Fat a touchy subject, once known as a taboo to think of on your body, is now the source of recent hype in the realm of aesthetic care. How did something so despised become useful? one may ask, it is indeed true that fat grafting has been dabbled around with for the past decade, nonetheless, it has debatably been found to be the ideal replacement for the temporary and overhyped fillers.
Let’s touch a bit upon the history of fat grafting and its uses in the medical world. Just like another thing of science, fat has been experimented with from the late 1800s. From facial reconstruction, hand restoration and breast asymmetry, the usage of adipose tissue for fat grafting, has irked the minds of many pioneers. However, this discovery came along with its heaps of hurdles. The biggest hurdle of them all was the high percentage of re-absorption of fat injections. It wasn’t until the late 1900s and the introduction of liposuction, that brought a light at the end of this dark tunnel. After which, the true potential of adipose tissue was uncovered and scholars started accepting said research.
Fat grafting has multiple applications all over the body that don’t just limit to plastic surgery. Fat has also been used extensively in trials involving; chronic obstructive pulmonary disease, Crohn’s disease, urinary incontinence, pulmonary fibrosis, fistula and regenerative medicine that helps with ailments like autism, Parkinson’s etcetera.
How is fat grafting different from fillers?
Fat grafting makes a natural resource available to redistribute across the body, whereas, fillers are chemical substances that require continuous maintenance and have few more risks. In essence, it performs the job of fillers yet provides much more natural and long-lasting results with better abilities to volumize. Nevertheless, the usage of fat still sends shivers down some spines, as its excellent effects come along with experience, expertise and constant refinement of technique.
The process of fat grafting is not as complicated as it seems, rather, it occurs in three simple steps.
Step 1: Fat harvesting
The process of fat grafting begins with the extraction of the required amount of fat. A donor site like the abdomen, thighs or other rolls are chosen and the fat is extracted via liposuction. The procedure of liposuction involves using long, thin straw-like instruments known as cannulas to remove fat from the desired area. The cannula is skillfully moved using windshield wiper motions and fat is drawn out using gentle suction.
Step 2: Processing
The extracted fat is purified and refined using a centrifuge, water or a saline solution. This process ensures that the extracted adipose cells are clean of excess blood, fluid, debris and necrosed cells that were brought along with the required fat.
Step 3: Grafting
The final step involves the refined fat to be transferred into the recipient site. The placement of the graft is crucial as it decides the final outlook.
A rather recent technique of improved fat grafting includes small volumes of grafts placed in multiple regions of the recipient site. This placement technique permits adept blood flow through the cells and prevents them from becoming necrosed. Another benefit of this technique is that it allows for a more seamless finish.
Let’s talk about eligibility;
The optimal candidate for this type of procedure should be 30 to 65 years of age, within their ideal BMI range and should not have any circulatory ailments. It is rather beneficial if the patient is a non-smoker or is willing to quit smoking for a few weeks prior and after the procedure.
The next big question is where is all this fat going to be put?
Within the niche field of plastic surgery, fat grafting has multitudes of uses which can be arranged into four categories;
Elevating features of the human body is the core principle involved in aesthetic surgery. Fat grafting is one of the popular methods currently to utilize what is naturally available and set it in the right place. So what does fat help enhance?
To begin with, it is a game-changer for breast enlargement. Breast augmentation is arguably one of the most sought after aesthetic procedures. Fat grafting is slowly growing to be the ideal technique for this procedure as it offers natural and seamless results that are soft to the touch, unlike implants.
The usage of fat grafting in breast surgery does not just limit to size enlargement but it is also used in breast asymmetry correction in congenital deformities with tuberous breasts or Poland’s syndrome.
Secondly, fat grafting aids in elevating the aesthetic features of lips. Lip fillers are a growing trend, that helps elevate the patient’s facial profile; unfortunately, they are temporary and require quite a bit of maintenance. This is where our pal fat steps in as the perfect long-lasting candidate in par with chemical fillers to enhance that pout.
And lastly, fat transfer helps in enhancing the abdomen. One may think that fat on your belly is bad, but, haven't we all dreamt of having a six-pack without having to exert ourselves with constant high-intensity training or stringent diets? Now, all that can be achieved using abdominal etching.
Abdominal etching is a procedure that combines liposuction and lipofilling to redistribute the fat already present in the abdomen on top of the abdominal muscles to create an impression of a six-pack. Though this procedure does not require heavy-duty effort to achieve, the patient will have to lead a healthy lifestyle to maintain the results.
It is a known fact that as we age, our skin tends to shrivel up and vividly show signs of ageing owing to its fragile nature. Anti-ageing treatments help tighten the skin, but recent developments show that using anti-ageing treatments in combination with fat grafting, provides more natural results that buy the patient a few more years.
The face and neck behold the initial signs of ageing. It all begins with wrinkles, fine lines and then gradually progresses to volume loss and drooping skin. In addition to the popular facelift, fat transfer helps fill out the hollowness caused by volume loss and have a blurring effect by gently stretching lines of ageing. Fat grafting is widely used to enhance the cheeks, forehead, brow bone, temple and mandibular (jaw) regions of the face, chin and neck.
During eyelid surgery or blepharoplasty, lipofilling helps smoothen out volume loss and provides a three-dimensional effect while enhancing a youthful appearance. Fat grafting can also help lighten under eye dark circles that have been caused due to volume loss.
Features like the earlobes, hands and feet are less noticeable in comparison, but, they can be the tell-tale sign of one's true age. Ageing is a uniform process that occurs everywhere on the outside and when obvious regions like the face have been worked on, these features become more prominent. Fat helps even-out the hollow, wrinkly and sagging skin to make one look a lot younger.
An unusual application of fat grafting is labial rejuvenation. Just like the rest of the body, the labia can also undergo volume loss and shrivel. This instance can also occur in women who have had multiple pregnancies. Fat injections help restore fullness and make the labia plumper.
Fat grafting is popularly used for redistribution of fat to help achieve a more cinched and curvaceous silhouette, thus, serving a dual purpose.
Liposculpture, as it is otherwise called, is widely utilized to contour the buttocks and lower limb region. Fat redistribution via fat grafting in these regions effectively helps in achieving the desired hourglass figure.
The widely popular Brazilian butt lift is also a body contouring procedure that combines a buttocks lift and fat transfer.
As mentioned previously, fat has the glorious ability to plump and smoothen out dents. Therefore, it can be used to correct any deformities that have occurred due to trauma.
Breast reconstruction after a lumpectomy or mastectomy is now possible by using fat grafting to restore the shape and size of the removed breast tissue. Another possibility of using fat transfer is scar correction. Whether it is due to surgery or trauma, scar hypertrophy and denting can be corrected to an extent to reduce scar visibility in mature scars.
Are there any potential risks?
Just like any other surgical procedure, fat grafting also comes with its set of medical risks like; bleeding, swelling, infection, fat/skin necrosis, nerve injury, cyst/haematoma formation, and embolism. The other risks are based on the practitioner's skills include; asymmetry, hollowness and dissatisfaction.
Let’s brush up on the advantages of fat grafting:
Lipofilling has reduced risk when using a skilled surgeon.