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Fat Transfer, also called Fat Transplantation or Microlipoinjection is the harvesting of fat from one area of the body for re-injection into another, such as the cheeks or hands. The fat is usually collected from the abdomen, buttocks, or thighs using a liposuction technique. The collected fat is then prepared before reinjection into the new area. For small areas of fat transfer to the face, tiny needles are used to distribute the fat carefully and evenly in the layer of the skin just under the surface. Repeat procedures are often required as transplanted fat is partially reabsorbed by the body. The length of time that these results last can vary significantly between patients. They are also dependent on the area treated and the skill of the doctor injecting the fat. Private costs for fat transfer can range from approximately £2,000 to £4,000 or more depending on the number of procedures required.
The history of the use of fat to correct tissue defects in the skin dates back over 100 years. In 1893, a German, Dr F. Nueber, published the results in a medical paper of possibly the first fat transfer operation. Neuber transplanted small amounts of fat from his patients arm into their face to correct a skin defect.
With the development of collagen in the early 1980s and other dermal fillers which can be used to fill or “plump out” the skin, the popularity of fat transfer declined. However, recent advances in liposuction (which makes the collection of fat easier and safer) have seen an increase in the use of fat for re-injection into other areas of the body.
In the U.S., according to statistics published by the American Society for Aesthetic Plastic Surgery (ASAPS), 23,340 fat transfers for breast augmentation were carried out in 2018; while the figure for facial contouring with fat transfer was 39,461 in the same year. Fat transfer for breasts showed an increase of 7.5% compared to 2017 in the USA; while for faces, there was a decrease of 27.9% for the same comparison. Likely due to the increasing use of dermal fillers.
No similar statistics are available for the United Kingdom as yet but more and more people in this country are opting for cosmetic procedures such as fat transfer every year.
If you are considering a procedure involving fat transfer the following information will give you a basic understanding of the procedure. It can't answer all your questions, since a lot depends on the individual patient and the practitioner. Please ask a practitioner about anything you don't understand.
The best sites for fat transplantation (sometimes called microlipoinjection) appear to be areas with the least movement, such as the cheeks where fat can be successfully injected to replace the fat lost by some people who develop hollow cheeks as they age.
Fat, however, can be transferred into many other areas of the face and has been used to fill out lips, the chin, the hollows underneath the eyes, acne scars, as well as helping to correct defects caused by surgery and trauma related injuries.
Fat transfer to the back of the hands can successfully camouflage the skeleton - like appearance of the hand that can occur with sun damage and ageing, and there are certain doctors who believe that this is the most effective use for fat transfer.
Fat transfer has also become popular recently in the U.S. for women who want larger "J-Lo" (Jennifer Lopez) buttocks.
Transfer to other parts of the body is also possible, but the use of fat to increase the size of breasts, is controversial although it is being increasingly investigated by more cosmetic surgeons.
Your first discussion with a practitioner should clearly set out your expectations of the treatment. This should be matched by what the doctor says the treatment will achieve for you.
A medical history should be taken to make sure that there are no reasons why you shouldn’t undergo liposuction and fat transfer. You would also normally be asked to read information and sign a consent form at this time which means that you have understood the potential benefits and risks associated with this type of procedure.
Photographs may also be taken by the practitioner for a "before and after" comparison at a later date.
Your surgeon or doctor will give you specific instructions before coming in for the procedure. This may include avoiding the use of aspirin or any other non-steroidal anti-inflammatory (NSAIDS) drugs for a couple of weeks before treatment as these can cause increased bleeding. They may advise you to stop smoking as this can delay wound healing, and avoid alcohol for a few days before the procedure.
Your anaesthetic may be local, in the area of the treatment only, or general depending upon the area treated, the technique used, and your surgeon’s or doctor’s recommendations.
The use of a general anaesthetic carries a small additional risk which your practitioner will discuss with you before making any final decisions. Depending upon the type of anaesthetic used, you may also have to follow fasting instructions the night before and morning of your surgery.
Small areas of fat collection may be performed in an outpatient clinic room, (providing it has the right facilities) but large areas would normally be done in a hospital.
The fat is usually collected from the abdomen, buttocks, or thighs. Small cuts, around 5mm or so in length, are made around the area to be treated, and a hollow suction tube (cannula) is put in and moved around to break up the unwanted fat. The fat is removed, either by being sucked out manually with a large syringe, or with the use of a vacuum pump. The surface layer of skin remains attached to the tissue and underlying muscles, and a thin blanket of fat is left to help prevent rippling or lumpy or irregular looking skin following fat removal.
The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been improved and developed, several variations have been introduced. One of these is explained below.
This is the most common procedure and involves large volumes of fluid - sometimes as much as three times the amount of fat to be removed – injected into the fatty area. This procedure is usually performed on patients who only need a local anaesthetic.
For details on technique variation for harvesting fat, please go to the treatment procedure section in our liposuction section.
After the fat is removed, the cuts are stitched.
The collected fat is then sometimes washed and prepared before reinjection into the new area, which is first anaesthetised.
For small areas of fat transfer to the face, tiny needles are used to distribute the fat carefully and evenly in the layer of the skin just under the surface.
The whole procedure may only take an hour or so if small amounts of fat are collected and transferred.
Repeat procedures are often required as transplanted fat is partially reabsorbed by the body. Your surgeon or doctor may take a little bit too much fat initially, so that if some is reabsorbed, it will not spoil the overall look of your treatment. Even so, many patients require additional treatments to get a good long lasting effect (which may last for many years).
Some practitioners take out more fat than is required for the first procedure and freeze the excess fat so that it can be used to top up or maintain an effect for an individual patient at a later date.
Depending on the extent of the liposuction procedure, you may be able to return to work after something between a day and a week following your surgery.
Side Effects and Risks
Some pressure, movement, and stinging can be felt whilst fat is removed and again when it is injected into the new area, but it is rarely painful. Any pain following the procedure is usually controlled with pain-killing tablets.
Bruising, swelling, and some blood coloured fluid which drains from the incisions may be expected for a few days around the area from where the fat was collected. The newly injected area may also be swollen and bruised.
Infection is a potential complication, along with numbness, or nerve damage in both areas of the body.
Cosmetically, you may find some minor skin discolouration, or scarring at the incision points.
Fat transfer of small amounts from one area to other parts of the body under a local anaesthetic is a very safe procedure, and more serious risks or side effects such as infection are rare.
As in all areas of aesthetic treatment, there is a fine line between under and over correction. A little too much fat, or too little fat, can cause a patient to be unhappy with a fat transfer treatment - hence the skill and experience of the practitioner, as with most cosmetic procedures, is very important.
It is very important that you follow the advice of your practitioner carefully after any liposuction and fat transfer treatment to help to ensure the success of the procedure and reduce the risk of complications.
Post-treatment recommendations may include:
Most people can have a fat transfer procedure as long as they are in good general health and have realistic expectations of this treatment.
You may not, however, be a suitable candidate if you have experienced any problems with healing or with abnormal scar formation in the past.
Who Can Do It
Only suitably trained and qualified doctors and surgeons should perform a fat transfer procedure. This would normally be a surgeon or trained dermatologist.
Ideally you would want to find someone who specialises in liposuction and fat transfer as part of their cosmetic practice.
For more information about practitioner training, qualifications and relevant medical organisations please view the information contained within the Legislation section of the Consulting Room.
It is highly unlikely that anyone considering fat transfer surgery would be able to access this free of charge on the National Health Service.
However, depending on your individual circumstances, certain regions do make special cases, and we would always recommend that you visit your General Practitioner before embarking upon a cosmetic procedure involving surgery.
As well as their advice and guidance they may also be able to refer you to a local NHS Hospital who can treat you.
The NHS has set out the following guidelines on how to get cosmetic surgery through the NHS:
"To qualify for surgery on the NHS you must meet specific criteria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone. Reconstructive and cosmetic surgery to correct, or improve, congenital abnormalities and injuries will usually be carried out free of charge.
NHS reconstructive surgery is performed by plastic surgeons who have had extensive training and belong to the British Association of Plastic Reconstructive and Aesthetic Surgeons. Surgeons who carry out cosmetic surgery through the NHS also belong to the British Association of Aesthetic Plastic Surgeons.
To receive cosmetic surgery from the NHS, you will normally need a referral from your GP. You will have a consultation with a plastic surgeon and an assessment by a psychiatrist, or psychologist. It will then be decided whether there is enough social, psychological, or physical benefit to be gained to justify surgery."
Prices for a private fat transfer operation can range from approximately £2,000 to £4,000 or more depending on the number of procedures required to achieve the desired result.
Owing to the newer developments in fat collection techniques, transfer of fat to other areas of the body is enjoying a lot of new interest amongst cosmetic practitioners and patients alike.
A major aim in any cosmetic treatment to the face can be to restore the youthful, rounded shape of the face (particularly around the cheeks) and fat can be the ideal filler in this situation.
The length of time that these results last can vary significantly between patients. They are also dependent on the area treated and the skill of the doctor injecting the fat. Positioning the fat correctly in the area required is a highly skilled job, so if you are thinking of having a fat transfer operation, please try and find an experienced practitioner in this field. There are also no problems with allergic reactions to the filler, as can occur with other dermal fillers, as the fat comes from your own body.
Some doctors recommend combining liposuction with fat transfer. Having both treatments cuts down the cost of the surgery. It also gives you a double benefit as it reduces areas of unwanted fat and also replaces areas where fat has been lost owing to ageing in the face and hands.
Before and After Pictures
Please note that results of cosmetic surgery vary enormously, depending upon both the patient and the skill of the individual surgeon, so outcomes for procedures will always be more variable than those for less invasive non-surgical treatments.
(All before and after photographs featured are real patients treated by highly experienced surgeons, your results may differ).
Buttock enhancement with fat transfer (Before - Left, After - Right). 8 week follow-up.
Breast augmentation through fat transfer after 8 weeks. (Before - Left, After - Right)
Images provided courtesy of The Private Clinic