic and aesthetic purposes. But the actual fat itself is extremely feeble. It cannot be exposed to air and fat cells will die if the wand extracting the fat is too large or if the needle reinserting the fat cells is too narrow. Another critical step occurs when the blood-fat mixture is spun in a centrifuge to separate the two substances. If the device spins too long or too fast, again fat cells will die.

With LiveFill®, Dr. Moelleken trademarked a brilliant technique that expanded on decades of research in the Plastic Surgery field. Unlike other fat injections, he developed a way to transfer living fat from a patient’s own tissues that are fully alive. The basic biology is exactly the same as for fat injection, with several important differences. First, the graft material for LiveFill is obtained by a process that does not damage the grafted material, so more of the material is alive than with fat injection. This in return results in more of the material surviving. Second, precise pockets are fashioned in which to place LiveFill, rather than fat injection being injected into the tissues. LiveFill® consists of harvesting living fat and fascia, a flat band of tough tissue below the skin that covers and separates the underlying tissues. Once the material is obtained, usually from the lower abdomen, Dr. Moelleken fashions the tissue into very thin grafts or strips resembling strings of pearls that contain structural integrity and intact blood vessels. During a minor surgical procedure, Dr. Moelleken creates a pocket under the skin through a small incision before implanting the grafts into the deflated regions of your face. When LiveFill® is placed, the blood supply from the patient grows into the LiveFill® grafts becoming a permanent part of the patient. Since the tissue comes from the patient’s own body, there is no danger of disease transmission, allergic reaction, autoimmune diseases, or immunologic rejection. Dr. Moelleken states, “Within 72 hours, the body knows the strips are alive and that they belong to the patient.”

LiveFill® is different from any rendition of grafted material developed thus far. Conventional injectables must go through a harvesting tube involving aspirating fat into a syringe, purifying, then injecting which kills most of the tissue. LiveFill® is fully alive unlike fat injections, which are approximately 20% live tissue. This means that approximately 80% of the material injected into patients is cellular debris, free fat, dead cells, blood cells, etc. This is important because a patient’s body will start to work immediately removing the dead cells and free fat until it can either grow blood supply into living cells or encapsulate (surround with scar tissue) any offending agents. This reaction may account for the reason patients experience alarming amounts of swelling due to the over-injection necessary to compensate for the small amount of tissue that is actually healthy. Many materials grow lumpy, especially if they are bone fragment based, have synthetic material in them, or are not living. LiveFill® is superior to the more commonly performed fat injections because it offers a permanent solution for facial aging while fat injections only offer temporary results.

As your face ages, it appears hollow and LiveFill® is basically a way to fill in the hollowness. Your face does not age in lines; it ages in areas. This is why Dr. Moelleken feels it is better to fill in complete areas rather than placing something underneath a single line.

LiveFill® is placed underneath the areas in your face that need augmentation including:

  • Lip augmentation (upper and lower lips)
  • Nasolabial folds (smile lines)
  • Marionette lines (puppet lines)
  • Glabellar creases (frown lines)
  • Temporal hollowing
  • Malar region and submalar regions (cheek collapse; instead of cheek implants)
  • Lateral perioral commissure (lip corner crinkle)
  • Cheek hollowness (buccal space)
  • Eyebrows and the areas next to the eyes where crow’s feet appear
  • Deep facial wrinkles and folds
  • Fat Grafting vs. Cheek Implants

The problem with implants is that as facial fat goes away over time, the implants become more and more visible and they can show an apple-like appearance when the patient smiles. If the implant has a large submalar component, a large lower bulge in the cheek develops in the face as facial fat wastes away, creating the illusion of old age because the center mass of the cheek falls with time. The survival of all grafts will depend on the blood supply around the grafted material and it will also depend on how much of the fat that is transferred is alive. With fat injection, most of the grafted material is dead and for that reason, Dr. Moelleken does not use fat injection, Instead, he uses strips of the patient’s fat and fascia, disarticulated or LiveFill®. Dr. Moelleken often removes existing implants completely and replaces them with LiveFill® grafts. This enhances the blood supply around the new graft, since the bloodless implant is removed, and it enables positioning of the cheek mass not possible with implants.

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