Fat grafting is the surgical process wherein fat is transferred from one site to another. Fat injections can reduce the appearance of fine lines, wrinkles, hollow/sunken skin and sagging/drooping skin. Fat grafting aids in adding volume or augmenting areas of the body – resulting in plump, symmetrical and an enhanced youthful silhouette.
Fat transfer is popularly used to enhance the lips, face, neck, breasts, hips, buttocks, hands and feet. Fat grafting is also popularly used to reconstruct the breast post-mastectomy. This procedure has recently also gained popularity in the treatment of scars and breast tissue post-radiation treatment.
- Expectations – during the consultancy, the patient is prompted to express their desired expectations with the surgeon and discuss its possibilities. Showing pictures of desired results is more helpful in reaching a consensus.
- Medical history – the physician will ask the patient about their past-medical history as well as family history to ensure that they are eligible to undergo the surgery. Patients with blood disorders are advised not to undergo this procedure as they are at higher risk.
- Photography – a professional will take before and after pictures in different angles to record the change made due to the procedure. The patient may also be provided with a photoshopped picture before the surgery to have realistic expectations.
- Smoking – the patient is strictly advised to avoid smoking a week before the procedure as it can affect the surgery and healing process of liposuction.
- Medications – after reviewing the patient’s medical history, the physician may ask the patient to stop consumption of certain medicines. They include – aspirin, immunosuppressants, anti-inflammatory medicine, herbal capsules, blood thinners and other anti-coagulants.
- Care – the patient may be asked to arrange for driven transport if they cannot drive post-surgery.
- Step 1: liposuction
Fat grafting begins with liposuction and is typically performed using local anaesthesia. Fat is extracted from the adipose layer in the donor site. This is performed using thin liposuction cannulas to ensure that there is no unnecessary damage to the fat cells. The incision made is closed using sutures.
General anaesthesia may need to be used if liposuction is above 500cc.
- Step 2: purification
The extracted fat is then processed via decanting, centrifugation or by washing the adipose tissue in sterile saline solution. Processing the fat ensures that only healthy adipose cells are transferred into the recipient site while leaving behind debris, fluids and necrosed cells.
- Step 3: delivery of fat
The purified adipose cells are then delivered by the surgeon to the recipient site/ target area via injection to achieve desired results. The fat is deposited evenly to ensure that there is good blood supply to avoid necrosis.
Risks & recovery
- Downtime – the patient can resume normal activities in 5 to 14 days, depending on the extent of liposuction.
- Activities – Swimming, gymming or any strenuous exercise should be avoided until prompted by the surgeon.
- Bruising – since this procedure involves augmentation, the skin will stretch rapidly and lead to severe bruising.
- Sensation – there may be partial loss of sensation after complete healing. This can cause temporary or permanent numbness around the treated area.
- Necrosis – there is a possibility of fat necrosis/ adipose cell death.
- General risks – surgical procedures may cause redness, bruising, bleeding, haematoma, pneumothorax, scarring and infection.
- Rest – the patient is advised to take complete rest to promote fast healing.
- Ice & compression – the wound should be compressed with an ice pack to reduce swelling.
- Elevation – the patient is advised to keep the donor site in an elevated position. This reduces swelling and avoids tugging / pulling on the sutures.
- Smoking – the patient is strictly advised to avoid smoking for up to two weeks post-treatment. Smoking can interfere with blood flow and can cause problems with healing.
- Alcohol – the patient is advised to avoid alcohol consumption for a few days as it can counteract with medications prescribed for aftercare.
- Medicines – the surgeon may prescribe painkillers and antibiotics. They can be a combination of tablets as well as topical treatments. These medicines need to be used promptly as prescribed by the physician.
- Makeup – makeup can be used to conceal any prolonged bruising and scars post-recovery.