A Fat Transfer Gone Wrong Can Make You Feel Lopsided

Everybody ages naturally over time. One physical manifestation of aging is the loss of fat or unevenness in particular areas of the body. As people enter their late 30s and 40s, the loss of volume in the face becomes more noticeable under the eyes, the cheeks have less fullness, and there is less volume in the lips. Unevenness may occur in the body due to injury or previous cosmetic surgery that left creases and irregularities.

Cosmetic surgeons offer multiple options to their patients to deal with these issues. Synthetic fillers or implants are options, but an increasingly popular one is called fat transfer.

What is Fat Transfer And Where Is It Used?

Fat transfer, or fat grafting, essentially uses liposuction to collect fat from one area of your body and use it as corrective filler in another area of your body. It is used to plump cheeks, enhance lips, and fill in deep grooves at the corners of the mouth. It can fill in hollow areas under the eyes, plump up aging hands, and smooth out irregularities on the body. It is also an option for women who want breast and buttock augmentation that yield a more natural-looking result.

How Is Fat Transfer Performed?

The first step is to identify the areas on the face and body that need correcting or have lost volume. The second step is to decide from where on your body the fat grafts will be taken. Often the fat will be harvested from the stomach area or the inner or outer thigh using liposuction techniques.

The type of liposuction used for fat transfer is not the same as used in body sculpting. The body sculpting liposuction technique can destroy fat cells. The fat required for this procedure must be gently harvested and preserved as live tissue for grafting. The collected fat is then refined by filtering or rinsing to separate impurities and dead cells. The pure liquid fatty tissue is ready for injection after isolating it in a syringe.

Finally, the fat is carefully re-injected throughout the area needing treatment in the form of small droplets. Spreading fat droplets this way will ensure a good blood supply that helps the fat graft survive.

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Is Fat Transfer Painful?

A plastic surgeon performs the procedure with a wide variety of anesthetics to choose from. The physician’s choice of anesthesia usually depends upon the volume of fat they intend to extract from the patient during liposuction. A local anesthetic is adequate for the extraction of a small amount of fat. However, the patient must almost always be sedated with IV or General Anesthesia when extracting larger volumes.

The surgeon can administer the local anesthesia. However, a Board Certified Anesthesiologist or CRNA (Certified Registered Nurse Anesthetist) should administer IV anesthesia or General Anesthesia.

What Can Go Wrong With Fat Transfer?

A fat transfer is minimally invasive and shown to be safe overall. However, there are some risks to consider.

Fat necrosis, the death of fat cells, is the primary risk of fat grafting procedures. Fat cells can die if they don’t get enough oxygenated blood during the transfer process.

Dead fat cells can lead to dense and painful lumps, redness and bruising around the lumps, scar tissue, and skin discoloration. These can result in unevenness and asymmetry of the face and body.

Infection is another risk, but a small one. The incisions are small, so the risk of infection is low.

Fat reabsorption also needs to be considered. The body will naturally reabsorb a percentage of the fat injected into the site–somewhere between 20 to 50 percent. Reabsorption can make it difficult to gauge the final result, especially over time.

Because the fat is biological, the final result will depend on the amount of fat that survives in the area where it’s placed. The fat survival rate can also be affected by how it was injected and the general health of the patient.

Choosing the Right Physician

The application technique is crucial, and this skill is what separates surgeons around the country and internationally. The surgeon must make the injections both artistically and naturally for the best outcome.

The volume of fat injected must be the correct amount. Too little will result in no noticeable change. Too much fat will create too much fullness. The injection must be carefully administered so that there are no lumps, bumps, or unevenness.

These changes are permanent, so picking the right surgeon is of paramount importance. It can be a potentially marrying procedure if you are not in the right hands.

A fat transfer gone wrong will require a corrective procedure.

Synthetic Versus Natural Fillers

There are synthetic injectable fillers that have been in use for years now. But they have a temporary effect and must be eventually replaced. A freshly treated face will have the desired fullness, but as it gradually reduces, the patient must keep returning for more injections.

A physician injects dermal fillers in an office setting, with little downtime to the patient. If the patient doesn’t like the effect of the filler, it can be dissolved within 24 hours with an enzyme injection. The idea that the treatment is reversible and done quickly in a doctor’s office appeals to some patients.

The advantage of fat transfer is that the volume remains stable over time. Because it’s your own tissue, the fat becomes a permanent part of the area it’s grafted into. That can be a positive point, but also a negative one. While fillers are dissolvable, fat transfer is not reversible or easily removed. Because of this, fat transfer is best performed in multiple stages, as many as three sessions spaced several months apart to check that you are getting the best result.

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