Fat grafting, a technique known for many years and refined by the American surgeon Sydney Coleman, is now one of the key procedures in plastic surgery. Lipostructure is a refined lipofilling technique that increases the volume of certain areas using the patient’s own fat, so there is no risk of rejection. In most cases it can be performed under local anaesthesia.
It must be performed by experienced surgeons, because fat is very delicate to handle. The necessary amount of fat is harvested with small, specially designed cannulas from areas where it is usually available (abdomen, inner knee, inner thigh, etc.). The fat is then washed, filtered, sometimes centrifuged, and re-injected with microcannulas that place small amounts with each pass. Careful preparation of the graft is essential for a good result.
Fat can be used all over the body, although it is most often used in the face to treat:
- dark circles and hollow eyes
- cheekbones
- lips
- depressions of various origin.
In selected cases, when only a moderate increase is wanted, breast volume can also be increased with fat. The hands are another excellent indication: fat grafting rejuvenates the back of the hand, which is always on view and often reveals our age. On the body, fat grafting is used mainly to fill depressions, to treat scars, to enhance the buttocks (again, within reasonable limits) or to correct unsatisfactory results of previous liposuction.
Patients should know that a variable proportion of the grafted fat is inevitably reabsorbed. This may be minimal and not affect the result, or more marked and require a touch-up, which statistically is needed in about 25% of cases. Even when the operation is performed perfectly, some cells die during preparation and cannot take; the cells that do take are permanent and maintain the result.
Fat grafting is often combined with other procedures, such as a face lift, to refine the result. It is a real operation (in fact, two operations combined) and must be performed in an operating theatre. Costs vary and cannot be estimated without seeing the patient: a consultation with a specialist in Plastic and Reconstructive Surgery is essential.