Fat Transfer

The term fat transfer refers to the process of taking fat from one part of the body, usually from the stomach, hips or thighs, and injecting it into another area that had lost fat due to aging or other factors. Fat transfer can be performed through a variety of techniques and on many areas of the body, but the basic objectives and outcomes are the same. The goal of the fat transfer surgery is to add fullness to the face, breasts,buttocks and other desired areas.

Fat Transfer Areas

Technically speaking, fat can be harvested and then transferred to virtually any part of the human body, but some of the more popular areas are the face, female breasts, and the buttocks. As for facial fat transfer, the most common locations include the sunken areas under the eyes, forehead creases, upper and lower lips, cheekbones and the nasolabial folds - the deep wrinkles adjacent to the mouth often referred to as “laugh lines.”

When performed sensibly, fat transfers can make an area appear larger, help sculpt features and smooth out lines or wrinkles. Some research is underway to ascertain whether body fat transfer can be used to smooth out the appearance of scars, particularly those that are located below rather than above the normal surface of the skin.

The fat used in fat transfers can be taken from almost anywhere on the body-as long as there is enough or an excessfatty cells to extract.. Surgeons generally refrain from taking fat from more than one or two sites at one time, because doing so prolongs the procedure as well as the risk factors. For instance, if a patient wants to get quite a bit of fat transferred to the buttocks they will perhaps want to have the fat taken from either the thigh or abdomen, instead of the neck or face, since most people don't carry that much of their weight in those areas.

Fat Transfer Procedure

The first step duringa fat transfer is isolating and removing the fat from the donor area. This is typically done using a syringe which has a large-bore needle, although the fat can also be withdrawn using a liposuction cannula. Liposuction is a very popular procedure and most people who elect to have a fat transfer take advantage of the opportunity during liposuction surgery to re-purpose the excess fat removed and then inject it to another area of the body.

However, there are several liposuction fat transfer methods. Some of the most common include Tumescent Liposuction, Laser-assisted Liposuction, TickleLipo, Water-assisted Liposuction and Custom Acoustic Liposuction. Tumescent liposuction is one of the most reliable methods of liposuction available. It derives its name from the large amount of fluids injected during the procedure. The fluids cause the tissues to swell, or tumesce, which affords the surgeon better control while reducing the amount of bleeding and pain. Once the tissues are swollen, the surgeon uses a cannula to suck out the fat cells, remove the excess fat and contour nearly any area of the body.

Laser-assisted liposuction is pretty much the same as regular tumescent liposuction, except that it utilizes a special medical-grade laser to break down the fat before removing it. The use of laser makes this procedure more expensive than the other types of liposuction. Moreover there has been debate as to the use of laser per se, so it would be best to consult your surgeon about the prospects of combining laser-assisted liposuction procedure with a fat transfer procedure.

Water-assisted liposuction uses high-pressure water jets to wash the fat cells before extracting the fat while leaving the surrounding tissues intact. This increases the purity of the fat removed and helps the body recover faster. Water-assisted liposuction is often used in conjunction with fat transfers because of the high-quality, soluble fat that surgeons are able to remove using this technique.

Custom acoustic liposuction, in addition to Power-Assisted Liposuction and TickleLipo, makes use of hand-held devices and/or generators to generate vibration in the cannula which helps to loosen and dislodge fat cells prior to their removal. The advantage of these newly developed techniques is that they cause very little trauma to the body. However, just like laser-assisted liposuction, there is some debate regarding cell survival rate and whether fat cells sustain damage during the procedure.

Processing Fat for Fat Transfer

After removing the fat from the body, it is then prepared to clear the donor fat of blood, anesthesia, medications and other unwanted substances that can cause infections or other negative side effects such as decrease in fat cell survival and uneven or lumpy results. The three most common methods for processing fat include the use of centrifuges, strainers and wicks.

The centrifuge is one of the most common tools surgeons use to purify and separate the fat cells in preparation for a transplant. Placing the extracted fat tissue in a centrifuge makes it possible for the surgeon to isolate the fat cells from any other debris. Another way to purify the fat is to use a special type of screen to hold the fat while it is washed under running water. The screen allows fluids and debris to wash away, while providing support for the fat cells. The third method for cleaning the fat is to lay it on top of sterile strips of absorbent materials, and let these materials draw out excess fluids and impurities. This is by far the gentlest method of cleaning, but it is a little less thorough than the others, leaving a greater risk of implanting debris or other unwanted tissues along with the fat.

Replacing the Fat

There is less variation in this final step than in the other parts of the fat transfer procedure, and most of the differences are minor. There is some debate about the best type of needle to use and whether anything should be injected along with the fat cells, such as painkillers or additional medications. Depending on your goals for undergoing fat transfer surgery, the cells will be implanted at various depths, but no matter where the fat is implanted, the placement of it is a painstaking and time-intensive procedure because the fat must be placed in small clusters in a honeycomb pattern to ensure that it gets enough blood to survive.

Another difference is how to compensate for the death of some of the fat cells during the procedure. Some surgeons estimate the number of cells that will die then purposely overfill the area being treated in order to achieve the correct amount of fill. Others plan on doing multiple "touch-up" treatments after the first injection to fill in any dimples or to further increase volume. Some surgeons recommend a follow-up treatment, including a second liposuction to get the needed fat cells, while others extract more fat than needed the first time around and freeze it, thawing it later for touch-ups.

Fat Transfer Risks, Benefits and Side Effects

Just like other cosmetic treatments and procedures, fat transfer carries certain risks. Fortunately, most of the risks involved are not really serious. In fact, the risks are few, minimal and rare. Soreness, tenderness and swelling are possible, although not all patients experience them. If the surgeon performing the fat transfer procedure is not sufficiently skilled or experienced, some cosmetic damages can be incurred, including excessive scarring, dimpling, uneven texture at the fat removal or insertion points, stretch marks or sagging skin.

More serious medical complications with fat transfer surgery are quite rare, but not unheard of. They include an allergic reaction to the local anesthetic, infections, peri-operative bleeding, blood clots at the treatment or donor site, and other conditions that can occur with any cosmetic surgery procedure that is more invasive. It is important to note that the aforementioned risks increase with patients who smoke or drink heavily, who are sedentary or severely overweight, and those who fail to follow before and after instructions of the surgeon. With regard to the side effects, the most commonly encountered is bruising, which normally lasts less than a week. In addition, swelling and minor scarring is quite common, although these will fade over time.

In terms of the benefits of fat transfer surgery, there are many and these are well documented. For one, fat transfers utilize the patient’s own fat cells, so transitioning fat from one area to another tends to be less traumatic when compared to other types of surgery that require implants and synthetic materials. And since the body will recognize its own fat, there is far less chances of rejection, allergic reaction or developing infections. Another notable benefit of body fat transfer is that the result is both more natural looking and safer than other surgeries, particularly implant-based augmentations. The result also tends to look better and last longer because organic fat changes naturally as the patient’s body changes and ages.

While implant technology has improved significantly over the years, many implants and synthetic fillers are still perceptible to the trained eye. It’s also safe to say that patients benefit from implants and synthetic fillers, but others simply feel self-conscious on the thought that others may recognize they have had cosmetic surgery, so fat transfers offer added ease, comfort and peace of mind. Moreover, even implants that most closely resemble human tissue usually don't feel right to the touch. The change in texture can be disconcerting to some, and could also hinder intimacy. Such is not the case with fat transfers since all that is implanted is the patient’s own fat, so the results are almost indistinguishable from someone with no surgery at all. For instance, the breasts and buttocks have the right texture and bounce, and they look and feel as real and natural as they did before.