Fat Grafting

What are Fat Transfers?

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The terms Fat TransferFat InjectionsAutologous Fat Transfer, and Fat Grafting all refer to the process of taking fat from an unwanted area (or areas) of your body and re-injecting purified adipose fat tissues into another area (or areas) of your body. The goal of any fat transfer procedure is to add fullness to the area which receives the fat grafts. Fat injections are commonly made to the face, lips, breast. With the face, fat can be transferred to the cheeks, nasolabial folds, jawline, and the lower eye area.

The 3 components of Fat Transfer are:

  1. extraction of fat with liposuction
  2. processing and centrifugation of fat
  3. re-injection of fat

What concerns does a facial fat transfer address?

My face looks thin and sags–how do I get a youthful, glowing look?

a Maryland patient

Fat transferred from other areas of your body to your face will not only give some lifting to the general facial structure, but also improve the look of your skin. Patients seeking a fat transfer for facial rejuvenation often present these symptoms:

  • fine lines and wrinkles
  • crows feet
  • under eye bags or dark circles
  • worry and/or frown lines
  • ‘sunken’ cheeks
  • tired look

As we age, the dermis under our skin thins out, which can leave the face looking thin and has the effect of making the skin look like it sags. This happens to women of all body types: small frame, medium frame, large frame. A facial fat transfer adds adds fat to the area beneath the skin, and has the effect of ‘filling out the face’ to a more youthful state.

In addition to filling out wrinkles in the face, highly purified fat injections also enhance the blood circulation in the tissues. This is because there is a population of adipose stem cells in the fat cells that are re-injected. Even with only minimal manipulation, such as centrifugation, a small plug of Adipose Stem Cells (ASC’s) are collected in high density fat grafting. Thus, a small number of regenerative type cells are reinjected into your face with high density fat processing techniques!

How are Fat Transfers performed?

Fat injections can be done under local or IV sedation anesthesia. Using thin cannulas, fat is harvested from the hip, inner or outer thigh, lower back, or lower abdomen. These areas are called the ‘donor sites‘. The fat is then decanted and processed in a special centrifuge, and is then injected into the desired facial area. The area where the fat is re-injected is called the ‘recipient site‘. When performed properly, a large percentage of the fat transfer will ‘take’ and the face will fill out to look more youthful.

What areas of the face benefit from fat injections?

Fat injections are commonly used to rejuvenate nearly all areas of the face. Fat injections are best used to fill in bags under the eyes, fill out the cheeks and chin areas to lift facial structure, or as an all purpose filler.

As we continue to understand the aging process better, we have come to appreciate that in some patients, rather than dissecting tissues and surgically lifting, adding soft tissue volume such as fat will make the face look younger. We find ourselves using fat injections as an integral part of face liftsurgery. In my own practice, I am increasingly doing less surgical dissection and more fat grafting in the facial areas.

Do fat injections last?

Some patients think that fat injections “do not last.” However, this is not the case. When a fat transfer is performed properly, a large percentage of the injected fat cells do indeed survive and are permanent. However, since some fat cells are lost in the immediate post op period, we tend to ‘over-correct,’ or inject more than we need to. After the majority of the swelling is gone, approximately two weeks later, you will have a very good idea of what the final result will be.

How are fat injections different from injectible fillers like Juvederm?

Compared to injectable facial fillers such as Juvederm, the fat transfer procedure is more involved because the fat has to first be harvested from another part of the body with Liposuction. However, unlike injectable fillers, fat transfers can be used in larger volumes to fill larger defects. And above all, fat injections are a natural type of surgical enhancement, and they contain a small population of regenerating adipose stem cells.

What are the pre-op requirements?

During your consultation, we’ll discuss the liposuction areas as well as fat injection areas to determine the best surgical plan to achieve your goals. Be sure to listen to all of the pre-op instructions and get answers to any concerns you may have. Pre-op instructions will depend heavily on whether you elect to have the procedure under local or IV anesthesia.

At least half of my patients elect to do facial fat transfer under local anesthesia. This is comparable to going to the dentist, but you will feel some temporary discomfort during the liposuction part. The attraction to have the procedure done under local is that the total cost is less since we do not need the full OR staff, and no pre-operative testing is required.

What is post-op recovery like?

You will likely have some discomfort as well as some swelling during the immediate post op period. For a fat graft to be as successful as possible you’ll need to avoid stressing the fat injection area(s) for three weeks. It takes up to 4 days for the blood vessels to grow ito the fat grafts and another 2 or 3 days for the blood vessels to strengthen. It takes 2 to 3 weeks for the extracellular matrix surrounding the fat graft to reach enough strength to withstand minor stresses.

Post op instructions for facial fat grafting include the following:

  • wear surgical tape on facial areas for 5 days
  • sleep on back with head elevated for the first week
  • no rubbing of the face for 2 weeks (only soft washing)
  • post op office visit at day 5
  • return to work after 1 week
  • exercise as tolerated after 2 weeks
  • follow up office visits at month 1 , month 4


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