Lipofilling or fat grafting is now an established technique. It uses the patient’s own fat as a permanent filler to add volume to the soft tissues. The fat is harvested with thin cannulas through small incisions using conventional liposuction.
After filtering, the isolated fat cells are injected into the deficient areas. In addition to adding volume, lipofilling (fat grafting) reduces scarring and improves the quality and elasticity of the overlying skin. The mechanism of action is not fully understood, but repeated clinical use has shown this technique to be safe and effective.
What are the most common regions for body contouring through Lipofilling?
- Fat grafting to breast (breast augmentation, as a substitute for breast implants)
- Buttock enlargement (Brazilian-butt, buttock augmentation)
- Facial wrinkles
- Lip augmentation (lip contouring)
- Hand rejuvenation
- Loss of substance in the area of the cheeks, temples, forehead
- Intimate surgery
Who are the candidates and non-candidates for this process?
- Although surgery can be intimidating, take appropriate measures beforehand. With good planning and proper communication, you can ensure that the process is safer and free from unforeseen events than a lack of good advance coordination.
- Every adult patient with a stable weight and a healthy physical condition is suitable for this treatment.
- In very thin people who have very little fatty tissue, it can be difficult to get the amount of fat needed for breast or buttock augmentation using their own fat.
- Smoking: One of the factors that can greatly affect when you have plastic surgery is the fact that you are a smoker.
- Medications: They can have unexpected side effects, although they do not require a prescription, so our surgeon must be informed to avoid complications during surgery.
- Proper diet: It has been shown that people who eat a well-thought-out and balanced diet have a better prognosis in the recovery process, do so more quickly and avoid some complications.
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The different areas of application
Lipofilling of the wrinkles and the face
Wrinkling in the skin is a natural phenomenon. Due to a number of causes (sunlight, illness, poor nutrition/care, etc.) the skin can age more quickly, making it desirable to reduce these “aging characteristics”.
A treatment to reduce the depth of wrinkles is always a personal choice, whereby the plastic surgeon can advise you which method is most suitable for a specific abnormality. A combination of different techniques is often possible and sometimes necessary.
Lipofilling of the buttocks
Weight loss, pregnancy or age make the buttocks sag and lose firmness. With the fat grafting, the plastic surgeon can strengthen and possibly enlarge your buttocks. It is necessary for this procedure to have sufficient body fat.
Lipofilling of the breast
Breast augmentation is possible by means of an implant or with the body’s own fat tissue. The latter is increasingly chosen. With liposuction, fat cells are removed from the body, which are then placed in the breasts with a small instrument. This has the advantage that no large scars are left behind. Because the body’s own material is used, there is no chance of rejection or encapsulation.
Discuss your expectations preoperatively
- It is extremely important that you discuss your expectations. In many cases, it may take two or three attempts at lipofilling to achieve the desired effect.
- Unfortunately, after each procedure, approximately 50% of the injected fat is absorbed and every patient needs to be aware of this.
- Various scientific studies report a fat survival rate between 35 and 80%.
- Fat loss is due to trauma during surgery, excessive debris, apoptosis (programmed cell death), or other destructive cell mechanisms.
- This means that overcorrection may be required, but the volume of fat that can be injected once is limited by the thickness and slackness of the soft tissue at the recipient site.
- In general, there are two significant decreases in volume after surgery
- The first is after about 3 weeks, when the postoperative fluid build-up (edema) has subsided.
The second occurs 4 to 6 months later, when dead fat cells are reabsorbed by the body.
- The surviving fat cells increase the volume of the lifelong area, but hormonal and weight changes can be responsible for future gains or losses.
- In order to improve the surgical outcome, patients are advised not to smoke. Smoking decreases fat grafting survival and increases the risk of complications, especially delayed wound healing.
Lipofilling (fat grafting) process
The collection of fat is performed using the liposuction technique, that is, through a small hole in the skin where a cannula is inserted, coupled with an aspirator.
Back and forth movements are performed on the fat layer, which is aspirated and stored in a sterile bottle until there is the volume necessary for the surgery.
The collected fat can be prepared by three processes (decanting, sieve filtering and centrifuging), all with similar results. After this process, the whey and oil separated from the fat are discarded, leaving only the fat with the necessary components.
This fat is then prepared in syringes and infiltrated into the breast region through small incisions. An over-correction is usually done, since an average of 30% of the grafted fat is reabsorbed by the body.
Watch this video for lipofilling process
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Advantages and disadvantages of Lipofilling (fat grafting)
The advantages of lipofilling in filling treatments are several:
- The patient’s own fat is not reabsorbed and there is no rejection. This determines that the results are permanent (the natural aging of the patient continues).
- It allows treating larger areas. Being a living tissue, in the long term, it will behave with absolute naturalness.
- Parallel to the restoration of volume, a restorative stimulus is obtained on the adjacent tissues, so the rejuvenation effect is twofold.
Regarding the disadvantages we must point out the following:
- It must be done by a surgeon, in the operating room and under anesthesia.
- The necessary infrastructure and the need to perform a liposuction (major or minor) causes the price of the treatment to increase; although its permanence makes the investment profitable.
- There is a percentage of loss of the fat initially injected. The percentage ranges between 10 and 15% and, although this issue is taken into account, it may be necessary to reinject a little more fat in the treated area to compensate for excessive losses.
- The wounds are often only covered with small adhesive plasters. However, no bandages will be applied.
- In the first two weeks, the areas where the adipose tissue has been aspirated/injected may feel tender and sore.
- The skin is often swollen and blue (or otherwise discolored).
- There may also be some leakage of fluid or blood from the sting holes in the first few days.
- Pain is generally well controlled with acetaminophen, but sometimes needs to be managed with additional pain medication.
- Pain generally subsides quickly in the first few days.
- You should not wear a bra for at least three to four weeks to avoid pressure on the chest. In consultation with your doctor, you can wear a special sports bra without underwire.
- On the other hand, you should exert as little pressure as possible on the areas where fat has been injected and needs to grow further.
- Intensive exercise using the chest muscles is not recommended for 6 weeks.
- After about 6 weeks, most of the swelling is gone. After three months, almost all swelling has disappeared.
- The final result of the breast augmentation with your own fat tissue is visible after 3 months.
- After the procedure, you will be regularly examined by the plastic surgeon and the gynecologist, including ultrasound, NMR scan and mammography for certain age and risk groups.
- Another lipofilling session can be performed after 3-6 months.
In brief, 8 tips for maintaining fat after lipofilling ot fat grafting
- Wear your post-operative sheath
- Do not exert pressure on the operated area
- Stop smoking
- Follow a suitable and balanced diet
- Do not exert pressure on the operated area
- Sleep in the right position
- Resume adequate sports activity after 8 weeks
- Hydrate regularly
After lipofilling of the face, there are a number of factors that you can pay attention to to make the healing process as smooth as possible:
- Do not smoke!
- Immediately after surgery, you can cool the operated area to reduce swelling and discomfort.
- You may shower immediately after the procedure. You can just use soap and shampoo.
- The wounds are often healed within two weeks.
- Do not apply creams or make-up to your face before the skin has healed.
As soon as you get home, you can immediately start with light activities.
- Avoid movements that hurt. Gradually try to do more and more, but don’t force anything. The advice is to listen to your body.
- Try to avoid strenuous activities and vigorous exercise in the first 6 weeks.
- In the first months after the operation, it is wise to protect scars from the sun, because the scars are still sensitive to discoloration during this period.
- After lipofilling you will come back for the wound check and for the final check.
- Before and after the procedure, pictures will be taken so that the effect of the procedure can be clearly compared.
Results of lipofilling (Fat grafting):
The results of an autologous fat injection can be seen a few days after the treatment, sometimes several treatment sessions are necessary.
As mentioned, the long-term stability of the result depends on the success of the technique, ie on the amount of transplanted adipose tissue that is accepted and adequately supplied by the recipient tissue
The patient may have a slight swelling of the face immediately after the autologous fat injection. However, these will be reduced in the following week. At this point, the first results of the fat treatment itself can be seen. However, the end result will only become apparent after a few months.
We can then estimate how many fat cells have actually grown in new areas and, if necessary, plan a new treatment to achieve the desired result.
In the best case, the injection with autologous fat lasts a lifetime. However, it is important to remember that fat cells that have grown in a new location are subject to the same fluctuations as any other fat tissue.
So if you lose a lot of weight after the treatment, you will also lose volume in the treated area, especially the face. After a treatment with autologous fat, the skin is fresh and regains its elasticity.
This procedure has a particularly positive effect on the face. However, the natural aging process continues, so that the cheeks can lose volume again and the skin becomes loose again. Repeated lipofilling for wrinkle reduction, however, is no problem.
In summary, 7 results of the lipofilling can be recorded:
- a significant enlargement of the breasts, buttocks, mouth or other selected parts of the body
- Facial rejuvenation
- Scars and wrinkles are mended
- Skin tightening
- Removal of excess fatty tissue from the donor site
- modeled, well-formed silhouette
- Improved wellbeing and greater self-confidence
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10 steps to a successful consultation
- The specialist will ask you why you want to undergo the treatment. Be open and explain the desired effect and your expectations of the treatment. Tell your doctor exactly what you want to improve.
- During the first visit, the doctor will carefully assess the shape of the area to be treated, the size and condition of the areas from which the fatty tissue will be transferred.
- He will also explain step by step how the procedure works and what effects you can expect.
- Routine examinations necessary to counteract surgical intervention with absolute safety (ECG, chest x-ray, and blood chemotherapy routine) will be prescribed.
- The data collected from the pre-operative examinations will be carefully evaluated by the surgical and anesthesia team. It’s a good idea.
- Starting in the week before surgery, do not take acetylsalicylic acid (aspirin) to avoid clotting problems and for smokers.
- You must abstain from smoking for at least 4 weeks (two weeks before the operation and two weeks after the operation).
- You will also learn what recommendations to follow before and after treatment.
- In addition, he will decide what type of anesthesia to use and whether hospitalization is required.
- It is also a good opportunity to inquire about the total cost of treatment and a possible hospital stay.
10 possible complications of lipofilling or fat grafting
- Sometimes bleeding can occur. Using the elastic compression corset and respecting the postoperative instructions makes the risk of bleeding very small.
- An infection of the surgical wound is rare, except in smokers and diabetics. Smoking cessation a few weeks before and after surgery is definitely recommended. Good glycemic control in diabetics is also essential.
- High fever and redness of the chest after the procedure may indicate infection and should be reported immediately to your treating surgeon. An infection is treated with antibiotics.
- The disappearance of part of the injected fat cells is inherent to the operation, since the fat has no blood supply of its own.
- Smoking causes a reduction in the blood supply and decreases the survival rate of the fat.
- Sometimes the death of a certain amount of fat can lead to the formation of a fat cyst. These cysts sometimes only appear after several months, but are harmless. If a cyst is larger and palpable, it can be punctured and drained during the procedure.
- Sometimes the death of fat cells gives rise to the formation of small calcifications (calcifications). These calcifications are also harmless, but can be seen on mammography and can sometimes cause some concern, as certain breast tumors can also show calcifications on mammography.
- The risk of developing allergies is very low, because fat injection is a method in which fatty tissue is transplanted to an individual.
- Immediately after the treatment, bruising and swelling may appear at the site of fat removal. Cooling and rest help here, as well as mild analgesics. On the other hand, there is usually no pain in the face, only the skin can be a little tense at first.
- Subcutaneous fat injection into the skin or chest usually does not leave a scar due to the fine needles. However, as part of the liposuction procedure, small incisions must be made in the donor area. These scars heal after a few weeks and the potential scars fade more and more over time.
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14 Frequently asked questions about lipofilling and fat grafting
1- At what age can a fat transplant be performed?
The patient should be of legal age; there is practically no age limit upwards. The state of health should be stable and the skin in the donor and the transplant area should be of good quality.
2- What kind of treatment is Lipofilling?
It is a minimally invasive cosmetic surgery performed under local anesthesia with sedation, without the need for hospitalization.
3- What does it consist of?
With the liposuction technique, body fat is aspirated from areas where it is most deposited, such as the belly, thighs or hips. The adipose tissue is then used in the form of fillers to fill and shape areas of the face and body subject to emptying or sagging of the skin.
4- Is the sucked fat used directly?
No, the fat is treated with specific machines that remove excess fluids and, thus purified, it is loaded into syringes and then injected, with very thin needles, into the area to be treated.
5- Face lipofilling, for what purposes?
To fill in wrinkles, rejuvenate the décolleté, plump the lips, redefine the contours of the face, lift cheekbones, reduce dark circles.
6- Which areas of the body are most affected?
The most requested lipofilling operations concern breast augmentation and buttock lifting. We can also intervene with the grafting of adipose tissue for the rejuvenation of the hands.
7- Breast lipofilling. In which cases and why prefer it to mammoplasty?
Unlike mammoplasty, there is no scalpel or insertion of foreign materials such as implants. Obviously, patients who do not have adipose areas from which to take fat cannot carry out lipofilling. When, on the other hand, it is present, the result is double with a single intervention: cellulite reduction and breast augmentation!
8- Other areas of intervention?
Lipofilling represents a revolution in the treatment of scars on both the face and body. It serves to fill the scar furrow and revitalize the dermis.
9- Why choose lipofilling?
Because it guarantees a natural and permanent effect of the result. Because it does not involve any risk of allergic reaction or rejection as it is an autologous adipose tissue graft and not material foreign to our body.
10- Is it true that Lipofilling is able to regenerate tissues?
Yes. Let’s talk about another great virtue of this type of intervention. The regenerative effect depends on the stem cells present in the adipose tissue.
11- Is the first consultation at Sabina Medica free?
Obviously yes, as with any medical and cosmetic surgery treatment.
12- Is it possible to model the buttocks with a fat grafting?
Yes, it is possible to enlarge the buttocks and use the fat for modeling. A fat transplant will also help balance out the asymmetry. We call this treatment a Brazilian Butt Lift
13- How long does it take for the fat to be absorbed?
20-30% of the transplanted fat is absorbed in the first 6 months. After this time, blood vessels form in the adipose tissue so that the resorption process is completed. However, it should be borne in mind that this is living tissue, so its volume also changes with weight gain or loss.
14- How many sessions have to be done to achieve the enlarging effect of the lipofilling?
After the procedure, wait until 20-30% of the transplanted fat is absorbed to assess whether correction is necessary. Usually 1-2 sessions are enough, in some cases more.
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