Peter Attia· MD
But also remember that we're just talking about your under eyes, but let's say you're my typical patient. They need their temples filled. They need their cheeks filled. They need their chin filled, jawline enhancement. So, yesterday I did about 35 40 mls of fat on my patient. So, that if you were to multiply that, it gets very expensive. Um, are my temples too sunken? Yours are still good. So, and your cheekbones are still good. Your jawline is still good. I would put a little neurom modulator or Botox in your platisma muscle because I am starting to see some platisma banding there. Mine's worn off. So, you don't want to look at mine. Um, but that helps to relax that muscle that does nothing but pull lower to the lower face down. And I would possibly add a little volume right in your mar. In your case, I would love a bio stimulatory filler, something like polyelactic acid or sculpture is the other name for it to start building collagen and thicken your dermis thickness in here because I'm starting to see some of your buckle fat pad atrophy as well. And that just goes along with how fit you are. So using this to build your own collagen is a great way because and if you were a female, very thin, we would have an issue because those patients tend to burn through their fillers very quickly. So, if we can get a bioimulatory filler on board where they're building their own collagen, sometimes that works a little better. Now, do you ever look at a patient like me and say, "You're you're most fat depleted here and here, but you're not yet fat depleted here and here. I I only want to do one fat graft on you. So, let's cost aside. Let's use fillers until I have to do this procedure once and for all and then I'll literally just take a bunch of fat off you and do it or absolutely is that a better approach or do you are you afraid to do multiple fat grafts? Oh no. I have patients that come for fat grafting as they need it. So I've done some patients three, four times, but I have turned down a lot of patients who come in actually asking for a fat grafting for lips or for under eyes and I tell them that since they don't need it elsewhere, that's too much of a procedure to go through for like one anatomic area and in the lips it doesn't hold as long. But under the eyes, it works beautifully. But I would do it when they need it elsewhere.