Hey, guys. My name is Mavi, and I've spent the last 14 years in the plastic surgery and beauty industry working alongside top board certified plastic surgeons. Now I'm an independent patient coordinator who doesn't work for any surgeon. This means I have unbiased reviews for hundreds of doctors, and I can help you achieve the look of your dreams, whether that's a supernatural or a video vixen. I use my professional and personal plastic surgery experience to help you look and feel your best.
Join in on the fun as I talk to plastic surgery experts, friends, and real life patients about all things plastic surgery. Should be fun. Hey, guys, do I have the episode for you today all about facial rejuvenation. And I brought on, ah, one of the best in the country, dr. Kate O'Connor out of Tennessee. And we're going to go over all things facial, uh, plastic surgery. I'm so happy to have you on the show, Dr. O'Connor. Thank you for being here.
Thank you so much for bringing me on. This is literally my favorite thing in the world to talk about. Girl I love it when you get two people who are so hyped about the same stuff. Oh, my God. You can't stop. You can't stop. Sometimes I'm like, oh, God, this recording has gone on for an hour and a half. We might have to cut some of this. That's the truth. Honestly, it really is. So it's really refreshing to have surgeons come on the show and be transparent and just tell us what
you know. So one of the most popular procedures, especially now with the buckle fat removal, with the cat eyes, with the brow lips, is facial rejuvenation. So you guys know that I'm always going to tell you everything that I know, and I'm going to bring you the best that I can. And one of those things that, you know, I don't do is I don't follow trends. I don't think we should be
following trends. Plastic surgery is customized to you and what your hopes are and what you're looking for, and trends are going to come and go, but classic never goes out of style. So Dr. Kate O'Connor is perfect for this because she's going to give us the best recommendations for somebody like me. Dr. O'Connor I'm 33. I'm going to be 34 this year, and I'm starting to worry about my jowling, like, my under eyes. So I'm still at an age where I'm not ready for surgery. I'm not ready
to have a facelift yet. So I want to talk about what treatment options do I have for facial rejuvenation? Like, to keep a useful face. Absolutely. Mavi first off, you took one of our favorite tenants and principles is that trends only good for clothes, shoes, maybe bags. And even then, sometimes finding your own personal style pays dividends. And same thing with your face. Um, I'm new to TikTok by getting on there and just seeing the debate people have about, like you
mentioned, buckle fat. Like, people are talking as if it's just been around. There have been surgeons doing buckle fat removal and fat grafting that area since the 90s. But it's just funny how you see kind of the cyclical things come back when the answer is exactly like you said, your face is not
a trend. And finding someone that you trust and can have that long term relationship to actually create treatment plans centered around you, I mean, that's always going to be where you feel your best, look your best, and kind of get the investment that you're hoping to recoup. And I love what you mentioned about kind of thinking of your age and your demographic because that, uh, is something that we in the facial plastics world are
seeing. More and more people are being really mindful of what aging is and what aging is for them. So kind of one of my other soapbox things, like, what does aging gracefully mean? And people can be anti surgery and anti treatments, but at the end of the day, to me, aging gracefully means you get to choose what that is for you. That's beautiful. That's perfect. Yeah, because, uh, we're all up in each other's business anyways, thanks to social media and all
of that. But it does look different for different people. And so, like, facial rejuvenation could literally be someone's entire career. Like, it's such a broad topic, but kind of like, working systematically. We kind of need to think of how the face ages and then address the things that changes. So first, what I really, really want your lesson is to know is that your face ages in three dimensions. And finding someone who can articulate that to you lets you know that they're going to be
paying attention to all those different things. So we all know kind of that, uh, our collagen drops off. We see that with skin laxity, little fine lines and wrinkles. We then get below the skin and see that the actual fat pads of our face change. And this ties back to how, like, buckle fat removal for some people, they're arguing for it, against it. We'll circle back there, but knowing that the face changes at the level of the skin, the fat pads in which some areas they regress,
other areas they grow. And then to the skeleton, our bones actually remodel and we lose some of the bone density, particularly in our cheeks and along, uh, our jawline. And so kind of bringing that together in the whole package. It was really helpful to me when I was first starting out to imagine what we call the triangle of use, in which, like, nice full brows and eyes, and you picture the fat part of the triangle up at the brows going down to the skinny part at the chin,
also known as, like, a heart shaped face. But not everyone has a heart shaped base. So I like thinking of it as a triangle of youth. And then upside down, we get the reverse smaller along the jaw. Everything kind of sags. And you imagine the point of the triangle pointing up towards the brows and the fat or thicker part along the jaw. So we have so many different things to address all those different layers. And for my age group, what are you seeing? The most
common so for me, jowling would be what? My main concern is, like, I don't want to have any jowling. What would be the recommendation for that? So recommendation is, of course, you know me. I'm a purist. You have to talk to your surgeon. Um, because touching the skin, preaching the choir. You know this. You're really educated. Patient cohort know this. But I have to do my due diligence and say that. When I think of the jowls and someone who's not ready for surgery, two
things come into play. One, addressing the skin, as I mentioned, because that's changed. We do that through lasers. Some of the newer radio frequency devices can be nice in this area or replacing the lost volume. Right. Because as we talked about, if the cheek pads have fallen a little bit flat, if the mid face has gone in, sometimes using volume
can help with that area. The other thing that I want to just mention but not go too deep in, things like fillers and neurotoxins can be helpful, but I actually don't love them in the gelling area. The reason being it's really hard to get that area right without making it look fuller. You put the filler on one side, and all of a sudden you have some lymphatic obstruction, and
you can actually make those gels look worse. There are some really talented injectors who can get away with this, but for by and large, I think that the better things would be to kind of address what we talked about with the skin, with the fat and with kind of the tone and texture. I love that. So now that we're kind of on this not touchy, but like subjects that there's a wide range of opinions on, I would love to get your opinion on thread lifts.
Yeah, absolutely. Girl, you're hitting me with a hard hitting I know. Let me tell you why. I want to know what you think. So let me tell you guys. Dr. O'Connor also has trained with Dr. Jacano out of New York. And if you all have seen me share his before and after pictures on my Instagram stories, you know why I'm asking. They're amazing. And I want to know, what is the consensus on threads? Perfect. Well, I'll just come out of the gate and say they're not a part of my practice, and they're
not for me. The reason is twofold is, obviously, you mentioned training under Dr. Kono facelifting is something that he really has modernized and kind of brought into the 21st century. And it's an interesting tie in because you mentioned that you're not ready for surgery. But oftentimes if some people have really deep nasal label folds, the jowls and just kind of their facial architecture, doing a facelift when you're young can be life changing. You have enough collagen to
bounce back a little bit faster. It can look more natural than some of the more, quote unquote, noninvasive things we do. So one of the things that life sometimes happens is sometimes doing more makes the appearance of doing less. So with that, when I think of, um, a young person, thread lifts can be great for about six months, and then they go away. And what's your trade off during that time? It's increased cost. And each time we do something to the face, there's signs whether we
see an internal external. I always tell my patients there's no such thing as a free lunch, and we just got to know what our trade offs are. So for thread lift, it can generate scar tissue that if down the road you're interested in the facelift, it makes it harder for your surgeon to deal with that skin and some of the texture irregularities and that sort of thing on that. Whenever you're opening up for a facelift, do you commonly find stuff like fillers that have not
dissolved yet, or not really? Because I've seen some pictures and I'm like, uh, I don't know how that makes me feel. Yeah, all the time. Filler, you see it, imagine just kind of how it's looking in the syringe. The tissue gets a very kind of like jelly substance and you can actually just suction it out. And that's, quote, unquote, dissolvable filler, as people historically have used other types. Some of it is permanent, like silicone, and that needs to
be cut out. It kind of forms nodules and stuff like that if it's injected into the wrong plane. So great question. Absolutely. You can find filler. Even when people were like, oh, I had that done three years ago, they'll be there, right? Wow, that's amazing. That's really interesting because I stopped doing my lips. I'm giving my lips a little bit of a break. I had been doing filler on my lips for years, and I was deciding to let it all kind of go away and then I was going to
start again. And even though the filler only lasts, or it says it lasts from like nine to twelve months right? Or like six to twelve months exactly. Even till now, I still have some in there from a couple of years ago. It's not wild. It is. Yeah, it is. So also the reason why I'm very cautious and I've never had undereye filler, and I would love to hear your opinion on that. Perfect. I actually have had under eye filler and I
did not like it. I was a resident, I did it even now, I think I still see a pocket, like, in some light. So to what you said about the lip, it's kind of that same thing of like, holy cow, yes, there may be my little pocket of filler. So under eye filler, again, it's just like that skin is so, so thin. And we think about what kind of happens when you place filler. It draws in a lot of water, even if they have cross linked it, try to minimize that. And I think for some people, that's why they
don't like how puffy it looks. It can cause methatic obstruction. Let's get those words out. Or like that tindall effect where you kind of see that blue gray under the skin. For me, when I'm thinking under eye surgery is obviously always in my back pocket. I'm a surgeon. Go with what you
know. It's going to be the gold standard. But things like fat grafting, things like nano fat, things like PRP or PRF, and lasers can be really, really nice to rejuvenate that area, keep it really soft without having to go to surgery and won't have that kind of just like filler, pillowy puffy look. Mhm. Now that you touched on it, I think this would be the perfect point for us to talk about the nano fat grafting. I love Nanofat, so I really want let's go into it. Let's do it.
So let's talk about nano fat grafting. What is it and what's the difference between Nanofat and regular fat? Yeah, so nano fat is kind of like a continuation or like a further refinement of fat grafting. Your listeners and you do such great work of bringing the best of the BBL surgeons to light and all of that. So we know about fat grafting, right? We can take that out, put it in different areas of the
body to help replace volume. Those bigger clumps of fat are surrounded by little stem cells, little pieces of our vascular system, and the supporting immune cells and growth factors that all add to the fat growth and help it stay and live where it is. Then early in the 2000s, someone figured out that if you take that fat and you process it through progressively smaller filters, you're left with just the stem cells, those vascular precursors, those immune cells, and those growth
factors. So that's what the core of Nanofat is. Nanofat is really thin, almost like a PRP or a PRF. The difference is, while PRP has a lot of growth factors, it's not really rich in stem cells while Nanofat is. So we know from looking at the cells under the microscope, it causes more collagen growth and that leads to that, like, nice tone, texture changes, as well as decreasing some of the dark spots. Beautiful. And I think let's tell our listeners real quick, what's the difference between PRP?
Which PRP? They draw your blood. We spin it in a little centrifuge and we get this gold liquid out uh, the plasma, and everything gets separated. We pull it out. And that's what we use with nano fat grafting. You do a little bit of fat grafting, like a regular fat grafting, then you run it through the different filter systems. And then let's talk about PRF. Perfectly said. So PRF, I kind of view as PRP's glow up, and it has to do with how you process it.
So with PRP, you have to add additives so they kind of clump. And so that way, when you spin it down and collect the goodness, that kind of comes out of the blood, and you can get rid of the waste, the water, the plasma, et cetera. And you're left with, like you said, that liquid gold. PRF is a different way in which you process it, and it actually has been shown to have a higher level of those growth factors. So you take it the same way, get the blood, bend it down, et cetera.
But different companies and different surgeons have their own techniques to harness the PRF versus PRP. And the PRF, it almost feels like a little bit thicker. It's more like jelly like versus the serum of a PRP. And then a little bit of thickness of fat grafting. So they're all different textures. They all look different, but they do kind of different things. Yeah, exactly. Like a Venn diagram, like some
overlapping areas. That's a perfect way. And the texture thing is a great little nugget for everybody. What would you say are, like, the best benefits of Nanofat grafting? Uh, does it, for example, if I were to have some Nanofat grafting, like, all over my face, what would it do for me? Yeah, I mean, one is that it comes from you, right? So we talked about kind of some of the puffiness and limitations of fillers and all that. So one, it's your own stem cells. People oftentimes get
really impassioned about that. It kind of makes more intuitive sense if it came from your body. Less of an immune response. It kind of feels more natural. Natural. The benefit would be improved collagen formation. So with collagen, you'd see less wrinkles. Think of those fine, creepy crows feet or maybe early wrinkles around the eyes. We also see some increase in the thickness of the skin. So volume, right? Not volume in the sense of, like, fat grafting, where you're placing deposits of fat,
but just kind of that plushiness and thickness. If you look at 20 year olds, they just kind of have intuitively you see that their skin is a little bit thicker than at 60. And we know this is true because of the aging process. So you see increased thickness, that, like, texture that bounce back, and some of that glow that comes from increased collagen. So we've talked a lot around the eyes. I also love to use it, um, in those, like, barcodes
above the lips. Right? Everybody hates those. We used to call them smoker's lines, but thankfully less people are smoking and even people who have never smoked get them. Maybe straw lines. Straw lines, that's cute. I like straw lines and technique too. Right. We're all looking down at our phones. So like those horizontal lines in the neck, those are great uses. Areas of use too. Perfect. So once you get it done, how long is the recovery? Yeah. So with the actual injection site, I like to
compare it to how deep are we going? If I'm injecting it in fine land and wrinkles and using like a really small needle, it'd be about the recovery of the injection site. Like you would think of a botox needle, right? Maybe a tiny little prick. They wipe it off with a little alcohol at the end of the case. Mhm, signs of that are gone. You may have just like a little bit of swollen in the area. If we're going a little bit
deeper injecting it in that more middermis. And so kind of think of it, how invasive was it to put it in? And that will clue you to what the recovery time is like when thinking about your face. We talked about you can inject nano fat in the skin. You can also use cannulas and kind of layer it in. You can microneedle it in, right. Just like you do with PRP. And if that's the case, the downtime is going to be the same as the micro needling, not really the fat. You can also apply it topically
with laser. So again, you choose your downtime based on the way that you got it into the skin for the donor site. Because I'd say one of the biggest drawbacks is that it does require you to borrowing from somewhere else. Right. But like I said, there's no free lunch. We got to pay for it somehow and that is more dependent on how much we take. Right. If you need more volume, may have to take a little bit more. And there's just like the
risk of bruising. The little incision site closes with just a dissolvable stitch, so you don't need to worry about that. It's just like a little needle, you know, entry point, maybe a little bruising, a little bit of swelling. But we tend to take it in areas that you can hide pretty well. Lower belly, inner thigh, outer thigh, things that are going to generally be covered. Nice. And what are some common complications that somebody who has fat grafting to the face could see?
Absolutely. So this kind of gets on to different principles that we have if we're doing traditional fat grafting. And I do just kind of want to like bring in the whole umbrella, bring it back. Since we talked about facial rejuvenation and we mentioned that some of that is putting fat back in the face where you've lost it. Always anytime someone's touching your face, there's a risk of bruising, swelling, infection, and a little bit
discomfort. Right. We're pretty blessed in the face that generally pain doesn't really come to play. And in fact, I usually tell my patients, like, if they're hurting, I need to know, because that's usually on the rarer side of complications. Yeah, because all those little nerves and stuff are not disrupted or they're transfected, so that they have to grow and find their friend on the other side. We're blessed with a lot of numbness. Like when you think of a facelift or a rhinoplasty
and all of that. So that's why I tell them, it's like, you're hurting. Call me, because that's not really what I'm expecting to be talking about. Kind of like the generalities then, to get into the specifics of fat grafting, it's technically a free graph, right. We took the cells, and we're putting them somewhere new. So if it's the big clumps of fat to volumize the face, they need to grow their blood supply. And we know that that depends on nutrition status and age. So there's a
little bit of fat loss. So if I put two CCS of fat in your cheeks, someone who's a really young, healthy marathoner with a really high metabolism, they may metabolize all that fat before it can get to grow a blood supply. Each surgeon will tell you a different range of, uh, what gets absorbed. But generally, I kind of like to quote around 20% to 30% while fat will absorb. So what does that mean? It kind of means that one of the quote unquote
complications is a little touch up procedure. If you're in love with how much fat we put in, but then a little bit resorbed, sometimes going back later and just topping it off, that fat will then stabilize because it kind of already had a chance to grow its blood supply. The other complication that potentially could come into play with traditional fat grafting would be like lumpiness, right, that maybe would need massage or maybe even to have a little bit of microliposuction. And
that's really technique dependent. And so, obviously, talking to your surgeon and having them describe in detail how they will use the fat will help kind of you feel good about that nail fat. Luckily, there really isn't the same risks of fat grafting in that sense of traditional, because it's almost more like you mentioned that liquid
gold of a PRP PRF. The worst quote unquote complication would be like, maybe you were hoping for a knockout improvement in the skin, and you've got a really great one, and you need, again, just to go back, just kind of like with micro needling and the other stuff, what are we hoping to achieve? I love that. Okay, now we know that bringing volume back into the face helps keep us looking youthful. The second thing that you mentioned was the skin. So I have it here, like, in big black letters.
Talk about the importance of skincare for a youthful face. I love it. Skincare is everything. And luckily there are so many good product lines and things that you can do for your skin at every price point. And so many really great dermatologists who have built their entire social media presence about educating on skincare. So just getting on there and getting it from the source, from a board certified dermatologist and plastic surgeon is
just the best. But it boils down to what can you do reasonably and like, major on the majors, focus on what you can reasonably do. Number one across the game is going to be sunscreen. If you can wear a sunscreen and prevent the changes that are going to cause you to age, it's the biggest bang for your buck you'll ever achieve in your entire life. The sunscreen is end all, be all. And again, they have that at all price points, right? You can walk
into Target and get a great sunscreen. Or if you look kind of like that packaging and the fragrance, they make some really lovely ones in that camp too. So sunscreen, sunscreen, sunscreen. Then the second thing I would layer in would be like a Retina, right? Or Retinoid, some derivative of Tret that we know from long, long longitudinal studies. Helps with collagen production and stiffing off antiaging. Those are kind of like this one's. The secret one that well, not the secret, but this
one's getting on a Retina. Retinol or retinol. And that's the secret sauce. That's it. That's it. Absolutely. And it's just going to make everything you do look so much better because you're going to kind of have that just like we talked about. That like, young skin glow that's really hard to replicate with other means. Just keep it while you got it. Keep it while you got it. And, um, my thoughts on it is like, let's try to do everything before I
get there. So taking care of my skin. I have some appointments scheduled for some microneedling lean, a little bit of broadband light treatments. The BBL treatments. It's called BBL, but it's not the BBL that you all know the difference, right? It's a little bit different. So I think for me, that is how I'm going to tackle my aging concerns. I'm going to go with the nonsurgical, like skincare laser treatments and try to get it as tight as I can until I'm ready for my facelift.
Exactly. Same. That's what I'm out here doing, too. You're like, I'm just trying to maintain what I got. Maintain what I got. But until it's Facebook time, because, heck yeah, I'm going to do it. Heck yeah, I'm going to do it. Actually, I was looking at it before and after picture of a facelift and I was like, I'm going to get a facelift one day. I know I am. I know I am. So thank you so much for coming on the show today. I think you gave us so much. Just awesome, juicy
information for our listeners. One last thing I want to mention or I want to ask for your opinion on is after a face procedure, like a face lift, a neck lift, or any type of anything on their face, do you recommend lymphatic massages? I do, yeah. So I think that there's a lot of, uh, lacking and a lot of areas of improvement in that post surgical time that we could actually gain from in the face when looking at what people who are really good at body surgery to implement and
do. So I am a big believer in lymphatic massage and things like washa and all those, because intuitively, it just makes sense. We know during surgery, we had to make cuts, right, and lift and put the tissue back up in a new place. So those lymphatic channels have to grow and connect with their little friends on the other side. And while that's happening, there's going to be a period where your body just doesn't keep up as much with
that lymphatic fluid. So doing lymphatic massage would help while those channels are recantulating and kind of getting back up to speed. So I love, love, love it. Okay. Try to use it as much as I can. Good. That's what I love to hear. I love getting all the surgeons that come on. I like getting their opinion because, uh, as you know, there's such a wide range of opinions. So I like for our listeners to hear what everybody thinks. Are they
saying, let's do it? Are they saying, Hold off? So I'm happy to hear that you do recommend it for your patients in their recovery journey. Of course. Yeah. And it said that balance, right. There are some of my patients that they're like the go getters. They're chomping at the bit. Like, we took the last stitches out, and they're like, ten days after surgery. And they're like, okay, great. When can I start my massage? For them, you kind of have to be like, whoa, whoa, these things
are still healing. We're still very fresh, but that duo is kind of balancing. Okay, when do we go? So I start people pretty much as soon as they can, and everyone's a little bit different. Maybe a month, six weeks after surgery. We're doing it. Okay, I'd love to hear that. So for all our listeners who want to come see you, for either facelift, uh, or fat grafting, any of the procedures that you offer, where can they find you? Yeah. So? I mean, you mentioned I'm from Tennessee.
I'm located here in Nashville. Really easy to get to from all areas of the country. Check me out and kind of see what our practice is about. My website is Harmonysurgery.com, shortfall name Harmony, facial plastic surgery, but usually on social media and all of that. I'm just using my name, and it's kind of same everywhere you go. Instagram. TikTok, um, everywhere. It's just Dr. Kate O'Connor kept it real simple. Nice. And we'll include your tags in the
description. We'll link your website and your Instagram. You guys go check her out. I love the results that she's giving. I've heard from patients that she gives amazing natural results. And you all know that's exactly what I want for you all. And with that, we end the episode, and I'll see you all next week. Thank you so much for coming on the show. Uh, thank you so much. I was absolutely delighted talking to you. Thank you. We'll see you. Bye bye.
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