Fat grafting, also known as fat transfer or fat injection, has broad applications in aesthetic plastic surgery. Fat can be injected to enhance volume in tissues where fat has diminished. Fat grafting involves harvesting fat from one part of the body, washing and purifying it, and then carefully re-injecting it into the areas requiring augmentation. Many of Dr. Charles Hsu’s Beverly Hills plastic surgery patients choose to do what is commonly called a Brazilian Butt Lift, which involves a fat transfer to their buttocks. The procedure may need to be repeated several times to achieve the desired result but can produce long-lasting and natural-appearing results.
Best Candidates for Fat Grafting
The purpose of fat grafting is to augment or fill in volume-deficient areas. Common treatment areas include:
Buttocks augmentation: Many people who desire a fuller, more rounded buttock will opt for a Brazilian butt lift, which uses fat transfer instead of an implant.
Hand rejuvenation: Fat grafting into the hands is effective for adding volume, plumping up wrinkled areas, covering underlying vessels and tendons, and improving the quality of the skin.
During the consultation, Dr. Hsu will first ask about the patient’s goals, and specifically what areas of the body the patient would like to remove the fat from, and what areas they would like to put it into. He will also ask about medical history to determine if the patient is a good candidate, Dr. Hsu will explain the next steps in going forth with the procedure. In order to reach the best results, the patient and Dr. Hsu will decide all the necessary details and options together.
After liposuction is performed to remove fat ,the fat is purified and then washed with an antibiotic rinse, placed in sterile syringes, and then injected in small doses to the chosen area. Dr. Hsu's technique is to carefully inject various areas in very small deposits, which ensures that the fat cells receive enough blood supply to live and heal properly. One limitation of the fat transfer is how much fat Dr. Hsu can use from liposuction. The volume of the fat transfer depends highly on the amount of available fat after liposuction.
Recovery and Post-Op
The patient will be put in a compression garment that must be worn at all times for the first two weeks to ensure the fat remains where it was injected. Patients will need to keep the treated areas dry and avoid pressure by sleeping on their stomach and using a large pillow when sitting. Patients usually return to work after 2 weeks when the swelling and bruising have decreased. While patients should walk frequently during the recovery period to promote healing and prevent blood clots, strenuous exercise should be avoided for at least 6 weeks.
From Dr. Hsu
“Fat grafting has gotten more popular over the past ten years as there has been more recognition among plastic surgeons that there are changes in fatty tissue volume as the body changes. Central among these has been a rise in popularity of fat grafting to the buttocks, also termed a Brazilian lift. In reality, the skin is not being lifted, but the increase in volume from fat grafting gives an appearance of a lift to the area, and hence the name.
As with liposuction, this works well for patients who have specific areas that they would like improved. There is a limit on the amount of fat that can be transferred safely, so it is best used when the fat can be directed to specific areas in the buttocks. A large number of my patients for fat grafting to the buttocks mention specific hollows in the outer areas of the buttocks, particularly that they have noticed over time. In these patients, directed fat grafting to these areas can be very successful.
Fat transfer does require patience for the areas to soften. The increase in volume can be seen right away, and patients can usually get around without difficulty by two weeks after surgery. It can take some time for small areas of firmness to be softened up with the use of massage, so I always advise patience when it comes to this.”
Frequently Asked Questions
What can I expect from my Fat Grafting Results?
Patients can expect the areas to which the fat was transferred to appear softer and fuller, giving a refreshed and rejuvenated appearance. Some patients even notice an improvement in skin texture. The survival of the fat and longevity of the results depend on how the fat was harvested and purified, and how and where it was injected. To be performed successfully, fat grafting requires a surgeon, like Dr. Hsu, with highly developed skills based on experience and knowledge of the technique.
How is the fat harvested?
Dr. Hsu will select a site for fat removal based on his consultation with the patient and will inject it with a local anesthetic. Dr. Hsu will then create a small incision in the area for fat removal and, using a sterile technique, insert a cannula connected to a syringe to carefully extract fat.
How is the fat purified?
For the purification, Dr. Hsu will process the removed fat to prepare the fat cells for transfer to small syringes that will be used for fat injection. Purification may require the use of a centrifuge to spin the fat or a filtration process to remove impurities.
How is the fat placed?
To place the fat, Dr. Hsu will prepare the area designated to receive the graft. Dr. Hsu will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times, in what is known as microfat grafting. Dr. Hsu’s goal is to help patients achieve the most beautiful and natural-looking results, as well as to make the surgical experience as easy and comfortable as possible.