Fat grafting, also known as fat transfer or fat injection, is a relatively new procedure that’s catching on fast. And for good reason – it’s safe, effective, versatile, has a short recovery time, and produces natural-looking results. It’s also part of an exciting new field in medical research dedicated to stem cells’ regenerative properties.
Thanks to new scientific discoveries, excess fat deposits on your butt, stomach or thighs can now be used to enhance your face or breasts, or even stored away in the fat bank for a rainy day. “Regenerative scientists have demonstrated that fat is a huge reservoir for stem cells, which can be exploited to treat a host of medical and cosmetic conditions,” says North Attleboro, MA family physician and regenerative medicine specialist Dr. Ryan Welter.
Here’s the skinny on what some medical experts are calling “the liposuction gold rush”.
How fat is harvested and transferred
Common donor sites for fat grafting are the thighs, abdomen and butt – areas that act as reservoirs of fat that can be redistributed elsewhere, without us missing them. Plastic surgeons harvest the fat from these donor sites through liposuction, purify it, and then use special syringes to transfer it into the areas that need augmentation. This is most commonly done in the face, the breasts, the buttocks and the hands.
Facial volume restoration
As we age, one of the predominant areas we lose volume is our face. This explains why facial rejuvenation is currently the most common use of fat transfer, with some 50,000 procedures performed every year.
Facial fat grafting is most popular in 50-64 year olds, followed by the 35-50 year old range. The procedure lasts an hour and a half, and in some cases several sessions are required. The downtime is approximately two weeks.
“I always perform the liposuction and transfer on the same day,” says Palm Beach, FL facial plastic surgeon Dr. Jean-Paul Azzi. “The fat is transferred to the face in micro-droplets, which has a higher rate of permanent take.”
These micro-droplet injections are performed following the face tissue’s natural surfaces and planes, evenly distributing the fat following a grid to achieve the desired outcome.
The second most common use for fat grafting is in breast enhancement, with close to 20,000 procedures performed every year, most commonly among patients between 35 and 50 years old. “Breast augmentation with fat and stem cell transfer has been demonstrated to be very effective for long term minimally invasive breast enhancement,” says Dr. Welter.
Fat grafting is most useful when the breasts already have a nice shape and skin tone, since the technique can only provide modest increases in size. For sagging breasts or greater volume, implants and/or breast lift surgery provide more satisfying results.
The procedure takes between 2 to 4 hours, and it is sometimes necessary to undergo more than one treatment. Only 2 to 3 days of downtime are required, although the swelling from the liposuction may last significantly longer.
Fat grafting is very effective for evening out irregularities following the removal of breast cancers or lumps. It can also be used for complete breast reconstruction, although 2 to 4 fat grafting procedures are usually needed to achieve the desired breast volume.
Acne scar treatment
Some physicians use fat grafting as an effective treatment to elevate depressed scars. Also known as microlipoinjection, this fairly new procedure presents an interesting alternative to other acne scar treatments such as collagen or hyaluronic acid injections.
“Fat grafting can help with scarring and the overall appearance of the face,” says Dr. Azzi. “Since stem cells are simultaneously injected during this process, improvements are seen in both volume and skin texture.”
Brazilian butt lift
Fat transfer for a fuller, rounder butt is an increasingly popular procedure – so much so that The American Society of Plastic Surgery dubbed 2015 the “year of the rear”, with some 20,000 procedures performed.
This buttock augmentation procedure takes between 2 to 4 hours, and in some cases requires more than one treatment. Patients are normally back to normal activities within a week.
A person’s hands are a telltale sign of their true age. While skincare goes a long way to preventing sunspots and wrinkles, over time volume loss leaves us with vessels and tendons that are more visible on the back of the hands. Plumping up the wrinkled areas with fat transfer can provide visible rejuvenation and help improve the skin’s texture.
Fat grafting vs. hyaluronic acid fillers
Hyaluronic acid dermal fillers such as Juvederm Ultra, Voluma, and Restylane are among the most popular non surgical facial rejuvenation procedures. Though these prepackaged injectable fillers are made from naturally occurring substances, there still is a small risk of rejection, allergic reactions or irritation. In some cases, they can also be costlier than fat grafting.
“Fat can be used for someone who has a ‘gaunt’ appearance and needs a lot of volume,” says Dr. Azzi. “In such cases, resorting to dermal fillers can be financially impractical if many syringes need to be opened.”
And because it’s your own fat, there isn’t the risk of rejection or irritation that comes with prepackaged fillers. “The greatest advantage is the fact that, if done properly, a significant percentage of the fat transferred can have a long-term permanent take. It essentially becomes part of the face or body,” adds Dr. Azzi.
The biggest downside is that you will need to undergo liposuction first, since fat is only used for autologous transfer (meaning fat taken from a person can only be used in the same person). Furthermore, experts agree that fat grafting is highly technique-dependent, and that irregularities or unsatisfying results can be more difficult to correct.
Are there risks or side effects associated with fat grafting?
Slight swelling and bruising can sometimes occur after fat transfer procedures, but more serious side effects are quite rare. “The most common complications with fat grafting are the appearance of lumps or other irregularities,” says Dr. Azzi. “This happens when the fat cells are injected in areas that cannot handle such a large molecule. An example would be the tear trough under the eyes – the skin there is very thin and any large filler can appear irregular. I typically only use one or two fillers for such a delicate area.”
Since fat grafting requires a high level of skill and precision, the procedure’s success depends greatly on the surgeon’s technique and expertise.”The fat should be deposited after treatment in micro-droplets,” says Dr. Azzi. “This should be done in multiple levels of the face, but never too superficial to prevent the appearance of irregular lumps or bumps.”
Liquid gold: fat grafting’s powerful health benefits
Researchers have found that adipose tissue (ie, fat) represents an abundant and accessible source of adult stem cells. One of the main characteristics of stem cells is their ability to self-renew and become any type of cell in the body. “Because fat is abundant and because there is no ethical consideration in extracting fat – aside from patient consent, of course – these cells have been a focus of heavy research into how they may treat a host of conditions,” says Dr. Welter.
Once the fat is retrieved via liposuction, the extraction of stromal vascular fraction (SVF) occurs. This is where the stem cells are located. “Their regenerative potential is huge, and we are just now understanding their function in tissue repair,” explains Dr. Welter. “A good example is in the knee where SVF and mesenchymal stem cells from fat have been shown to stimulate cartilage growth!”
Other ways stem cells are used include stimulating hair growth, and in treating autoimmune diseases such as multiple sclerosis and rheumatoid arthritis. And since stem cells have a strong effect on modulating the immune system, there will no doubt be science emerging that reveals additional ways our own liquid gold can support our health, or perhaps even save our life.
The great part is that you can store your fat in a bank, much like actual gold. “Residual fat can be preserved in an accredited tissue bank for future use,” informs Dr. Welter. “This eliminates the need for further liposuction if another SVF procedure needs to be done down the road.”
So if you’re planning a liposuction procedure, consider storing your fat for future use. The investment could be well worth it.