Fat Transfer FAQ
What is fat transfer?
Fat transfer, also referred to as autologous fat transfer, fat augmentation, or fat injection, is a procedure which uses a patient’s own natural fat to treat unwanted wrinkles and creases or to provide additional volume and shape to the face, buttocks or liposuction defects from prior surgery. While injectable fillers such as Restylane® and Radiesse® are good options today for replacing lost volume in the face, fat transfer is often preferred in cases where a more significant amount of volume enhancement or replacement is required. Fat transfer is commonly used to treat the lower eyelids, cheeks, nasolabial fold and jawline.
In what areas can be fat be grafted in the body?
Any area where fat exists underneath the skin.
Who is a good candidate for fat transfer?
Fat transfer is often preferred over injectable fillers like Restylane® and Radiesse® in cases where a more significant amount of volume enhancement or replacement is necessary.
Where is the fat removed from?
Areas where you have an excess of fat. It should also be an area where a reasonable amount of fat can be removed, unlike the knees or arms.
Are all areas on the body equally good sources for fat?
Soft and non-fibrotic fat is best, usually from the central abdomen. Areas of previous liposuction with scarring are not good.
How many sessions of fat grafting are needed?
As many as it needs to obtain the results desired. In the lips and laugh lines it often may take three sessions, but one may work. All other areas are usually successful in one session.
What is the science and theory behind fat grafting?
Fat cells are very delicate and fragile and only loosely connected to their blood supply. The cells are harvested very gently with a syringe and needle, then prepared, then injected into the treatment site in many small crisscrossed tunnels (microfat grafting). The fat cells survive and keep their volume if and when the new blood supply grows into them.
What factors determine the feasibility of fat grafting?
The anatomy and contour of the area to be treated, how much fat is available as a source for transplantation, how much fat is available to graft once it is harvested and prepared, and how much fat actually survives once it is transplanted.
How much fat is usually available for fat grafting?
This depends on your body. If you have a lot of fat, it is easy and usually taken from the hips and/or abdomen. If you do not have much fat, you will need harvesting from many areas and it is helpful to gain weight.
How do you harvest the fat?
With small cannulas so that only small fat parcels will be harvested. This will allow the best opportunity for new blood supply to grow in. It is harvested under very light suction so that the fat cells will not be destroyed. It is harvested using a minimal of anesthetic solutions so these will not violate fat cell vitality.
Fat is harvested through a small incision made in the planned donor area. For instance, fat taken from the abdomen involves the use of a small incision made within the umbilicus (belly button). The fat is harvested using specialized liposuction techniques. Narrow liposuction cannulas that are specifically engineered for use in fat transfer allow for gentler removal of the fat. In most cases, suction is created using a hand-held liposuction device rather than the normal suction machine. Using the hand-held liposuction device, the fat is less likely to be damaged by undue negative suction pressure and more likely to survive.
How is the fat prepared?
The fat is carefully and gently washed with a special solution and then mixed with some antibiotics. The healthy fat cells are then separated from the dead cells and the fluid. They are loaded into syringes and made ready for injection.
How is the fat transfer procedure performed?
Fat is injected and transplanted using the micro-grafting technique. This means using very small cannulas. This is so very thin tunnels will be created with fat filling these tunnels. The fat tunnels are at different levels, and cross through the area to be augmented. Together, these will allow the best opportunity to have the new blood supply grow in.
What type of anesthesia is used for facial fat transfer?
Dr. Light performs the facial fat transfer procedure with light IV sedation and tumescent anesthesia (numbing medicine).
How many procedures are needed to achieve the desired results?
Most patients reach the goals with just one procedure, but a series of sessions may be required.
Where are the incisions located for fat transfer?
The incisions for harvesting the fat (using the liposuction technique) involve narrow slits made around the abdomen (umbilicus), hips, buttocks or thighs. The fat injections are performed through even smaller slits (termed stab incisions) which are hidden within facial skin creases that are already present.
How long does the fat transfer procedure take to perform?
It depends on the areas to harvest and to graft. If it is a small area like the lips, it can be as little as one hour. If it is a larger area like the buttocks with liposuction, the procedure usually takes three hours.
Is fat transfer a painful procedure?
Any pain or discomfort associated with the fat transfer procedure is usually very minor
What is the recovery like after the fat transfer procedure?
It depends on the areas and the size to be treated and where the fat is harvested. In lip grafting you feel fine right away; you just look very swollen for days to weeks. For buttock grafting, after about two days most patients feel good enough to walk around and slowly get back to their normal activities. There is not much unusual swelling. Patients are not allowed to sit on their buttocks for the first week to two weeks.
When will I be able to return to work after undergoing fat transfer?
Patients are usually able to return to work within three to five days after the fat transfer procedure, sometimes sooner.
When will I be able to exercise after my fat transfer procedure?
Most exercise can be resumed within seven to ten days after the fat transfer procedure.
Are there risks or complications with fat transfer?
Though all types of surgery carry potential risks, fat transfer is a relatively safe procedure. In rare cases, patients may note lumping of the fat in a particular area which is often more a reflection of the body’s healing process rather than a technical issue with the procedure. If this occurs, gentle massage may help to smooth the contour. Alternatively, steroid injections and/or lipodissolve injections may provide additional benefit.
How long will it take for fat graft blood supply to take effect?
The new blood supply to the fat grafts takes several months to grow. By about 6 months after surgery patients will find that their grafts (and results) will start to blossom as the grafts finally have a robust blood supply that allows the fat cells to become more full. This process continues until about 12 to 18 months after surgery.
How long do the results of facial fat transfer last?
Up to 80 percent of the fat survives. The results are usually as permanent as any other surgical facial procedure. The face will continue to age, but the fat that is placed is slowly lost over many years just like native facial fat.
Can grafting be done more than once?
Yes, if necessary a refinement procedure can be done after an initial fat grafting procedure without any problem. This typically involves a much smaller volume of fat harvesting. It is important to wait for the initial procedure to heal fully before undertaking any refinements since the final result from fat grafting takes up to 18 months to become evident.
What is the cost of the procedure?
Pricing depends on the patient’s anatomy and the donor sites or areas to be liposuctioned.