Lipotransfer is one of the most exciting new techniques in cosmetic surgery. In this novel approach to fat transfer, fat is removed from one area (usually the hips or buttocks) and then injected into other areas of the body. Thus, we recycle fat from one area (where we don’t want it) to an area that we do. Fat fills from the bottom up, similar to padding underneath a carpet. Thus, it gives a soft filling effect, unlike other filler substances. Also, because fat is part of the normal human body, it is not palpable under the skin.
Fat is frequently used to structurally augment the bony structures of the face. It can be injected along the cheekbones, the apples of the cheeks and along the jaw line. Fat can also be used to “lift” the face. When augmenting areas such as the cheekbones and jaw line and chin areas, the face will have a more lifted appearance. Frequently, multiple areas will be injected to achieve the best result possible.
The advantage to this procedure is that over time some of the correction becomes permanent. It is unclear whether the fat cells actually graft, or whether the body responds with a process called fibroplasia where the body lays down new cells and collagen. We do have biopsies of patients who have had this procedure done which show both live fat cells as well as fibroplastic response.
There are many different techniques in which fat is injected. Some surgeons do a single procedure where multiple injections of fresh fat are performed on that day. There is usually a significant amount of fat transfer and swelling can last for weeks. Others remove a large quantity of fat at one visit, inject a small to moderate amount that day and freeze the remaining fat. The fat can then be defrosted and injected as needed, usually at monthly visits. The results, as well as the side effects, will be dependent upon the technique used.
In my technique, with local anesthesia, a volume of fat is removed with a mini-liposuction session and some fresh fat is injected and the remaining fat is stored for future use. After the initial injection of fresh fat, there is typically some mild swelling for 3-4 days. Most people feel it looks similar to having had a dental procedure performed. Thereafter, a small amount of fat is injected monthly. This allows for a layering of the fat over time. It is also helpful to correct asymmetries, which are present in every person’s face. When you leave, the area will have a complete correction, but should not look over done. There is a small chance of getting a bruise, thus we ask patients not to schedule their injection the week prior to any major event such as a television appearance, wedding, etc. Over the year, approximately 30%-40% will become permanent. We can show you pictures of how patients look one year after their final fat transfer injection and you will still see an improvement in their face. Depending on the amount of correction wanted, some people do two years worth of treatments to optimize their outcome.
As with any procedure there are risks associated with it. There will be a small scar at the site of fat removal. When injected, there is a small chance of swelling or bruising, infection, and in rare cases scar.