WHAT do eyebags and Christmas decor have in common?

They?re both called ?festoons,? because they form a curve between two points. While decorative festoons brighten up a place, the fat pads in the eyebags weigh down the face, giving off that world-weary look.

The usual recourse is to undergo lower lid blepharoplasty (eyelid surgery), which removes the excess fat and redundant skin.

As eyelid surgery and nose jobs are the most popular procedures in the country, Dr. Rene del Castillo Valerio espouses the use of the individual?s tissues to improve his or her looks. Valerio is head of the reconstructive and aesthetic surgery departments of St. Luke?s Hospital and the cosmetic surgery of Beverly Hills 6750 Multi-Aesthetic Institute.

Relocating fat

He points out that autologous fat transfer will be a major cosmetic surgery trend. This is a technique in which a person?s own fat is used to plump up sunken or gaunt parts of the face or boost measurements where desired, such as the breasts.

It?s cost-effective because it comes with liposuction, where fat is zapped from unwanted parts and then pumped into areas which need perking up.

Fat transfer has become a preferred method of facial volume enhancement for patients who are sensitive to traditional dermal fillers such as restylane or collagen. After liposuction, the excess fat is processed and then injected into the deep lines and wrinkles, depressions under the cheeks or thin lips, for a fuller look.

One advantage of volume enhancement using fat injection is that there is no chance of allergic reaction since it comes from the patient?s body.

Valerio says that in conventional eyelid surgery, the removal of the fat pads results in hollowness under the eyes. Ironically, this method of rejuvenation still makes the individual look older. On the other hand, relocating the fat to the tear trough (the area that covers the open socket of the eye or where you apply under-eye cream and concealer) gives a more pleasing contour to the eyelid, and consequently a well-rested look.

Breast uplift

Valerio has also been substituting the patient?s fats for implant augmentation mammography. Fat grafting to the breast is an alternative treatment for such concerns as abnormally small breasts, droopy breasts due to aging or childbirth, and asymmetric breasts (one breast is smaller than the other).

The process consists of moderate liposuction in places where there is excess fat. In Filipinos, it?s normally the puson or lower abdomen and the thighs or saddlebags. The fat is segregated and cleansed, then placed in a syringe and injected into the breast.

?I inject about 150 to 200 cc of pure fat for each side of the breast. For every 200 cc of fat, as a rule, you gain a cup size more. The surgery takes about two hours. The recovery is faster?about two or three weeks. You wear an elastic garment support over the area where the fat was harvested and in the breast. The support is worn for four weeks. It will have to be retouched after three to six months, until you reach the desired cup size,? explains Valerio.

He estimates it would take two more procedures get a C-cup from an A-size. ?You can only inject 200 cc of fat at a given time. Fat has to survive, otherwise it will liquefy.?

This procedure is still in its infancy stage in the country; accurate, enduring results of fat transfer to breasts still have to be observed. Nonetheless, the initial results have been softer, more natural-looking breasts, though the repeated touch-ups may seem time-consuming compared to implants, which are replaced every 10 years.

Gel implants are still preferred by women. Now on its sixth generation, the USFDA-approved gel implants cost about P37,500 a pair and won?t leak or slosh. However, Valerio cites the drawbacks of implant augmentation, such as breast hardening or capsular contraction, implant deflation, and infection.

?You?re talking about a foreign body versus your own tissues. Choose between the two,? he says.

Nose lifts

Even in nose lifts, Valerio has been a proponent of using the patient?s own tissues instead of implants. In rhinoplasty, he uses the patient?s cartilage taken from the back of the ear, which regenerates after a month.

?Traditionally, we used silicon or Gortex implants, which are synthetic materials, to augment the bridge of the nose. By using the conchal (external ear) cartilage, you avoid complications like the rejection of the implant. There?s also faster recovery.?

Most of cases Valerio handles are either repairs of botched surgery or people who want to feel more secure about their looks.

Still, a case close to his heart is that of Lea Cabanillas, an indigent patient who expressed her desire to look normal in the TV show ?Wish Ko Lang.? She was born with hemangioma, a tumor in the blood vessel. Surgery was done at a young age using cryo or dry ice therapy.

Although she was healed, the cryo surgery brought about defective skin growth, noticeably in her cheek. The vestiges of the procedure made her look emaciated.

Valerio plumped up Cabanilla?s face by transplanting fat over the cheeks, jawline, nose, chin and lower eyelid. But the biggest reward went beyond her physical transformation. It restored her confidence.

?Her eyes are now happy,? he says with a smile.