Fat transfer/grafting is the transfer of fat from an unwanted area to another area which has lost volume or that needs reshaping. Thanks to popular celebrities like Kim Kardashian and Nicki Minaj, this procedure has seen its popularity soar. The most common areas where fat is transferred are the face and the buttocks. It may be paired up with liposuction procedure when necessary. Recovery time is between 1-4 weeks, depending on the areas treated.
The process of fat grafting involves three steps:
Extraction of the fat from the donor area with liposuction
Decanting, centrifugation, and processing of the fat
Reinjection of the purified fat into the area needing improvement
In the first step, fat is extracted from a donor area using liposuction techniques. This is best accomplished by manual methods using thin liposuction cannulas with small holes. Laser or ultrasonic liposuction should not be used for the extraction as it may destroy the fat cells.
The fat is then processed with decanting and centrifugation to separate debris, excess fluid, and dead cells from the viable adipose fat cells. An alternate method is to wash the fat with a sterile saline solution. The fat that is discarded are the fat cells which will likely not survive in the graft and they can even create problems for the good cells.
In the final step, the fat is reinjected in small droplets throughout the subcutaneous tissue of the recipient area. This is to ensure good blood supply to every fat droplet so that the fat graft can survive.
The amount of fat injected is measured in cc’s and ultimately varies according to patient case specifics and the area of the body where the processed fat is being injected.
Types of anesthesia used
Fat grafting is performed with a wide variety of anesthetics. The choice of anesthesia usually depends of the volume of fat that is extracted from the donor area via liposuction. Extraction of small volumes of fat can easily be tolerated using a local anesthetic. However, larger volumes (>500cc) almost always require that the patient be sedated with IV anesthesia or General Anesthesia.
While local anesthesia can be administered by the surgeon, IV anesthesia or General Anesthesia should be administered by a CRNA (Certified Registered Nurse Anesthetist), or better yet, a Board Certified Anesthesiologist.
Common areas of fat grafting
A summary of common fat grafting applications and the associated volumes of fat injected is as follows:
- Restores youthful appearance by adding volume to hollowed out or wrinkled areas such as the area below the eye and the nasolabial folds
- Helps repair scars
- Adds volume to the cheeks to create the appearance of higher cheekbones
- Improves the texture and appearance of the skin
- Increases the breast size by one or two cup sizes
- Corrects breast asymmetry
- Repairs radiation tissue damage and can treat breast implant capsular contractures
- Helps correct scar deformities from lumpectomy or breast reconstruction
- Adds volume to achieve a more feminine profile and better waist-hip ratio
- Makes buttocks appear perkier
- Augments buttocks size (aka Brazilian butt lift)
- Reduces wrinkles and rejuvenates appearance
- Provides padding for bony feet