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The second biggest problem with fat transfers is that the final results cannot be guaranteed. Not all the fat that is transferred will survive the procedure, and some will just be reabsorbed by the body.
From my own experience, this can vary from about 15% to 85% survival rate.
The average is about 60% to 70% fat survival rate. Therefore to compensate for this, I tend to overfill the area, knowing that the final result will be smaller. The fat cells that survive the transfer should last a lifetime.
In fact, over the years after the procedure, as the patient puts on weight, the volume in the recipient’s areas will get larger too.
Other potential downsides to fat transfer include infection, fat embolism, asymmetry and fat cyst formation. The risk of infection can be mitigated by using sterile or clean techniques and antibiotics prophylaxis.
Using blunt cannulas instead of sharp needles for the fat injection will almost eliminate the risk of fat embolism. Asymmetry is not common in large volume fat transfers.
However, if this does happen it can be corrected by further fat transfers. If fat cysts happen to form they will need to be drained.