During the aging process, we lose much of the youthful fullness in our face leading to a tired, sunken look. Today, the new thinking in plastic surgery is to replace this lost volume in the face, rather than pull it tighter. Oftentimes, the good option is to use a dermal filler material (Restylane® or Radiesse®) if the area to be addressed is relatively small, such as the lips or smile lines. In cases where a more significant amount of volume enhancement or replacement is required, fat transfer is a better way to achieve the desired result. Fat transfer, also referred to as autologous fat transfer, fat augmentation or fat injection, is a procedure which involves the use of a patient’s own natural fat to treat unwanted wrinkles and creases or to provide additional volume to the face.
Fat Transfer Candidates
Good candidates for fat transfer include men and women who are physically healthy, have realistic expectations, and are interested in improving the contour of the face by diminishing lines and/or adding fullness. Areas commonly treated with fat transfer include the lower eyelids, cheeks, nasolabial folds, and the jawline.
The Fat Transfer Procedure
Most fat transfer procedures are performed in a surgeon’s office-based facility and typically involve local anesthesia on the donor and recipient sites. Some patients may also be given oral sedation. The procedure usually takes less than an hour to complete and is associated with only mild postoperative discomfort. Many patients elect to have fat transfer performed as an adjunct to a more invasive surgery. In this case, the procedures may be performed together in an outpatient surgery setting with deep sedation or general anesthesia.
During the fat transfer procedure, fat is harvested through a small incision from either the neck or the abdomen. The fat is then cleansed and concentrated, after which it is injected into the desired area. In those seeking a natural alternative for treating deep facial wrinkles or simply adding volume to the face, this is an excellent option. There is minimal swelling and rarely any significant bruising. Most patients can return to normal daily activities within a short period of time following the procedure.
Chin Augmentation with Fat Transfer
Fat transfer is a great alternative for those patients looking to augment their chin with an implant. Although chin implants are still used quite regularly – and provide excellent cosmetic results – fat is a wonderful option to consider as well. Fat transfer chin augmentation has the advantage of being able to correct for inherent asymmetries around the chin (which chin implants cannot do). Plus, fat transfer chin augmentation provides a significant long-term cosmetic improvement using your own body’s tissue.
Fat Transfer FAQs
Q – What is fat transfer?
Fat transfer, also referred to as autologous fat transfer, fat augmentation, or fat injection, is a procedure which uses a patient’s own natural fat to treat unwanted wrinkles and creases or to provide additional volume and shape to the face. While injectable fillers such as Restylane® and Radiesse® are good options today for replacing lost volume in the face, fat transfer is often preferred in cases where a more significant amount of volume enhancement or replacement is required. Fat transfer is commonly used to treat the lower eyelids, cheeks, nasolabial fold and jawline.
Q – Who is a good candidate for fat transfer?
Men and women who are physically healthy, have realistic expectations, and are looking to improve the contour of the face by diminishing lines and/or adding fullness may be good candidates for fat transfer. Fat transfer is often preferred over injectable fillers like Restylane® and Radiesse® in cases where a more significant amount of volume enhancement or replacement is necessary. In general, patients who have slightly more body contour and shape to begin with are considered better candidates for fat transfer compared to individuals who are excessively thin. These patients have fat cells that are more robust and plump and, consequently, these fat cells are more likely to provide volume enhancement when placed elsewhere.
Q – Where is the fat transfer procedure performed?
Fat transfer is an office-based procedure when performed on its own. However, many patients elect to have fat transfer done as an adjunct to more invasive surgery performed in the outpatient surgery setting.
Q – What type of anesthesia is used for fat transfer?
Local anesthesia with or without oral sedation is used if fat transfer is performed in the office. Deep sedation or general anesthesia is used if the procedure is performed in the operating room.
Q – How is the fat transfer procedure performed?
Fat is harvested through a small incision made in the planned donor area. For instance, fat taken from the abdomen involves the use of a small incision made within the umbilicus (belly button). The fat is harvested using specialized liposuction techniques. Narrow liposuction cannulas that are specifically engineered for use in fat transfer allow for gentler removal of the fat. In most cases, suction is created using a hand-held liposuction device rather than the normal suction machine. Using the hand-held liposuction device, the fat is less likely to be damaged by undue negative suction pressure and more likely to survive.
Once removed, the fat is then cleansed and concentrated using a special technique that minimizes potential damage to the fat cells. The fat is placed into individual syringes and injected using a micro-injection technique. This technique involves the use of specialized injection cannulas that are approximately 1mm in width. The fat is deposited into the area of concern using literally hundreds of different droplets of fat dispersed along multiple tissue layers. This micro-injection technique of fat transfer maximizes the chances that the fat being placed will have an optimal blood supply to survive. In most cases, more than enough fat is placed in each area (termed overcorrection). This is done because of the fact that some degree of fat resorption will take place over the following weeks. It is somewhat difficult to predict just how much fat will be lost in any particular patient. Due to this fact, most patients require a series of fat transfer sessions to ultimately achieve the desired level of augmentation.
Q – Where are the incisions located for fat transfer?
The incisions for harvesting the fat (using the liposuction technique) involve narrow slits made around the abdomen (umbilicus), hips, buttocks or thighs. The fat injections are performed through even smaller slits (termed stab incisions) which are hidden within facial skin creases that are already present.
Q – How long does the fat transfer procedure take to perform?
Fat transfer usually takes one to two hours to complete depending on how much augmentation is necessary.
Q – Is fat transfer a painful procedure?
Any pain or discomfort associated with the fat transfer procedure is usually very minor.
Q – What is the recovery like after the fat transfer procedure?
Patients will experience mild swelling and mild bruising during the first three to five days after treatment. If patients note an area that is not necessarily as smooth as the remaining areas, gentle circular massage may help to blend the fat into the surrounding tissue. It is important, however, to avoid excess pressure as this may cause too much dispersion of the fat. Most patients are scheduled for a follow-up appointment within four to seven days after the procedure for a recheck. Patients are usually able to return to work within three to five days. The final results of a particular fat transfer session cannot be determined in many cases for upwards of several months. If additional volume is desired after this waiting period, another round of fat transfer may be scheduled.
Q – When are the stitches removed after the fat transfer procedure?
The stitches are removed within four to seven days after the fat transfer procedure.
Q – When will I be able to return to work after undergoing fat transfer?
Patients are usually able to return to work within three to five days after the fat transfer procedure.
Q – When will I be able to exercise after my fat transfer procedure?
Most exercise can be resumed within seven to ten days after the fat transfer procedure.
Q – Are there risks or complications with fat transfer?
Though all types of surgery carry potential risks, fat transfer is a relatively safe procedure. In rare cases, patients may note lumping of the fat in a particular area which is often more a reflection of the body’s healing process rather than a technical issue with the procedure. If this occurs, gentle massage may help to smooth the contour. Alternatively, steroid injections and/or lipodissolve injections may provide additional benefit.
Q – Does insurance cover the fat transfer procedure?
Fat transfer procedure which are performed for cosmetic purposes alone are typically not covered by insurance.
Read more about fat transfer procedures.
Dr. John Hilinski has either authored or reviewed and approved this content.