What's involved with Fat grafting?
With fat grafting, or fat transfer, the borrowed fat is taken out via liposuction – typically from the abdomen, flanks, or inner thighs – where there is generally good quality fat for transfer. Once removed from these areas, the fat cells are permanently gone, and only with significant weight gain would the fat deposit back into these areas. Common areas to inject the fat into recipient locations include the breasts, face, buttocks, hip-dips, and other areas of the body that have contour irregularities to help sculpt the regions in more aesthetic manner.
In order to maximize the “graft take” (or survival of the fat cells) in their new location, a very careful process of centrifuging the fat is undertaken. The fat is spun down to help separate any blood cells, serum, and inflammatory cells from the actual fat. This allows the purified ‘clean’ fat cells to then be injected with small needles to their new location without placing any scars. There is the added bonus of being able to ‘steal’ fat from other areas of the body where there may be some excess fat which can help improve the contour through lipo-sculpting. Sometimes fat grafting is done in conjunction with other procedures.
Dr. Sharma will sit down with you to discuss your goals for the surgery and the look you are hoping to achieve. Most patients are interested in a natural appearance and we strive to get you the look that you deserve.
Frequently Asked Questions
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Am I a Good Candidate?
Good candidates for this procedure are men or women who:
- have sufficient areas of fat on their bodies to use as ‘donor sites’
- want an all-natural way to enhance volume to another area (such as breasts, buttocks, face, hip-dips, etc)
- are self-conscious about the lack of volume in a particular area and want to improve their shape and volume
- are physically healthy to undergo surgery and have realistic expectations
- want to have a minimally invasive procedure that can provide long-lasting stable results
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How much fat can be transferred?
There are a variety of factors that go into determining this. Dr. Sharma will discuss this with you, since it is different for each individual. Some factors that play an important role in determining the amount of fat that can be safely transferred to a particular area include:
- how much ‘recipient site’ volume you have to start with that can ‘accept’ the transferred fat in order to provide blood supply to the new fat cells
- how much fat you have in ‘donor areas’ and in which locations
- if there has been previous liposuction done in the past
- your personal measurements including any asymmetries, skin excess, your height/weight, and body habitus
- your goals and expectations
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What happens on the day of surgery?
Surgery takes place in the operating room with you asleep under a general anesthetic, and can take 2-3 hours. Markings are first made before going into the OR to plan the areas of fat extraction with liposuction, and the areas to inject the fat into its new location. Once you are asleep tiny 0.5cm incisions are made very carefully to suction out the fat and smoothen out any contour irregularities. The fat is then collected in a canister and centrifuged then transferred into syringes and injected in multiple planes throughout the recipient tissues through very small needle holes, without putting any scars in these recipient sites. The technique is done to allow for maximum fat survival and to minimize fat necrosis. The small incisions are closed. All of the stitches are dissolving underneath the skin to give you the best possible scars. Drainage tubes are generally not required. Paper tapes and gauze dressings are applied. You are placed into compression garments that we give you at the end of your surgery to provide support and minimize bruising/swelling. After surgery, you will be in the recovery room for a couple of hours and monitored closely. All post-operative instructions and prescriptions will be given to you before going home. You will be able to go home the same day of surgery with a responsible adult.
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What happens after surgery?
Recovery is a gradual process. You are encouraged to take it easy but still get up frequently for short walks to reduce the risk of blood clots in the legs from immobility. The first 1-2 days you may need some of the prescribed pain medications, and will be recovering from the anesthetic and medications you were given. Most patients are needing only Tylenol or Advil after that. You will be able to shower directly over the paper tapes after 2 days. Generally it is a good idea to take 1 week off work, depending on what type of work you do. At 3-4 weeks from surgery you will typically feel fully recovered. You will have to avoid heavy lifting and vigorous exercise up until about 6 weeks from surgery. The final shape and contour can take up to 3 months before all residual swelling is resolved.
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Is fat transfer safe?
Several studies have proven the safety of fat transfer. It is a common technique to use in breast cancer patients who have had their breasts removed, especially after having radiation. There is no association between fat grafting and breast cancer. It also has negligible impact on breast-feeding ability.
It is important to note that there is an upper limit to how much fat can be safely transferred to another area, and it can be different for each individual patient. Much like planting individual seeds in the soil to obtain a good crop, if the fat is not carefully ‘planted’ in multiple rows throughout the recipient area in small quantities in order to be nourished with new blood supply, then survival of the ‘crop’ will be poor. Over-ambitious fat transfer can lead to fat necrosis, oil cysts, abscesses, and poor survival of the fat. In order to maximize the survival of the fat, Dr. Sharma methodically places the fat cells in order to obtain around 80% fat graft survival. Once the fat has established a blood supply it stays forever. If there is significant weight gain or loss, the fat in the new recipient area may also fluctuate in a similar manner. Because it is your own body’s natural tissue, there are no issues with any rejection, or concerns with a foreign substance inside you.
Dr. Sharma will be able to discuss fat transfer in more detail with you, and review all of your options to ensure that you are making a fully informed decision.
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