Fat grafting

What is fat grafting?

Fat grafting is a procedure which removes surplus fat cells from one area of the body and then re-implants it where needed. For example, fat grafting fills facial features with a patient's own fat. Fat grafting is also called free fat transfer, autologous fat transfer/transplantation, liposculpture, lipostructure, volume restoration, micro-lipoinjection and fat injections.

The fat used for fat transfer is extracted from the abdomen or thighs and injected into another area.

The advantage of fat grafting is that the fat is autologous (it comes from your own body), so allergic reactions do not occur, unlike when other external implant substances that are introduced into the body. Your body naturally accepts the injected fat.

Where can fat grafting be used?

Fat grafting can be used for correcting or improving:

• Facial scarring, such as acne scars and lupus panniculitis
• Facial volume, in diseases such as hemifacial atrophy
• Sunken cheeks and facial lines

Fat grafting lasts longer in larger areas of non-movement, so while it is successful for the correction of grooves under the eyes and sunken cheeks, it may not be as successful for creating fuller lips. Fat grafting can also correct ageing hands where the natural tissue is lost between the bones.

Fat grafting is not recommended for breast augmentation as the grafted fat can later make it difficult to detect breast cancer.

How is fat grafting performed?

Fat grafting is performed in your doctor's rooms on an outpatient basis. There are basically 3 parts to the procedure.

After the procedure, avoid massage and excessive facial movement, as this will stop the migration of the fat away from the desired areas of treatment. Ice compresses may be used for 24–48 hours to minimise inflammation.

The doctor will review about a week after the procedure to check both the donor and recipient sites. A follow-up appointment 6–8 weeks later should see most of the swelling resolved and early results. A repeat procedure may need to be performed if the desired outcome has not been achieved but this should not be within 3 months of the first graft.

How long do fat grafts last?

How much of the graft survives and for how long is currently unknown. Over the first few months, about 65% of the fat is reabsorbed. The remaining 35% will usually stay in place. It appears that the amount resorbed by the body and ultimately the longevity of the graft is highly dependent on the technique used in grafting. Newer techniques are being developed to increase longevity. For longer lasting results, patients may receive 3 or 4 treatments over a period of 6 months to a year.

Are there any side effects or complications from fat grafting?

A moderate amount of swelling is expected after the fat graft. This is usually evident for 2 weeks after the procedure. Some bruising may also be apparent.

Some complications of fat grafting include:

• Undercorrection: desired outcome not achieved thus requiring a further graft to complete the correction.
• Overcorrection: too much fat is injected into the area. This prevents new blood vessels growing to supply the graft, leading to cell death and a lumpy consistency.
• Clumping of the graft.
• Accidental damage to underlying structures such as nerves and blood vessels, particularly around the eye.
• Bleeding: usually associated with the use of sharp needles for fat injection.
• Infection.
• Scarring of the donor site.