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Fat Injection

When did they start this procedure?

The first 'fat grafting' procedure dates back to the late 19th century, 1893, when a German Plastic Surgeon, Gustav Neuber (1850-1932) transferred fat from the arm to the orbital (eye) region to correct scars formed from osteomyelitis (bone infection). Only two years later, 1895, Dr. Viktor Czerny (1842-1916) transferred a lipoma to the breast to establish symmetry following a unilateral partial mastectomy. However, fat grafting had trouble gaining acceptance during the next 100 years due to the many complications that routinely accompanied the procedure. Modern liposuction techniques had not yet been developed or standardized and the extracted fat was generally of inconsistent quality, which yielded poor results.In the 1990's, Dr. Sydney Coleman, a New York City Plastic Surgeon, began publishing papers describing standardized techniques for fat extraction, processing, and injection. Since that point in time, the procedure's popularity has only increased along with a wider variety of clinical applications.

What is this procedure?

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. Body fat makes excellent soft tissue filler material. Fat injection (also called autologous fat transplantation) transfers fat from one part of the body to another to recontour the face; diminish frown lines, crow’s feet and nasolabial folds (smile lines); and provide definition to areas like the cheeks and chin. It can also be used to fill out depressed scarred areas on any part of the body. Fat injection is not permanent, and may require an effective maintenance program.

Who needs this procedure?

Patients who benefit from this procedure are patients who want to look Natural. Outpatient procedure that generally takes under an hour.

  • Injections may last from several months to permanently.
  • Little or no downtime.
  • Minimal discomfort, which can be controlled with medication.
  • Because fat is from the patient’s own body, no pre-testing is required and the fat cannot be rejected.
  • Good alternative if the patient is allergic to bovine collagen.
  • Cost effective if combined with another procedure like lipoplasty (liposuction).

The advantages of fat injections are:It uses your own tissue instead of an implant.Fat is removed from an area where you don’t want it.Many women report that their fat-graft-reconstructed breast has some sensation and feels soft, much like the other unreconstructed breast.

What is the advantage of this procedure?

The donor site (for example, abdomen, buttocks or thighs) and the treatment site are injected with local anesthetic. Intravenous (IV) fluids also are injected into the donor site to facilitate fat collection. Fat cells are extracted through a small needle attached to a syringe. The fat is then processed to remove excess fluids and reinjected with another needle in multiple thin strands in the desired area. "Overfilling" is a necessary corrective due to fat absorption in the weeks after treatment. Fat also can be harvested during a lipoplasty (liposuction) procedure in one area of the body, and then reinjected in another. For longest-lasting effect, patients generally receive 3 to 4 treatments over a six-month period.

Are there non-surgical treatments?

With patented AirSculpt® technology, quality fat can be safely transferred from one part of the body such as tummy or thighs to naturally enhance buttocks, breasts or aging hands. AirSculpt® procedures are minimally invasive and require no needles, stitches or general anesthesia, Using AirSculpt® technology, unwanted fat is carefully removed from a large area of the body such as the tummy/waist, then transferred to your buttocks. This simultaneously sculpts a flatter stomach and smaller waist while contouring a shapelier butt—all in one procedure.

Up a Cup™ breast augmentation removes a patient’s natural fat from one part of the body—typically tummy or thighs—and transfers it to the breasts during the same session. There’s no silicone or other foreign material implanted. AirSculpt® natural breast enhancement is best suited for women who want to go up only one cup size.

The rejuvenation of aging hands is a simple, minimally invasive procedure using the AirSculpt® fat transfer process. It can make hands look smoother and more youthful.

What is the surgical treatment like local or sedation?

The level of anesthesia depends on the kind of surgery you might need. If there is a significant muscle separation, repairing that with only local anesthesia can be uncomfortable. If you require liposuction as well as skin removal, the surgeon must infiltrate higher volumes of dilute local anesthetic. Injecting the local anesthesia can be very uncomfortable in some patients. You should consult with a board-certified plastic surgeon.

How long does it take?

Fat injection procedures generally take about one and a half hours to complete. Once the procedure is complete, the results may last for more than one year. In some cases, however, the results may last for as little as three months. Therefore, it may be necessary to have the procedure repeated.

What are the complications?

The decision to use fillers is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications of dermal fillers are acceptable.Your plastic surgeon and/or staff will explain, in detail, any risks.You will be asked to sign consent forms to ensure that you fully understand the procedure, as well as the risks and potential complications.Severe complications from dermal fillers are uncommon. Potential risks vary depending on the specific filler used and the relative permanence of the filler substance and include:

  • Acne-like skin eruptions
  • Asymmetry
  • Bruising, bleeding from the injection site, swelling
  • Damage to the skin that results in a wound and possible scarring
  • Infection at the injection site
  • Lumps
  • Palpability of the filler under the surface of the skin
  • Skin rash with itching
  • Skin redness
  • Under- or over-correction of wrinkles
  • Blindness
  • Skin necrosis (ulceration or loss of skin from disruption of blood flow)

These risks and others will be fully discussed prior to your consent.It is important that you address all your questions directly with your plastic surgeon. Although good results are expected from your procedure, there is no guarantee that you will be satisfied with your results. Because significant complications can occur from dermal filler injections, it is important to be in the care of a board certified plastic surgeon who understands the risks and is trained and prepared to deal with any complications that may occur.In some situations, it may not be possible to achieve optimal results with a single procedure. Most fillers do dissipate over time. To maintain your correction, you will need to consider repeating the injection process at intervals.

What is the recovery like? What can you do to speed up recovery? Do you need to rest up afterwards and for how many days?

For the first few weeks after surgery, your initial results will be completely masked by swelling caused by tissue damage. Even after the swelling goes down, it can take upwards of six months to see your final results. Be patient and don’t worry, this is all part of the recovery process.

Like with any surgical procedure, you can expect some pain and discomfort during your initial recovery period as your tissue begins to heal. There is a very good chance that you have extensive bruising and swelling in the areas where the fat cells were taken from, and in the area where they were injected. This pain can be managed with prescribed painkillers from your doctor, or even Tylenol, depending on your level of discomfort.You shouldn’t do any heavy exercise or strenuous activity for at least a month after the procedure. That said, after a full week of recovery, walking is greatly encouraged. Walking will improve your blood circulation, speed your healing, and might even improve your results!