Fat Transfer To Face

Fat transfer (or fat grafting) is a dynamic procedure which has gained immense popularity for correcting contour defects in various parts of the body. The technique involves aspirating fat through a special small diameter cannulae. The fat is then treated to remove oil and excess water. This leaves concentrated fat cells which are gently re-injected to fill out the desired area.

The whole concept is based on ‘structural fat grafting’. Fat cells injected by this special method lie in different tissue planes and are able to get an individual blood supply. The end result is that the fat injected persists long term. It is estimated that about 70% of the fat injected survives permanently and 30% disappears away. The additional benefit of fat transfer is the therapeutic effect of stem cells which are present in fat cells. This has an emerging role in tissue regeneration and wound healing. Facial lipofilling, can not only fill defects and improve contour, but also regenerates skin to offer a more youthful appearance.

The procedure can be carried out under local or general anaesthetic and takes about 40 minutes to perform. Fat is aspirated using fine metal cannulae of different sizes. The tiny incisions are closed with a single stitch; which is covered by a small waterproof dressing.

The fat is then injected into the area of interest with a fine needle so there is no visible scar. This process is time consuming and relies on delicate fat handling and careful reinjection.

You will feel quite bruised and swollen after the operation but this will settle over 1-2 weeks. Most patients will be able to go home the same day.

Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are away of possible complications.

There will be some discomfort for the first day. Occasionally bruising may occur, but this should resolve rapidly.

Scar – are very small and hidden in a skin crease on the abdomen or thigh. They should be barely perceptible. However some people heal with thick scars and this can make them more noticeable.

There will be no scars on the face, as the fat is injected with a needle.

Bruising and swelling – this is very common and bruising may take a couple of weeks to settle.

Infection – this is rare but may require a course of antibiotics.

Fat necrosis – if some of the fat does not gain a blood supply it will die and gradually be reabsorbed. This can sometimes leave a small lump. Massaging should resolve this but occasional a procedure to remove the thickening may be required.

Fat loss – of the fat that is injected, 40-70% should ‘take’ and become permanent. The remaining fat will simply melt away over the next few weeks. Should you wish further fat, then the procedure can be repeated after 12 weeks or more.

Fat cysts – can sometimes occur after fat transfer. Most cysts can be aspirated with a needle if they are problematic.

Fat embolus –  when fat is injected near the eye there is a very small risk of it being injected into the blood vessels themselves. If this did occur then the fat could form an embolus and become lodged in the blood vessels supplying the eye. This could cause permanent blindness. The injection needles are blunt and inject fat from the side rather than the tip to reduce the risk of this ever happening.

DVT/PE – following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. In order to reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are not mobile.

Further fat transfer procedures – these are sometimes required to achieve the desired result. Only a certain amount of fat can be injected at one operation. If you desire more volume then a second procedure gives the flexibility to add this.

All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to contact me. Decisions about cosmetic surgery should never be rushed and you must do your research.

At the end of the procedure, a light waterproof dressing may be placed over the stab incision where the fat was harvested. This can either be on your abdomen or thigh. As long as you are feeling well after the operation, you will be able to go home the same day. You will not be able to drive yourself home from hospital, so it is often a good idea to get someone else to drive you.

Before you leave the hospital, a follow up appointment one week after the operation will be booked with the nurse to check everything is settling well. I will normally see you in clinic in 6-12 weeks.

Recovery times vary from one person to another. Depending on the amount of bruising and swelling, you can return to work after a few days. If you have any concerns during this period, do contact the hospital team for advice.

Anne Dancey

I hope you find this information useful. If you have any questions or require a little more information then please do not hesitate to contact me.

Anne Dancey

Plastic and Reconstructive Surgeon FRCS(Plast), MBChB(Hons), MMedSci(Hons) and MCh(PASP)