Fat transfer involves the removal of living tissue through the technique of liposuction and placing it into a new area with the intention of having it survive. There are certain steps that have to be taken to accomplish this.
First, we have to be gentle when we remove it. Most forms of liposuction are fairly destructive to the tissue since it will be discarded later. So, the parameters of fat removal have to be altered to maximize fat cell survival.
Next, the fat cannot simply be poured into a place. If you add a lake of fat anywhere, the fat dies. The body clears up the area, and little if any change is noticed. So placement of fat has to be performed with specialized instruments that lay narrow tubes of tissue into the new tissue. Fat has to get a new blood supply if it’s to survive as anything more than an oily slick. The fat has to be put where the blood vessels are. That means we put fat just beneath the skin, into the fat, and in most areas into the underlying muscle too.
Fat survival is variable. Studies tell us that anywhere between 40% and 80% of the fat will survive if the procedure is performed correctly. So we have to overcorrect the area if we expect a great correction. Fat has to be protected after the transfer, so keeping weight off the area and chilling it slightly to avoid inflammation is very important.
One interesting area of fat grafting research is the use of stem cells. These are cells, which occur, in fat tissue as undifferentiated tissue; they can become nearly anything with the right stimulus. We acknowledge that part of the fat we introduce is made up of stem cells. These differentiate into mature fat cells and blood vessels. There is a body of evidence which demonstrates that the more stem cells, the greater the fat survival.
In fat transfer, more is not necessarily better. It has to be performed very carefully, with the final goal in mind. The final results of fat grafting do take months to be seen.
Careful judgment is important in any fat transfer. With Dr. Geldner’s superior surgical skills, his 25 years of experience, his experienced and compassionate staff, we exceed our patients’ expectations.
Fat transfer in breasts is very popular. It is often used to improve the appearance of breast reconstructions or to smooth select contours in esthetic breast surgery. Some surgeons advocate the use of fat for complete breast augmentation. Fat transfer breast augmentations work well when you have a motivated patient who does not need an immediate result, wants limited size increase, and has accepted the controversies that exist with this procedure.
Fat is often used to improve contour in face-lifts and correct asymmetries. Faces have a superb blood supply so fat survival is often excellent. The biggest limitation is the uncertainties of which areas will become enlarged and when they will do so. Fat is clearly preferable to fillers in facial improvement but unlike fillers, it cannot simply be dissolved. You have what you were given until it is removed.
Buttock augmentation is very common and best performed with fat. Large amounts can be introduced safely and effectively to make more shapely buttocks. Postoperative care is important to avoid damaging the transplanted fat, but the results are usually very gratifying.