Fat grafting, also referred to as fat transfer or fat injections, is the surgical process by which fat is transferred from one area of the body to another area. The surgical goal is to improve or augment the area where the fat is injected.
Common areas of fat grafting
This summary covers the common areas of fat grafting, how the procedure can help, and who makes a good candidate:
Face (10cc – 100cc, total):
You are a good candidate for facial fat grafting if:
- You are older than 30 years old
- Signs of aging started to appear. The physiology of natural aging includes atrophy or loss of facial volume
- You have sagging skin and shrinking of tissue as well
Facial Fat Grafting can help to:
- Restores youthful appearance by adding volume to hollowed out or wrinkled areas such as the area below the eye and the nasolabial folds
- Helps repair scars
- Adds volume to the cheeks to create the appearance of higher cheekbones
- Improves the texture and appearance of the skin
- Rejuvenate your face by smoothing laugh lines, smile lines, or crow’s feet
- Achieve longer-lasting results than temporary fillers provide
Breast (25cc-400cc, each breast):
Natural augmentation with fat grafting has very different outcomes as compared to breast augmentation with implants. Fat is only able to give moderate enlargement of the breast and improvement of shape.
Patient is a good candidate for breast fat grafting if:
- For patients complaining of gapping of the top of their bra, injected fat into this area will give more fullness. It will help them to fill out their bra size, but not necessarily change their bra size.
- Patients who have been pregnant, breast fed, and then lost the volume of their breasts may be excellent candidates as their breast tissue has become expanded by the pregnancy.
- Similarly, women who have had their breast implants removed may be good candidates for fat transfer breast expansion. Their breasts are already expanded by the previous implant and should accept the fat without problems.
- Women who have experienced multiple capsular contractures with implants are good candidates for fat grafting breast enlargement. Most do not want another implant.
Breast Fat grafting can help to:
- Increase the breast size by one or two cup sizes
- Correct breast asymmetry
- Repair radiation tissue damage and can treat breast implant capsular contractures
- Correct scar deformities from lumpectomy or breast reconstruction
Hips (100cc-300cc, each side):
Who are good candidates for hips fat grafting surgery?
Nonsmokers who are within 30 percent of their ideal body weight, with highly responsive skin elasticity and no prior history of bleeding conditions, may be good candidates for liposuction procedures like hip dip surgery.
Hips Fat grafting can help to:
- Add volume to achieve a more feminine profile and better waist-hip ratio
Buttocks (200cc-1300cc+, each part):
You are a good candidate for Buttocks Fat grafting if:
- Are unhappy with the current shape of your buttocks and have realistic expectations of results
- Have lost natural volume and shape due to age or weight loss
- Want to increase the size of your buttocks without implants
- Have enough fat in surrounding areas to inject into the buttocks
Buttock Fat grafting Can Help to:
- Make buttocks appear perkier
- Augment buttocks size (aka Brazilian butt lift)
- Increase size of the buttocks and make them look more shapely
- Add volume to the hips for a more dramatic waist-to-hip ratio
- Can be used to smooth out any visible dimples, scars, or other irregularities
Hands and Feet (5-10cc, per extremity)
You are a good candidate for hands /feet fat grafting if you are:
- Want to rejuvenate or correct specific parts of hands or feet but are keen to avoid more invasive surgical alternatives, such as implants
- Are in good health with sufficient fat on their body available for transfer to the treatment site or sites
- Have realistic expectations about the results possible from the procedure
- Are prepared that more than one session may be required to achieve optimal results
Hands / Feet fat grafting can help to:
- Reduces wrinkles and rejuvenates appearance
- Provide padding for bony feet
Consultation
The first step in a fat grafting procedure is a consultation, which will comprise a discussion regarding your expectations, your overall health, any prior surgeries that you may have undergone and your lifestyle. Your questions and concerns will also be addressed during this consultation. Make sure to ask about everything you are concerned.
Procedure
- In the first step, fat is extracted from a donor area using liposuction techniques. This is best accomplished by manual methods using thin liposuction cannulas with small holes. Laser or ultrasonic liposuction should not be used for the extraction as it may destroy the fat cells.
- The fat is then processed with decanting and centrifugation to separate debris, excess fluid, and dead cells from the viable adipose fat cells. An alternate method is to wash the fat with a sterile saline solution. The fat that is discarded are the fat cells which will likely not survive in the graft, and they can even create problems for the good cells.
- In the final step, the fat is reinjected in small droplets throughout the subcutaneous tissue of the recipient area. This is to ensure good blood supply to every fat droplet so that the fat graft can survive.
The amount of fat injected is measured in cc’s and ultimately varies according to patient case specifics and the area of the body where the processed fat is being injected.
The fat transfer procedure can range anywhere from 30 minutes to multiple hours depending on the location fat is being grafted from, how much is being grafted and wherein the body it is being placed.
Risks of Fat Grafting
Is it safe?
Fat transfer risks are far and few. Fat tissue is non-allergenic as it is sourced from the patient’s own body, so the chances of your body rejecting the material are practically impossible. However, some possible complications with fat grafting include:
- Swelling
- Bruising
- Soreness
- Potential allergic reaction to anesthesia
Is fat grafting painful?
Fat transfer is not a painful procedure. You will be under the influence of anesthetic or fully sedated during the procedure and will not feel anything. Afterwards, you will be given paracetamol to manage any mild discomfort you may experience.
Immediately following the procedure, the patient can expect to have bruising and swelling in the areas used to harvest the fat cells. Pain can be managed with medication. which also helps to avoid constipation.
Recovery
Breast Fat grafting:
Recovery time for fat transfer procedures to the body can depend on how many areas the initial liposuction was carried out on. You may be bruised and swollen for 1-3 weeks and should avoid exercise during this time and you may wish to be off work for 1-2 weeks also. The few days following your fat transfer augmentation you may feel some discomfort around the breasts and experience an aching sensation for a week or two following treatment – this is completely normal and will subside as will any bruising and swelling. Some areas of the breast may feel firm or even tender for many months. This is deep bruising and fat, which is slower to incorporate.
Buttock Fat grafting:
Every patient recovers differently from surgery, but most often one can expect to be up and walking a day or two after the procedure. Moving around will also help with constipation. Excess tumescent fluid may also drain from the incision points. Do not be alarmed if the fluid is tinged with blood, as this is completely normal and will cease a few days after surgery. One of the most important recovery tips regarding butt grafting surgery is to not sit directly on your buttocks for at least eight weeks after the procedure. Patients are often advised to sleep on their stomach or sides, and if you absolutely do have to sit, it is recommended to use a donut pillow or inflatable pillow. Placing the pillow behind your legs is helpful to avoid putting pressure on the fat graft by raising the buttock. This is very important to achieve long lasting results, as sitting directly on the buttocks can affect blood circulation in the area. Reduced blood circulation could destroy the fat cells transferred to the buttocks. After the first eight weeks of recovery, it is important to still use a cushion when sitting, and to avoid sitting for prolonged periods of time.
Face Fat Grafting:
Face Fat transfer recovery time varies from patient to patient, but most people should arrange to take at least 7-10 days off from work and other social activities. Initial healing takes a few weeks, after which the swelling will gradually subside before the results are apparent. Though the recovery period is mild for fat transfer, patients should allow adequate time to heal properly.
Hands Fat Grafting:
Following treatment, ice may be given to ease discomfort and swelling. Avoid applying firm pressure on the treatment area. Hands will be swollen for up to 2-3 weeks, but most patients are able to resume normal activities within the first week.
Hips Fat Grafting:
Recovery from hip implant surgery is less challenging than with similar implant procedures for the butt or calves since the hip area is not as functional for sitting or walking. Full recovery from hip fat transfers takes eight or more weeks. During this time, patients must sleep mostly on their stomachs or backs to ensure proper healing and optimal fat survival. Typically, short intervals of seated desk work can be resumed in 10 to 14 days, but your surgeon may recommend a standing desk at first.
The treated area should receive no pressure for at least three weeks post-op.
Results of Fat Grafting
Buttock grafting:
The results of buttock augmentation and/or buttock lift surgery are visible almost immediately. However, it will take some time for the results of the procedure to fully develop. Satisfaction with your new image should continue to grow as you recover from surgery.
The tissues will settle a little within the first 3-6 months and the scarring can take up to two years to fade to its mature level. Some visible scars will remain, but the overall results are long-lasting, if you maintain a stable weight and general fitness. As your body ages, it is natural to lose some firmness. However, most of your initial improvement should remain.
Although good results are expected from your buttock enhancement surgery, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Following your physician’s instructions is essential to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, motion, swelling or abrasion during the time of healing. Your doctor will give you specific instructions on how to care for yourself. If your procedure was performed with fat transfer, it can take up to a year to see your final results. Some of the fat that leads to the initial shape after surgery will be reabsorbed by your body.
If your surgery was performed with fat transfer, it is important to keep in mind that this fat can behave like any other fat in your body. If you gain weight, the fat in your buttocks may grow. If you lose weight, you may lose some of the volume in the buttocks as the fat shrinks.
Breast grafting:
By the one-year mark, your breasts will conform to their final shape. One of the most significant advantages of this kind of breast augmentation is that the results are permanent. Once the transferred fat cells are completely incorporated into the breast tissue, they’re there for life, and there’s often no need for any additional fat transfers. The breasts may change shape over the patient’s lifetime, of course, just as anyone’s breasts will change due to the effects of age and gravity. However, the fat that was transferred and fully incorporated won’t need to be removed or replaced, as is required with breast implants.
Face Grafting:
Facial fat transfers can last for several years; in many cases, results can be permanent. Keep in mind, however, that facial fat transfers do not protect against future aging. While a facial fat transfer can minimize current aging symptoms, patients should expect to see results slightly diminish over time.
Hips Grafting:
As the swelling from your procedure begins to subside, your results will begin to appear. However, your final results may not be visible for several months. In most cases, it takes about six months for the newly transferred fat cells to establish a blood supply and take permanent hold in their new location. Whatever fat remains several months after a fat transfer is also considered permanent, but that doesn’t mean your body won’t change.
Hands Fat Grafting:
Fat transfer to the hands is permanent and will last many years after the fat has integrated into the tissue at the back of the hands. This is different to a filler treatment which will need repeating every 6-9 months. There is no downtime with this procedure, requiring only local anesthetic with no scarring.
Thins to keep in mind
- Don’t consider fat grafting as the filler injection. Unlike other filler procedures that require no special care or downtime afterwards, fat grafting is more of a cosmetic surgery procedure that requires adequate and planned recovery time.
- There’s Almost No Scarring
In the case of any cosmetic procedure, many patients worry about potential scarring. In the case of liposuction and fat transfer, however, there’s usually not much scarring to worry about at all.
Some patients do experience very, very small amounts of scarring from the injection and removal sites, although these are minor and localized. Most experienced surgeons will also take care to reserve the injection and removal sites for areas where clothing normally covers, anyway.
