(603) 775-7444
137 Portsmouth Avenue Stratham, NH 03885
(603) 775-7444

Plastic & Cosmetic Surgery Skin & Laser Center

January 2018

Facial Fat Transfer: what is it and how can it benefit you?

Fat transfer remains a valuable option for patients desiring a more natural improvement in facial contour and fullness.


Fat transfer uses your own tissue as a graft to improve facial volume and contour. Often patients are seeking facial and dermal fillers which provide temporary improvement at a significant cost with side effects such as delayed swelling or an unnatural look. Fat transfer is an alternative that reduces these complications (although it has it’s own risks ). Fat can be transferred into the cheeks, cheek bone area, temples, eyelids, lips and lower face (marionette lines).


Fat is harvested from your abdomen or hips using local anesthetic It is then processed and transferred to small syringes which are used to inject the fat into the desired areas. The procedure can be done under local or general anesthesia depending on patient and surgeon preference.

Fat is transferred as a graft. This means it does not have its own blood supply, and the expectation is that it will develop its own blood supply in order to become permanent. Some of the fat will not survive. Typically patients can expect 40 – 50 percent of the fat to survive the transfer process. Once the fat has taken, the result is permanent. This is in contrast to most dermal fillers which are temporary. In general, fat that does not take simply disappears. Rarely, it can form lumps or calcifications.

Learn More. 

Contact us today and schedule a consultation with Dr. Zeff to determine the best approach to provide natural correction to facial volume loss.

All about lip lines and how to get rid of them.




Lip lines are one of the more common complaints in our practice. Here’s our recommended treatment plan to best get rid of them.



Successful lip line treatment is multimodal. This means no single treatment will provide the correction desired but rather a series of treatments will be required to obtain the best result. Lip lines are best addressed with (1) Filler, (2) Botox® or Dysport® and (3) Resurfacing.


Filler – Volbella® and Restylane Refyne®


Wrinkle formation is a complex interaction of structural tissue support and muscle pull on the tissue. Filler addresses issues of structural support. New fillers such as Volbella® and Restylane refyne® are specifically designed to provide this support in areas with significant movement such as the mouth. Filler is placed directly in the lip lines and underneath them to return the support that was present in youth. In our practice we frequently use Volbella® in the aging lip. This product spreads uniformly with low risks of lumps and does not provide excessive volume to the lips. Additionally, the water attracting nature of Volbella® provides an almost internal lip gloss. Volbella® can last up to a year after injection. Patients who are interested filler to the lips should avoid any medication that can increase bleeding risk. Patients should also do this on a day when they do not have any special events planned – lip swelling can last for 48 hours.




Neuromodulator – Botox® or Dysport®


Botox® or Dysport® block muscle movement around the mouth. Muscle contraction is the predominant reason for lip lines. Injection around the mouth is difficult and requires experience. Small amounts of neuromodulators are needed to have sufficient effect and reduction in wrinkle formation. Patients fall into two categories with respect to the treatment: love it or hate it. Some patients feel as though it affects the way they speak, making them self conscious. Typically, neuromodulators last approximately 2 to 3 months around the mouth.



Resurfacing – Microneedling, Ablative Laser, Chemical Peel


Resurfacing removes the top layer of skin but more importantly stimulates collagen production in the dermis. This collagen production reduces wrinkles and provides structural support much like filler. Microneedling is the least aggressive while a phenol peel and fractional laser are the most aggressive. More aggressive treatments result in more impressive results but have longer downtime.



Ultimately, all three treatments, filler, neuromodulator and resurfacing should be used in combination to treat pesky lip lines. Schedule your consultation today to meet with our surgeon to discuss your treatment plan.

What are you waiting for gents?

Stress, sun, beer (sorry, but it’s true) and time take a toll on our faces (and bodies). There are many options to both prevent and treat the changes brought on by these factors. Here are some answers to commonly asked questions and concerns for male patients.

1.       How can I treat the fine lines, age spots and redness of my face?

Good skin care is essential to both prevent and treat these concerns. Skincare should start with a retinol and a vitamin C (topically) followed by sunscreen. These three agents will both slow down the aging process and improve the skin texture. In addition, Botox and Dysport, will help soften lines around your eyes, brow and forehead. Botox and Dysport are neuromodulators which suppress muscle activity and reduce the strain on your tissues. Treatments are typically three months apart and the cost varies based on the degree of muscle suppression desired and the number of areas treated.  Try your first 20 units on us!

 The addition of retinol and vitamin C to your regimen will certainly help decrease sunspots and redness but they will not eliminate them. To treat these concerns completely, a more aggressive resurfacing will likely be needed and possibly light therapy. Certain prescription agents can further reduce the redness depending on the cause.

2.       My double chin makes me look heavier than I am. Is there anything I can do for this?

You are not alone with this concern! Over one-third of the population feels the same. A heavy neck not only makes you seem heavier but it also camouflages the chin making your profile look weak. Treatments for this concern range from non-surgical (Kybella) to surgical, either a neck liposuction or a necklift. A consultation with a surgeon will help you determine what treatment will best correct the concern.  Please see our prior post on Kybella to learn more about this injectable treatment.

3.       Can I still look natural with these treatments?

Yes! No one in our region has any interest in an artificial look. Our goal is to provide change without drawing attention. This applies for both surgical and non-surgical procedures. Often a combination of procedures will provide the best and most natural outcome.

 It is important you seek out a provider with experience in treating the male face. The shape and structure of a male face is different from that of a woman. Practitioners who do not frequently treat men may over-feminize the face without that being the intent.

4.       It’s not my face but my chest and abdomen that bother me. What are options for this?

Body contouring is common among male patients. Procedures range from liposuction, lipo-etching (creating the appearance of abs), abdominoplasty and gynecomastia treatment. Most of these procedures can be performed with limited downtime.  A consultation with a surgeon is the most appropriate way to learn more about options to make you more comfortable with your body.

What Our Patients Are Asking About Facial Enhancement Procedures

What are the best alternatives to a face lift?

Generally, there are no equal substitutes.  Every alternative does something different. A facelift tightens the skin of the face and neck as you might do with your fingers by gently pulling back towards your ears. This takes away excess skin and most wrinkles but doesn’t alter the actual texture of the skin. Injectable fillers can fill out indentations or creases but can’t compete with facelift with regard to tightening or restoring more youthful lines. >BOTOX® Cosmetic simply stops the undesirable creases associated with some facial expressions.

What is the best treatment for under eye wrinkles?

When very subtle, these lines might respond to topical creams. For more severe lines especially when associated with bulging and excess skin, surgical options include blepharoplasty and laser skin resurfacing.

What’s the difference between popular wrinkle fillers? There are so may “wrinkle fillers” like Restylane, Juvederm, etc.  How can I pick the right one?

Restylane and JUVÉDERM are very similar products manufactured by two different companies. It’s generally a question of personal preference. Fillers can differ in how long they last and how effective they are for different areas.  What’s effective for lip enlargement might not be best for a crease.