Fat Transfer

Has the passage of time left you with a gaunt looking face devoid of youthful fullness? Do you have deep furrows or wrinkles around your nose, lips or elsewhere on your face? Fat transfer or the process taking fat from one area of a patient’s body where it is plentiful and transferring it another area where it is lacking can often be a good solution. When used appropriately, fat transfer can yield very satisfying cosmetic results.

The Search For The Ideal Filler

Cosmetic surgeons have been searching for years for the ideal filler to rejuvenate volume depleted faces, those with wrinkles, scars, depressions and creases. To date there is no perfect filler, all have their drawbacks. Transferring a patient’s own fat has always been an attractive idea as there are no allergic reactions, there is usually an abundance of it, and it is inexpensive. However, the main disadvantage to date has been the durability of the fat transferred. Now, after much trial and error by many cosmetic surgeons, newer techniques to harvest and implant the fat have dramatically improved its survival after transfer. In fact, many of us are transferring fat to enhance the results of other cosmetic surgeries such as facelifts. The future of fat transfer is bright and it is only a matter of time before the results of it will be reliably longer lasting.

The Fat Transfer Procedure

The fat transfer procedure is actually two procedures performed in a single session, lasting about an hour. The first procedure is the fat “harvest.” A small amount of fat, about one or two ounces, is taken from the hips, buttocks and/or abdomen (the donor site) previously “numbed” by a dilute solution of local anesthetic. This anesthetic solution not only makes the procedure pain-free, but also minimizes any bruising and bleeding afterwards at the donor site. The fat is harvested by running a thin metal tube called a cannula back and forth in the donor site. The cannula is attached to a special collection syringe (the LipiVage system) which in turn is connected to a suction device. As the fat is collected in the syringe, the excess numbing fluid is simultaneously filtered off, leaving pure healthy fat behind. The harvested fat is then carefully removed from the collection syringe and placed into smaller syringes for injection. The one or two tiny incisions made to introduce the cannula into the donor site heal quickly without sutures.

Injection of the fat into the site to be enhanced is the second of the two procedures in the fat transfer process. The area to be improved (usually on the face) is anesthetized with local anesthetic prior to fat injection. The freshly harvested fat is then carefully injected into the desired area in very tiny amounts until the desired volume replacement is achieved. As with the donor site, no sutures are needed where the fat is injected.

Recovery Time And Complications

Recovery time after a fat transfer is very short. In most cases, patients can return to their normal activities almost immediately. Complications are very rare and include infection and bruising both of which can easily be remedied. As we use the patient’s own fat for transfer, there are no allergic reactions or graft rejections.

How Long Do Fat Injections Last?

The length of time fat lasts after transfer is unpredictable. Sometimes the transferred fat disappears within several months; often it can remain much longer, even for years. It is not uncommon to require up to three injections to sustain desirable results. We try to harvest more fat than we need the first time and store the rest in a freezer for later injections to avoid additional harvesting procedures. Occasionally, no matter how many times we inject fat into a particular area, it will not “take.” Our experience to date is that fat transferred to the lips doesn’t last long enough to make a fat transfer there worthwhile.

For Whom Is A Fat Transfer A Good Choice?

For those who have suffered marked loss of fat in their faces, particularly the high cheek area, fat transfer is ideal. In this area, fat seems to last the longest and transfers to these areas are often aesthetically very pleasing. The back of the hands is another area that does quite well with fat transfers when the loss of volume there has altered their appearance for the worse.

Richard D. Fisher, MD