Fat grafting is removal of fat cells from a part of the body where the fat can be spared and injecting it in another area where extra volume is needed, such as the hollows under the eyes or in the cheeks, the backs of the hand or under scars. Since there are multi-potential Stem Cells in the fat, the fat can actually improve the area into which it is placed. Both the harvesting, preparation of the fat and placement of it is done at the same time.
Fat can correct any of the major lines, areas of fat loss or apparent loss and contour irregularities anywhere in the body, such as:
It is especially ideal when a large amount of filler is needed and when you desire facial correction at the time of a Liposuction procedure. If done properly, most of the injected fat remains alive and present where placed. However, to achieve the proper correction, slight overcorrection initially and more than one injection is frequently required. This is because the fat is a living tissue and requires good blood supply in the area where it is placed. If we inject too much at one time, the pressure reduces the blood supply, and some of the injected fat dies. In spite of this limitation, most people require only one procedure.
The major advantage of this procedure is that it is generally permanent. Additionally, the fat contains multipotential stem cells and there is some indication that they rejuvenate the tissues in which they are placed and the overlying skin. Not only do you look better from correcting the folds and volume loss, but also the overlying tissues look better because they are rejuvenated.
The procedure does require harvest of the fat from an area where you have excess, such as the tummy, upper thigh or neck. We then process the fat to remove everything except viable fat and stem cells. The technique of these steps is critical in achieving permanence of the injected fat. Once we have adequate fat, we inject it where you need it using specially designed, fine, blunt tipped cannulae. This step is also vital to the success as the fat requires excellent blood supply to remain viable and stay where placed. This can determine whether the problem can be corrected in one session. We do this under local anesthesia in the office. To reduce bruising and speed its resolution, we encourage perioperative use of Arnica Montana and Bromelain (over the counter products, though we can provide them) or Pineapple juice. What minimal bruising that does occur can usually be covered with makeup, such as Jane Iredale®, and you can return immediately to most activities.
Fat transfers, like any procedure, have risks. However, in expert hands, those risks are minimized and the procedures are quite safe. Small volume transfer which is what we usually do, most commonly to the face but also to the hands and small areas of the body, has the same risk as using a filler such as Juvederm to the same area.
Since the fat that is transferred is living cells, it requires a good blood supply wherever it is placed. It also requires proper technique in harvesting, preparation and placement to keep it alive. With newer techniques, about 75-90% of the injected fat survives and continues to function like your normal fat and is, thus, permanent. Anything that is present 4 months after the procedure will remain permanently.
Fat transfer consists of 2 parts, harvesting the fat and injecting it. Harvesting is done with regional numbing of the area from where it is taken. Injection is done through numb entry points and, occasionally, into a regionally numb area. However, the injection is no more painful than any filler like Juvederm.