Fat transfer

Ageing skin has a tendency to lose volume through the face, particularly beneath the eyes and in the cheeks, which can make the whole face look gaunt and hollow. There are many aesthetic solutions to restore some of this volume, and one of the options that most appeals to prospective patients is taking fat from elsewhere on the body, and inserting it into the face to create a more youthful appearance.

The most problematic aspect of fat transfer surgery has always been ensuring that the fat cells survive. Just injecting the cells with a needle leads to a very low fat cell survival rate. But via careful harvesting of the fat cells, cleaning them before transplanting and using an advanced method of injecting, significant fat cell survival rates can be achieved – as high as 50%.

Fat transfer to the face is effective in replacing lost fat, and very good at filling out deep facial folds and wrinkles. Additionally, it can be useful for reshaping areas of the face in order to improve or restore facial balance. The more mobile areas of the face, like the upper lip and the lips themselves, respond poorly to fat transfer, because immediately postoperatively, fat cells have to attach themselves to the surrounding tissues in order to establish a healthy bloody supply. In mobile areas like around the mouth, fat cell survival can be as low as 20%. This is the exception to the rule, though, and in most areas of the face it is possible to achieve a 50% take – meaning that half the fat injected into the treatment area will survive permanently.

What does the surgery involve ?

The fat cells that will be used for grafting are removed by a traditional liposuction technique. Most commonly, these are taken from either the lower abdominal wall via a small incision in the umbilicus, or from the inner thigh area. The amount of fat taken for the transfer will vary from patient to patient, and will typically have very little impact on the area it is taken from. From time to time, there might be a slight lumpiness in the skin after the fat has been taken.

Following this, the fat is processed and cleaned before it is ready to be transplanted into the face. It is administered into the face with specialist needles that are blunter than normal surgical needles, inserted through several small punctures in the face.

Multiple, layered channels are made into the site of treatment so that fat cells can be deposited under the skin strategically to achieve the desired effect. Due to the fact that only half the grafted fat is likely to survive, an excess will be placed into the skin during the procedure, in anticipation of absorption. In the first 6-8 weeks after surgery, the majority of the fat will settle, and by the 2-3 month mark there will be further change still.

Fat transfer can either be provided as a surgical procedure in its own right, or it can be used for facial reconstruction. In facial rejuvenation and anti-ageing, it is often used in conjunction with other treatments like facelifting in order to enhance the final results.

Often two treatments are advised to get the best results.

What are possible risks and complications ?

There is a risk of developing complications or side-effects postoperatively. This is a rarity, but it is something you should be aware of before pursuing treatment. Potential side-effects to fat transfer surgery include:

  • Infection It is unusual to contract an infection after fat transfer surgery, as antibiotics are usually used during surgery in order to prevent it.
  • Bleeding Because blunt needles are used during the procedure, bleeding and potential risk to blood vessels, the chances of untoward bleeding as a result of fat transfer surgery are very slim.
  • Skin irregularityIf fat absorption is excessive in one specific area of the face, skin irregularity may occur. It can easily be remedied by further fat injections.
  • Numbness You may experience some temporary numbness after the procedure. This will last from anywhere between a few days to a few weeks.
  • Fat absorption Fat absorption is unpredictable, and in some areas of the face, may be excessive. Overt fat absorption can easily be corrected by repeat treatments.
  • AsymmetryAll faces are slightly asymmetrical, but this may be exacerbated by the treatment due to swelling. It will usually correct itself after the swelling has gone down.
  • Persistent swelling Very rarely, persistent swelling may occur, particularly in the cheeks and under the eyes. It is very unlikely to be permanent.
The Face Surgeons