Definition & Overview
Fat transfer is a two-part process that removes excess fat from specific areas of the body (donor site) and transfers it to a recipient site that needs added volume. Also known as fat injection or fat grafting, it is a minimally invasive cosmetic procedure that has high satisfaction rating and minimal risks.
Fat transfer is one of the many options for individuals who desire to restore the volume lost typically due to the natural aging process. This aesthetic issue is typically more pronounced around the eyes, the cheeks, and the jaw line as the skin in these areas sags and appears sunken due to loss of volume. This can be exacerbated by the development of loose skin in the neck and jowls, making people appear older than they want to. Fat transfer can also enhance other parts of the body such as the breasts and buttocks and can be an alternative to using implants.
Fat transfer can also improve the quality of skin, making it appear younger and rejuvenated as volume is added underneath it. This result is more evident in the months following the procedure.
Who Should Undergo and Expected Results
Fat transfer can be taken advantage of:
Those with facial areas that appear sunken and creased - Fat transfer is especially popular for those individuals with facial areas (such as under the eyes, cheeks, and lips) that appear sunken and creased, making them look older than they really are.
Individuals with aging hands – As people age, underlying structures in the hands become more prominent making the hands look unsightly and old. Injecting fat into this body part can help enhance its appearance by reducing lines and crinkly skin.
Individuals who underwent liposuction – Several liposuction patients now consider fat transfer. The harvested fat can be used to enhance certain body parts, removing the need for implants in certain cases.
Individuals who require an alternative to dermal fillers – Some people who previously had temporary dermal fillers injected can take advantage of fat transfer if they desire more permanent results.
Patients with severe scarring - Fat transfer can address extensive scarring as well as acne scar by minimising their appearance.
Patients who had their implants removed - Fat transfer is a good option to consider when a patient wishes to remove irregular contour of the breast following the removal of implants. This is also true for those who had their buttock implants removed or those who just want to improve the overall appearance of their buttocks.
Fat grafting generally takes place in several sessions spaced a couple of weeks apart, so the results of this procedure are not immediately evident. However, most patients are highly satisfied with the end results. Since the fat injected comes from the patient's body, allergic reactions are highly unlikely, making this procedure relatively safer compared other similar cosmetic procedures.
How is the Procedure Performed?
Prior to the procedure, the patient is scheduled for a one-on-one consultation wherein the details of the procedure, including its possible risks and complications, are discussed. This is performed to effectively manage patient expectations.
To start the procedure, local anaesthetic is administered to the identified donor site, which is typically the hip, lower abdomen, lower back, or the thighs. Once the effects of the anaesthesia have taken effect, the first part of the process, which is liposuction, is started. A small incision is made in the donor site and a thin tube called cannula, which is connected to a syringe that collects the extracted fat, is inserted into it.
The collected fat is then purified and placed in a device (centrifuge) to separate the fat from other tissue components. A filtration process is also carried out to take out impurities and leave only the useful fat components. The fat is then transferred into small syringes and the patient is prepped for the second phase of the process, which is the injection of fat into the donor site.
An incision is then made at the donor site and a cannula is inserted. After a small amount of fat is injected, the surgeon withdraws the cannula and massages the site to distribute the fat evenly. The cannula is then inserted again to deposit another small amount. This process is repeated several times until enough fat is deposited or the desired results have been achieved. This is performed to make sure that the recipient site would look as natural as possible, without any appearance of irregularities that usually results if a large amount of fat is injected in one go. Afterwards, the cannula is removed and a dressing or bandage is placed over the graft site.
Swelling at the donor site is typical following the procedure but should resolve on its own after a few days. Patients are advised to rest for a week or two after fat transfer, taking care not to put stress on parts that received the fat. They can resume normal activities after a few weeks.
Possible Risks and Complications
Although relatively safe, fat transfer is linked to a number of risks and possible complications, including:
- Adverse reactions to local anesthesia
- Blood accumulation under the skin of either the donor or graft site leading to dark or purplish appearance
- Numbness and scarring in the graft site
- Damage to underlying tissues and structures
Chajchir A, Benzaquen I, Moretti E. Comparative experimental study of autologous adipose tissue processed by different techniques. Aesthetic Plast Surg. 1993 Spring. 17(2):113-5.
Gerth DJ, King B, Rabach L, et al. Long-term volumetric retention of autologous fat grafting processed with closed-membrane filtration. Aesthet Surg J. 2014 Sep. 34(7):985-94.