the full face; Stop obsessing over wrinkles.

Byline: Maggie Bullock

From her bright-eyed good looks to her crisp white jeans, Olivia* is every inch the chic, ageless Manhattanite: pretty, poised, clever-even with a not-so-tiny needle plunging swiftly into the skin above her cheekbones. With the concentration of a painter, dermatologist Patricia Wexler, M.D., jabs shot after shot into the contours of Olivia's face, molding each injection with her finger, occasionally stepping back to survey the effect. Her subject unflinchingly explains the miracle at hand: fat injections.

Ten minutes and two vials (6 ccs.) of fat later, Olivia's face is Wexler's best advertisement. Only slightly irritated, it looks minutely more filled out, subtly more youthful. Her lips are noticeably more defined; the fine lines around her eyes have softened. "People are always asking how I look like this at my age," chuckles Olivia, pressing ice to her cheek. "My friends all know I'm 50. They don't know I've been coming to Pat for years," she says. "Fat injections give me back a little baby fat. They make me look softer, like I've gotten about five years of sleep. It's a difference you can't put your finger on. Surgery can't do this." And with that, Olivia walks out of Wexler's office looking exactly the way most women would kill to look at 50: refreshed.

Though they're hardly cutting-edge-Wexler has been performing them for eighteen years-fat transplants, along with the new wave of high-tech fillers, are now more relevant than ever. In contrast to the "wind tunnel" aftermath of aggressive surgery, the focus now is on restoring the volume lost with age. As doctors reconsider what it means to look "young," they are coming to the conclusion that fighting age isn't as much about tightening skin as resurrecting the full, rounded contours of a youthful face. Some call it the 3-D face.

The 3-D face is soft and dimensional; it is the opposite of the inevitable 2-D face-characterized by the sunken cheeks, slack chins, and hollow-looking under-eyes that seem to deepen with each passing year-which results not from gravity but from a process called facial wasting. This gradual breakdown of skin, muscle, fat, and bone occurs throughout the body but most obviously in the face and hands. It makes itself known at the 30-to-35 mark, when naso-labial folds (the creases that run from the corners of the nose to the corners of the mouth) appear. "Think of a sofa," explains dermatologist Fredric Brandt, M.D. "What would happen to the fabric if you took out the stuffing? Look at a photo of yourself in high school or college. The youthfulness in your face, your cheeks and chin-that's what we want to put back."

NEEDLE KNOW-HOW

The process of "putting it back" is most often delivered by a needle. Wexler's Park Avenue office houses three industrial freezers full of hundreds of vials of fat. She liposuctions the fat from her patients' "harvesting areas"-generally outer thighs and stomachs-and stores it for up to one year. Wexler aims for 40 to 50 percent of the fat injected during initial sessions to graft permanently to the face. Patients then graduate to a maintenance plan, returning for touch-ups as needed.