Dallas Surgical Arts

Fat transfer vs fillers. What is the one best for you?

One of the first signs of aging is loss of facial volume. There is a loss of fat under the eyes, around the mouth, and in the cheeks.  This volume loss starts in our early to mid-thirties, mostly evident by a shallow hollowness under the eye, and early signs of dark circles around the eyes.  It progresses with brow and cheek drooping, and wrinkles around the mouth.

Today, these signs of aging and volume loss can be corrected with the use of a dermal filler or the injection of your own abdominal fat to the areas of the face where fat has dissolved.  The primary injectable fillers used today are Voluma, Juvéderm, Restylane, and Radiesse.

Juvéderm and Restylane are used mainly in the lips and lower eyelid/cheek areas where small-volume (1 to 2 cc’s) syringes of filler may be used. They are hyaluronic acid (HA) gels and best used for superficial wrinkles, volumizing the lips, and filling in the depression under the eyes. After adequately numbing the face with painless measures, the filler is injected through a very small cannula.  The procedure takes roughly 30 minutes with minimal pain during the treatment, and no pain following the injections.  You can expect little to minimal swelling and bruising. Your results are immediate, making your face appear more rested and refreshed. These products usually last 6 months or more once injected.

Voluma is an incredible filler that is very similar to Juvéderm, but is used to address the loss of volume in the mid-face.  One of the most noticeable changes is the loss of cheekbone definition. Historically, this was addressed with surgery to tighten the overlying skin and lift the deeper soft tissues. More recently, volumizing fillers have been used to provide a similar ‘lift’ without surgery.  Voluma is the first filler formulated with lidocaine that is FDA approved to restore age-related volume changes in the cheeks, temples, chin, and jawline. The cost of Voluma is slightly more expensive than other fillers, but it is worth the additional cost when comparing the duration of Voluma to other fillers.  The results are immediate and can last up to 2 years. The duration of filler correction depends on the facial area treated, the injection technique, and the rate that the patient’s tissues break down the filler.  In our practice, we recommend injecting two syringes on your first visit and then to touch up the areas six to twelve months later with an additional syringe.  This filler is also dissolvable with an injectable medication.

Radiesse is a filler that is also reserved for deeper placement near the facial skeleton. This can be used in the cheeks, chin and jawline, to fill in lost volume. It is not a gel, but more of a paste that allows visible results typically 10-14 months after injection.  However, it is not reversible and at times may feel bumpy or cause small lumps or nodules close to the skin.  Although this remains a great filler, Voluma creates a more natural, longer lasting result with a similar ability to volumize or fill the face without visible or palpable irregularities or bumps. This one reason why we prefer to use Voluma in our practice.

Fat transfer to the face is a single-visit, full-face rejuvenation for a price that is significantly less than using an equal amount of volume from filler.  Fat transfer is longer lasting than fillers (2+ years) and often semi-permanent after the initial swelling goes down.  This procedure requires an in-office IV sedation, where the fat is carefully harvested via liposuction and injected back into the face. Fat transfer is used for volume replacement, not to treat fine lines. Much larger volumes (20-60 cc’s) are used so the entire face can be injected. The brows, forehead, temples cheeks, chin and entire peri-oral area may be treated with a fat transfer. Fat transfer is often performed in conjunction with a facelift to achieve a natural result without having a “pulled” look. It also improves the overall skin tone and texture.

Fat transfer is a surgical procedure and has a recovery period with bruising and swelling that typically last 1 week.  The pain, similar to filler, is minimal. A fat transfer is often what a patient needs if they are concerned about their aging face, have already had a facelift in the past, and are not ready to proceed with a facelift.

Which is best for you?  This will largely depend upon your aesthetic goals.  Our focus is to perform a full-facial analysis, prioritize your needs, and keep the overall cost within reason for each patient.

Please call Dallas Surgical Arts Phone Number 972-776-4888 for your complimentary cosmetic consultation.

What causes puffiness in the lower eyelid?

The problem arises when the membrane under the lid becomes weaker with age and allows the fatty protective tissue around the eye to bulge forward. This pressure on the skin and muscles of the lower eyelid stretches them and causes noticeable puffiness or bags to form under the eyes. Unfortunately, this type of bulging can also be inherited as well and can start as early as young adolescence for some people.

This problem will never be healed by any topical cream or lotion. They may make the skin look smoother, but the underlying cause of puffiness needs to be treated.
Puffy and baggy lower eyelids can make you look much older than your actual age. Lower blepharoplasty combats the fatigued and worn out expression that prompts others to suggest that you need a vacation or a good night’s sleep.

In lower eyelid blepharoplasty procedure, fatty tissue is removed using a transconjunctival approach. This means that the surgery is performed through the inside part of the eyelid so that no external visible scar is created.

Before bleph after bleph

      Before                                                             After

Benefits of eyelid lift surgery include:
* A relatively low cost
* The procedure is done in-office in most cases
* Recovery is relatively quick

If you’re interested in learning more about the eyelid surgery (blepharoplasty) procedure, contact Dr. Randy Sanovich. Dr. Sanovich is cosmetic facial surgeon located in Dallas, TX. Call Dallas Surgical Arts Phone Number 972-776-4888 today to schedule your complementary cosmetic consultation.

Read more about the eyelid lift (blepharoplasty) procedure and view our before and after photos in the photo gallery

My ears stick out, what can I do?

Several procedures are available for altering the shape or size of the ears. Some ears protrude out too much and require the ears to be set back closer to the head. Other ears are too long or some earlobes are overly redundant. Other people suffer from torn earlobes often because of wearing pierced earrings.

Prominent, protruding or poorly shaped ears can be flattened, and contoured to a more elegant form with ear reshaping surgery. The cartilage in the ear is responsible for its shape. The cartilage is flexible and elastic so it can be bent but will return to its original shape. By altering the amount, thickness or shape of the cartilage, the contour of the ears can be permanently improved.

Computer imaging is usually performed before ear reshaping so that you can see what changes are possible. This helps you see exactly how you want your ears to look, and it helps Dr. Randy Sanovich determine the best technique to achieve your cosmetic goals.

Call Dallas Surgical Arts Phone Number 972-776-4888 to schedule your complimentary consultation!


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Lifestyle Lift Shuts Down Most of Its Business, Considers Bankruptcy

This headline, published in The Wall Street Journal on March 2, 2015, summarizes the demise of a national facial cosmetic surgical procedure provider that was the focus of many questions from our patients.

Some of our patients came to us after a consultation at the Lifestyle Lift center in Dallas. Many patients were disappointed because they had little or no time with a surgeon during their consultation at the other office. They compared the experiences they had at the Lifestyle Lift center with their experiences in our office, and were amazed at the amount of time Dr. Sanovich and Dr. McBride spent with them during their consultations. We feel that the different experiences are due to the patient centered approach that is the focus of our patient care, and is frequently missing in other practices.

At Dallas Surgical Arts, we encourage all patients to spend as much time with our doctors and staff as they need to understand their problems, the various treatment options, and the time, cost and potential improvements to be expected. Come to us for a complimentary facial cosmetic surgical consultation and experience the difference. Call today to schedule Dallas Surgical Arts Phone Number 972-776-4888! You will be glad you did!

Read full article published 03/02/15


Looking Young Without Surgery

The three changes that make us look older are the loss of facial fat, wrinkled skin and loose skin. As we age, our faces turn from plumbs to prunes. Now we can reverse these negative changes without surgery.

Fillers like Voluma, Radiesse, Juvederm, Belotero and fat produce fantastic results by filling in depressions and restoring the youthful contours we all want. And, by filling, we can tighten loose skin to help smooth wrinkles. Botox or Xeomin will weaken the muscles that cause wrinkles when we smile or frown. The combination can produce extraordinary improvements with no surgery.

These products are all extremely safe and last long enough to be practical treatments. With Dr. McBride & Dr. Sanovich techniques there is almost no discomfort, rarely any bruising, and consistently natural results. Give them a try, you will be very happy you did!

Come in for a consultation to see if these simple procedures are right for you. Call Dallas Surgical Arts Phone Number 972-776-4888 today to schedule your complimentary cosmetic consultation.


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Am I a good candidate for eyelid surgery (blepharoplasty)?

Any one, or combination, of the following conditions may indicate that you are a good candidate for eyelid surgery:

  • Excess skin obscuring the natural fold of the upper eyelids
  • Loose skin hanging over the edge of the upper eyelids, perhaps impairing vision
  • A puffy appearance of the upper eyelids, making the eyes look tired
  • Excess skin and fine, “crepe paper type” wrinkles of the upper or lower eyelids
  • Bags and dark circles under the eyes
  • Creases or folds in the lower eyelids


Aesthetic eyelid surgery (blepharoplasty) can usually correct these problems. This simple surgery can tighten the skin, smooth the wrinkles and recreate a youthful, rested, healthy appearance.

Other treatment may also need to be considered. If the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of the crow’s feet may be accomplished with Botox® or Xeomin, or laser resurfacing procedures. Dr. McBride & Dr. Sanovich can provide further information if you have an interest in any of these additional procedures.

If you’re interested in learning more about the eyelid surgery (blepharoplasty) procedure, contact Dr. Kevin McBride & Dr. Randy Sanovich. Dr. McBride and Dr. Sanovich are cosmetic facial surgeons located in Dallas, TX who have a combined 30 years of facial cosmetic surgery experience. Call Dallas Surgical Arts Phone Number 972-776-4888 today to schedule an appointment. Read more about the eyelid lift (blepharoplasty) procedure and view our before and after photos in the photo gallery

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