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The Evolving Face of Rejuvenation


Both tailoring and delivering natural-looking results requires strategic product selection, placement, and effectively managing patient expectations.

This is part 2 in a 2-part series

Part 1: Pivotal Changes in Facial Rejuvenation

Another pivotal change took place in 2014—one that questioned the definition of beauty and the inherent challenge in creating it within a broad range of ethnicities.

“We realized… we have an international community, and it's a melting pot of Houston and Texas and of the U.S. Everybody looks more and more assimilated,” says Dr. Chilukuri.

Again, it’s understanding the three-dimensional aspects of facial change that is key.

“It's understanding what the change is going on three dimensionally and understanding what's happening with the bony changes as well as the muscle changes, and how can we recreate and lift this back up and get the structural support that's needed,” he says.

At the same time, facial rejuvenation is an ongoing process.

"We know if we don't continue with this work, continue to enhance that patient or keep them looking youthful, things are going to change and shift," he says.

Ultimately, natural-looking results come from strategic anatomical approach.

“We want to respect the anatomy,” Dr. Chilukuri says. “We want to make sure that we're using the products that are going to best give [the patient] either anterior projection or structural support.”

Tools for Facial Rejuvenation

Tools include neuromodulators, fillers, and energy-based devices.

“I think fat is an incredible tool that we have. I think it's something that's very inexpensive,” says Dr. Chilukuri. “We're going to harvest this fat, and we're going to reinject it.”

And it saves on practice cost compared with injecting 20 cc or more of dermal filler, he says.

“[Fat harvesting is] done under local anesthesia—we're doing this in our office with tumescent anesthesia—and it takes a total of about an hour-and-a-half to two hours.”

Fat processing systems abound, and it’s simply a matter of finding one that works best in your practice, he says.

“My only purpose here is just to make sure that you understand that we have lots of tools,” says Dr. Chilukuri.

And those tools can be used to improve patient results and experience over the course of time.

“We want to make sure that we showcase those results and understand that it's not just what you put in, it's where you put it… Manage those patient expectations, and really understand what you can do with that patient journey.”


Rohrich RJ, Pessa JE. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plastic and Reconstructive Surgery. 2007;119(7):2219-2227.

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