What is fat grafting?
Fat grafting is a technique wherein living fat cells are transferred from one part of the body to another. The transferred cells obtain blood supply from its new location. Since they become integrated with the body they tend to be last long. This is in contrast to the injectable fillers which produce temporary results and need to be repeated at intervals for volume enhancement.
What are the benefits of fat grafting?
Fat grafting provides an increase in soft tissue volume. This helps in obtaining a more youthful proportion. Aging changes of face and body are associated with laxity (loose) of skin with loss of the volume of the underlying tissues. These changes are partially reversed with fat grafting.
What are the areas which can be treated with fat grafting?
Fat grafting techniques are used for improvement of
1. Face: Cheeks, Forehead
3. Buttocks (Brazilian butt lift)
4. Scars ( Depressed scars)
Where is the fat harvested from?
Abdomen and thighs are the sites commonly used as donor areas for fat harvesting. This has the added benefit of improving the contours of these areas.
Who is a right candidate for fat grafting?
This would include individuals who need volume enhancement but want to avoid the use of any artificial substances. The volume enhancement in the case of breast augmentation with fat transfer would be lesser when compared to the conventional silicone implants.
Individuals for fat grafting should have good health and not have any serious comorbid illness. It is also important to have realistic expectations about the outcomes which can be achieved with the procedure.
How is fat transfer performed?
It begins with a consultation when a surgeon evaluates you to find out if you are a right candidate for the procedure. A treatment plan is made which depends on the physical features as well as the treatment expectations of the individual. Fat grafting to face may involve multiple sessions wherein small quantities are transferred to avoid over correction.
Anesthesia for the procedure is either with local or general anesthesia. This depends on the extent and areas being treated. Fat grafting to areas in the face is done under local anesthesia. Breast and buttocks are treated under general anesthesia. Fat is harvested from the thighs and abdomen with thin cannulas. The harvested tissues are processed to increase the fraction of viable cells which would then be transferred back into the body. The processed tissue is injected back into the recipient sites with thin cannulas.
Patients can soon return home after correction of smaller areas. More extensive grafting though performed as a short stay or day care procedure and individuals can return to work in a week.
Recovery from fat grafting will include swelling at the treated site. This is more prominent at highly vascular sites like face. This gradually subsides with time and usually does not need any specific treatment.
What are the possible complications of the procedure?
The complications specific to fat grafting will include:
1. Fat did not last long enough: This can be lessened with refinements of harvesting and processing the fat. Fat transfer does suffer from a lack of precise predictability of the take. It tends to take up better in highly vascular areas like the face. It tends to be lost more in highly mobile areas like lips.
2. Over grafted look: This can be avoided by carrying out the procedure in small sessions and trying to avoid over correction. This complication probably results from the treating doctor trying to compensate for the possible loss of the fat cells with time.
3. Irregular and lumpy appearance: This is seen in areas where the overlying skin is very thin. This can be minimized with grafting at deeper planes.
What are the benefits of volume augmentation with fat grafting?
Since we are using part of the body for volume enhancement, it tends to
1. Last a long time when integrated by the body (this is in contrast to the temporary fillers).
2. Do not suffer from extrusion as can happen with foreign implants.
I like to keep it simple.