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2025.08.24
Hamra or liposuction + fat transfer? Which one?
A dual-specialty doctor with a background in plastic surgery, bridging cosmetic surgery and ophthalmology. At the university hospital, he performed numerous high-difficulty cases, primarily focusing on eye and facial bone surgeries, cultivating precise techniques grounded in anatomy. He prioritizes achieving both aesthetic beauty and functional safety, offering customized treatments around the eyes that incorporate ophthalmological expertise. He actively utilizes not only incisional surgery but also non-invasive procedures like hyaluronic acid injections. By carefully assessing each individual's condition and unique appeal, he provides bespoke treatments that guide patients toward naturally harmonious, well-defined eyes.
This blog answers the question: Is it better to go with the back of the thigh or fat removal + fat transfer?
Please also refer to past blog posts!
A Blog Explaining Bear Treatment in General Terms https://biancaclinic.jp/blog/43093/
Explanation Blog on the Ura Hamura Method https://biancaclinic.jp/blog/43209/
Conclusion: When in doubt, go with the reverse Hamra! (Doctors may have different opinions! This is just my personal view.)
①: Orbital fat bulge ②: Tear trough ③: Mid-cheek groove
・Bulge at ①
・Looseness of the ligaments below ② and ③ + indentation caused by reduced surrounding fat between ② and ③
When the resulting unevenness becomes noticeable, dark circles appear.
① acknowledges that even individuals in their teens can have high body fat levels,
The grooves in areas ② and ③ are formed because ligaments connect skin to bone; particularly with age-related changes, when bone atrophy occurs, the skin also sinks in.
② typically begins to deepen gradually from around the age of 20, while ③ starts to appear around the age of 40.
① When there is protrusion of orbital fat + ②/③ with pronounced depression,
I actually think this is the most common pattern.
There are two solutions.
◯Ura-Hamura Method
Cut the ligaments causing the skin in areas ② and ③ to be pulled inward and create a depression, thereby releasing the pull while placing the bulging fat between them.
◯Fat Removal + Fat Injection
Remove the enlarged fat in area ① through liposuction.
②③ Fill the indentations with fat grafting
So which one is better?
If the surgeon is experienced with the procedure, I believe the results will be excellent.
The fat graft survival rate varies from person to person. Since it's difficult to reduce excessively injected fat, we inject an appropriate amount or slightly less. Therefore, it may take about two sessions to completely eliminate the indentations in areas ② and ③.
Since fat removal plus fat grafting does not release the retraction of the causative ligaments, as skin retracts with bone atrophy due to aging, areas ② and ③ may become sunken.
Therefore, my view is that we should release the ligament retraction using the reverse Hamra technique.
However, even when the indentations in ② and ③ are pronounced, there may still be insufficient volume.
Especially ③, the so-called Gorgon line cannot be improved with a reverse Hamra procedure. In such cases, combining it with fat grafting yields more effective results.
In reality, however, the Urahamura alone is often quite satisfying.
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Summary
Considering the Kuma principle, the reverse Hamra method is thought to be a treatment with a low recurrence rate when used alone.
If you're concerned about depressions that cannot be fully filled even with the Hamra technique, consider combining it with fat grafting.
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※There are various approaches to aesthetic medicine, and opinions and practices may differ among physicians. Please consider the information provided here as one reference only, and we hope you will choose medical care that suits you and meets your expectations.
We apologize if any unintended inaccuracies or misleading expressions were included. In such cases, we will make appropriate corrections or additions.
【Profile】
Plastic Surgeon Dr. Ryutaro Natsume
https://biancaclinic.jp/doctor/natsume/
Performed numerous facial surgeries, particularly focusing on the eye area and facial bones, in the field of plastic surgery.
Regarding treatments for the eye area, I believe that not only aesthetic appearance but also ophthalmic functionality is extremely important. To provide safer and more reliable treatments, I am currently deepening my expertise as an ophthalmologist.
We actively incorporate non-surgical procedures such as hyaluronic acid injections, in addition to treatments requiring surgical instruments.
From a multifaceted professional perspective encompassing cosmetic surgery, cosmetic dermatology, reconstructive surgery, and ophthalmology
BIANCA CLINIC, a leading Japanese clinic specializing in beauty and regenerative medicine, provides the latest aesthetic treatments.
【Career】
2020: Graduated from Tokyo Medical University Tokyo Metropolitan Saiseikai Central Hospital
2022 Jikei University Hospital Department of Plastic Surgery
2023 Department of Plastic Surgery Jikei University School of Medicine Kashiwa Hospital
2024 BIANCA CLINIC
【Professional Affiliations/Qualifications】
Japanese Society of Aesthetic Surgery (JSAS)
Full Member of the Japan Society of Plastic and Reconstructive Surgery
Full Member of the Japanese Society of Craniofacial Surgery
Full Member of the Japanese Ophthalmological Society
Full Member of the Japanese Society of Aesthetic Medicine
【SNS】
Instagram account
https://www.instagram.com/dr.natsume?igsh=OHBvd3VtajV1bmY1&utm_source=qr
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