The 411 on Fat Grafting/Fat Transfer

To me the ability to graft or transfer fat from one part of the body to another has been a tremendous tool I use almost daily to eliminate some of the stigma of aging.  This has been a remarkable advance in cosmetic surgery.  I tell my patients this is “liquid gold”.

One of the sure signs of aging is the loss of soft tissue.  If we look at a patients face, as they age they lose volume as do a women’s breast and buttock.  In about 60% or more of my facelifts I will recommend fat grafting.  I also will do a composite aug when I add an implant and then add fat to enhance superior fullness of the breast.  I sometimes will do a mastopexy or breast lift and rather than add an implant, add fat into the breast to enhance the aesthetic appearance.  I have even removed implants and not replaced them with new implants but rather use a patient’s own fat. Prior to surgery we decide on a donor site.  This is usually the abdomen but if I am going to do a lot of fat grafting then I will sometimes harvest fat from several areas especially if we are doing an area of high volume such as the buttock.  Once we get the fat we decant it and in some cases I will mix it with a patient’s own PRP or platelet rich plasma.  I feel this helps retain more of the fat graft.  I tell patients not all of the fat will survive but whatever fat does survive is yours and I would say 50-70% of the fat will survive.  What fat does not survive is broken down and absorbed by your body.

Another area that is sometimes forgotten is  our hands.  As we age our hands look think cachetic but doing fat injections to our hands can go a long way in making them more youthful.  Personally I prefer fat to fillers for two reasons.  One is that fat is natural – it’s your own tissue and unlike fillers that go away in 6 months to a year fat will last.  But remember you are still aging and part of the aging process is loss of tissue.  I also think it is more cost effective.  In some of my facelift patients I’ll put 100 cc’s of fat in their face and if fillers are used the cost is $600.00 to $700.00 per cc., you do the math.  So fat is my preferred method to restore soft tissue.  If we are going to do extensive fat grafting usually patients are under general anesthesia, for instance if we are going a buttock augmentation or merely sedated if we are going a facelift with fat grafting.  After the fat is harvested there may be bruising and swelling from the donor site so I tell patients to place ice compresses over the donor site to minimizing bruising and swelling.  Also, I recommend patients rub the area with vitamin k cream to minimize bruising.  This is also good to use post operatively.

So we now have a new tool in our repertroise to ward off those tell tale signs of aging.  Interested in a consult?  Please call my office at (239) 244-2329.  I have an offices in Fort Myers, Cape Coral and Punta Gorda.

Dr. Brueck

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