CONSULTANT PLASTIC SURGEON
FAT TRANSFER
What is fat transfer surgery?
Fat transfer surgery, also known as fat grafting or fat injection, transfer fat from areas in which you have excess fat, such as the outer thighs, and injects it into areas that may be lacking in volume, such as the hands, face (including the lips), depressions in the skin (following liposuction and scarring), breasts, buttock (for augmentation) and vaginal area. This safe, long-lasting, well-tolerated procedure produces natural-looking results. Every year, thousands of people undergo successful fat grafting and are pleased with the results.
“Fat transfer surgery is a highly individualized procedure. You should do it for yourself, not to fulfil someone else's desires or to try to fit any sort of ideal image, especially those coming from social media. Choosing a procedure based on “what’s new” is never a medically sound decision. Hearing about a procedure on television, through an advertisement or online does not necessarily mean it is the best procedure for you.”
Who is a good candidate for fat transfer surgery?
Facial fat transfer: If you have facial creases, such as laugh lines, smile lines, and crow’s feet, fat can be removed from your abdomen, thighs, or other areas and be injected into your face. Acne scars and sunken areas of the face, lips, and cheeks can also be filled in. Dr Ricardo can even use grafted fat to minimize lines between your nose and mouth, correct skin depressions or indentations, and minimize forehead wrinkles.
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Breast augmentation: If you desire a modest increase in breast size, you are a good candidate for fat grafting to the breast, but your breasts should already have a nice shape and good skin tone. If you have poor skin, sagging breasts, or want a significant increase in breast size, breast augmentation with fat transfer is not for you.
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Breast implants plus fat grafting: If your breast shape needs optimizing during a breast implant procedure, fat grafting can be useful. If you have residual breast irregularities after undergoing breast augmentation with implants, the irregularities can be filled in with fat to produce a smooth contour and an optimal shape.
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Breast reconstruction with fat grafting: If you have breast defects following a lumpectomy for breast cancer, fat grafting is an effective method for filling in these defects. Fat grafting is also an option for total breast reconstruction following mastectomy; however, to achieve sufficient breast volume, this is usually a multistage process that requires at least two to four sequential fat grafting procedures.
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Buttock augmentation with fat grafting: Many people who desire a fuller, more rounded buttock will opt for a “Brazilian butt lift,” which uses autologous fat transfer to provide a more curvaceous buttock without the use of an implant. Liposuction is commonly used to both sculpt the surrounding area and collect the autologous fat to be injected.
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Hand rejuvenation with fat grafting: Fat grafting into your hands is effective for adding volume, “plumping up” wrinkled areas, covering underlying vessels and tendons, and improving the quality of your skin over time.
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Vaginal rejuvenation with fat grafting: Labia augmentation, also called labia puffing, is a procedure that enhances the size or shape of the outer lips of the vagina, the labia majora. Fat can be transferred to the labia for a more youthful appearance.
What should I expect during a consultation for fat transfer surgery?
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Dr Ricardo will evaluate you as a candidate for fat transfer surgery and clarify what approach is best for you. Alternative and additional treatments may be considered, once he understands your goals and medical condition. It is important to be completely honest during the consultation and be prepared to discuss your surgical goals, medical conditions, drug allergies and medical treatments, current medications, vitamins, herbal supplements, alcohol, tobacco and drug use, and previous surgeries.
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Dr Ricardo will also evaluate your general health status and any pre-existing health conditions or risk factors, evaluate the elasticity of your skin, take photographs, discuss the approach to your surgery, including the type of procedure or combination of procedures and tell you whether your expectations are in line with typical results, discuss any risks or potential complications and share before-and-after photos of cases similar to yours.
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The success and safety of your fat transfer surgery depend very much on your complete candidness during your consultation. It's very important to understand all aspects of your procedure. It's natural to feel some anxiety, whether it's excitement about your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with Dr Ricardo.
How should I prepare for fat transfer surgery?
In preparing for fat transfer surgery, you may be asked to get lab testing or a medical evaluation, take certain medications or adjust your current medications, stop smoking in advance of surgery and avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding.
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Your surgery will be performed in an accredited hospital and is usually performed on an outpatient basis unless you and Dr Ricardo have made other plans for your immediate postoperative recovery. You must arrange for a friend or family member to drive you to and from surgery and to stay with you the first night following surgery.
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Dr Ricardo and the entire staff will provide thorough preoperative instructions and answer any questions you may have. The goal is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy, comfortable, and safe as possible.
What are the steps of a fat transfer procedure?
Step 1 – Anaesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anaesthesia. Dr Ricardo will recommend the best choice for you.
Step 2 – Surgical procedure
Fat grafting can be explained as a three-stage process: harvesting, purification and transfer, and placement.
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Harvesting: A site will be selected for fat removal. Dr Ricardo will then create a small incision in the area for fat removal and, using a sterile technique, insert a cannula connected to a surgical vacuum or syringe to carefully extract fat (liposuction).
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Purification and transfer: Once enough fat is obtained from the donor area, Dr Ricardo will process it to prepare the fat cells for transfer to syringes that will be used for fat injection.
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Placement: The area designated to receive the graft will then be prepared. Dr Ricardo will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times. Each time the needle or cannula is withdrawn, a line of fatty tissue parcels is carefully deposited in natural tissue planes. This process is repeated until the desired correction has been achieved, creating a grid of grafted fat.
Step 3 – Closing the incisions
Sutures, skin adhesives (glues) or tapes close the skin incisions.
Step 4 – See the results
Your improved contour will be apparent once the swelling and fluid retention commonly experienced following fat transfer subside.
What should I expect during my fat transfer recovery?
During your fat transfer recovery, a compression garment or elastic bandages may cover treatment areas once your procedure is completed. These help to control swelling and compress the skin to your new body contours.
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You will be given specific instructions on how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with Dr Ricardo. Remember to always follow his instructions to ensure the success of your surgery.
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Initial wound healing may take 10 to 14 days. Sutures will be removed when it is appropriate. You should be ready to return to work and normal activity after 5-10 days, depending on the procedure that you underwent. However, you must realize that the amount of time it takes for recovery varies greatly among individuals.
What results should I expect after my fat transfer surgery?
When done successfully, the injected fat establishes a new blood supply from your body and receives the nourishment it needs for survival. When this happens, results can and often are permanent.
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You can expect the areas to which the fat was transferred to appear softer and fuller, giving you a refreshed and rejuvenated appearance. You may even notice an improvement in skin texture. Fat transfer results are natural, long-lasting, and safe.