Fat Grafting

Fat grafting, or fat transfer, is a technique that can be used by plastic surgeons for a variety of purposes.  While often used for facial rejuvenation, fat grafting has also become a popular option for improving breast shape and volume. Fat grafting can serve as the final procedure after a breast lift, breast augmentation, or breast reduction.  It is also used frequently as an adjunct to breast reconstruction. In either case, fat is harvested from areas where a patient has excess fat such as the hips or abdomen. A tiny incision is made and the fat is then suctioned out with a thin cannula and kept in a container to use during surgery. The fat is then injected into the target area to improve the contour or enhance volume.  Fat can actually be grafted anywhere in the body where a contour deficit is present or where extra soft tissue volume is desirable.  Because fat grafting uses fat tissue from the same individual, it is considered very safe. Dr. Walton was an early pioneer of fat grafting and has extensive experience in the technique.

Why Have a Fat Grafting Procedure?

Fat grafting is considered a minimally invasive procedure because it requires only a small incision to insert a hollow tube to suction out excess fat, and a small incision to insert the fat into the area(s) to be augmented.  This fat is suitable as an injectable “Natural” filler.  The amount of fat that can be injected into any particular area depends on the specific area of the body and the condition of the tissue environment into which the fat is injected.  The volume of fat injected into will usually dissipate over time (usually within 6 months) to 40-50% of its original volume and thereafter remain stable. Repeated fat grafting interventions can permanently restore contour and volume in selected areas and for this reason, fat grafting is thought to be a better solution as a soft tissue filler compared to commercially available fillers.

Fat injections into the breast are performed in conjunction with other procedures such as breast augmentation, breast reduction, and breast reconstruction. Fat grafting alone is generally insufficient to use as the sole means for restoring an entire breast volume, although some surgeons have demonstrated the feasibility of fat grafting for such purposes.  Fat grafting in the breast is most commonly performed as an adjunct to other breast procedures.  For example, in breast augmentation, after a saline or silicone gel implant is inserted, a small amount of fat can be injected in a depressed area or along the base of the breast to improve breast contour and create a more natural look. (Remember the magazine models in whom can be seen the “edge” of the implants in their augmented breasts?) After a reduction surgery to make the breast smaller, fat can be injected around the nipple and areola area to improve projection and contour. Fat grafts can also be used to fill small areas where growth or tumor was removed, leaving a hollow area in the breast.

Fat injections in the face are performed to soften the nasolabial creases that form with age, add volume to the cheeks, and correct the hollowing of the temples.  Fat grafts are also used to smooth the tear trough deformities around the lower eyelids.  Compared to breasts, fat grafting in the face generally gives the best results with volume retention, which in some cases may exceed 80%.

Fat Grafting Procedure

Fat is suctioned from an area of the body that has excess fatty deposits. In most women, excess fat can be found in the hips or abdomen.  These are the areas usually targeted for fat harvest, but any body area can serve as a harvest sit. The fat is suctioned into a sterile container.  After the fat has been harvested the tiny skin incisions may be stitched closed and a compression girdle placed to minimize swelling and fluid collection.

Depending on the amount of fat harvested, a local or general anesthetic will be used.  Local “touch-up” procedures can usually be done in-office under local anesthesia.  Larger fat volumes harvested from multiple areas are usually performed under general anesthesia in a surgicenter or hospital setting.

Are You a Candidate?

In General, a patient will require one or more consultations to determine if a fat grafting procedure is suitable and will address a specific concern. During your consultation with Dr. Walton, we will collect information about previous surgeries, medical conditions, or allergies to avoid complications during the fat grafting procedure.  It is important to list all herbal remedies, medications, or supplements you are currently using to avoid problems such as excessive bleeding during and after surgery.

Preparing for Your Fat Grafting Procedure

Before undergoing the fat grafting procedure, patients will be provided with guidelines to minimize risks and improve outcomes. By following these guidelines, patients will be less likely to experience complications such as excessive bruising or bleeding. By being active participants in the perioperative decision process, patients will also have a better understanding of their health issues and consequences that might affect the outcome.  Below are common things we recommend prior to fat grafting:

  • Smoking – Patients who smoke are required to stop at least six weeks before undergoing the fat grafting procedure to prevent respiratory difficulties and impaired healing.
  • Stop Using Certain Medications – At least two weeks before fat grafting, patients should avoid using non-steroidal anti-inflammatory medications such as aspirin or ibuprofen that increase the risk of bleeding. In addition, many supplements and herbal remedies can also cause bleeding and these should be discontinued.  Dr. Walton’s office will provide a list of some of the most common medications and supplements to avoid prior to surgery.
  • Drink More Water – Surgeons often advise patients to drink more water before a fat grafting procedure to have better-hydrated tissue throughout their body.
  • No Alcoholic Beverages – Stop drinking alcoholic beverages at least one week before a fat grafting procedure to minimize anesthetic and bleeding risks.
  • Arrange Postoperative Care – A patient cannot drive immediately after a fat grafting procedure and will require somebody to be present at home and with them for a minimum of 24 hours following surgery.
  • Have a Compression Garment – Patients require a compression garment after a fat grafting procedure and should wear comfortable clothing to the surgeon’s facility.

Next Step

For an appointment, please call Chicago Plastic Surgery, LLC office at 312-337-7795, or contact Dr. Walton by filling out our online form. We look forward to meeting you and helping you achieve your fat grafting transformation here in Chicago.