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Introduction
CHAPTER 61 Fat Transfer
Marie DiLauro
SUMMARY
Fat grafting is an involved, detailed procedure that requires planning,
instruments, and expertise that may be gained by expert training and experience.
Fat transfer can create an entirely new shape or replace volume that was lost.
Choose donor sites ahead of time if possible, ideally body areas that show
minimal change with weight loss.
Beginner Tips
Avoid injecting fat into the forehead.
Fresh fat is best. Avoid using refrigerated or frozen fat.
Avoid using needles for fat injection.
Inject only thin strands of fat at a time.
Expert Tips
If the grafting cannula enters the oral cavity during injection, withdraw and do not use
that cannula again to transfer fat.
Avoid lumps in the face by injecting small volumes and molding the area after
injection.
Make significant overcorrections when placing fat in the body.
Perform only slight overcorrections in the face, and watch for symmetry.
Donโt Forget!
Unlike facial fillers that can be purchased and are readily available to be injected, fat
must be harvested from a separate donor site on the patient during a separate procedure.
Some patients may find that filler injections are more convenient for them, and may not
want the inconvenience of undergoing a small liposuction procedure prior to being
injected.
Pitfalls and Cautions
Be careful in the infraorbital area and do not overcorrect.
Not only does fat have to be specially prepared, but it is not always smooth or easy to
inject. Cannulas and syringes often become clogged, and fat transfer can be messy.
Patient Education Points
Communication is critical, as patients must understand both the possibilities and the
limitations of fat grafting.
Most patients prefer some degree of overcorrection, as even in the best case scenario
approximately 25% of grafted volume will be lost.
Make sure you know exactly what shape the patient wants when they request buttocks
augmentation.
Billing Pearls
It may be cost-effective for patients to combine fat transfer with scheduled liposuction,
as the added cost may be significantly less than performing the two procedures at different times.
Patients may prefer to freeze excess fat for future transfer, as this may lead to
significant cost savings and improved convenience; this must be weighed against a possible decline in fat quality after freezing and thawing.
CHAPTER 61 Fat Transfer
INTRODUCTION
Fat transfer, or the grafting of autologous fat from one area of the body to another, is a useful skill for any dermatologic surgeon who performs liposuction, body contouring or sculpting. Not only is fat transfer an effective method of providing a natural filler for facial aesthetics, but it can also be used for filling defects that occur during liposuction, correcting naturally occurring asymmetry and depressions, and remediating postsurgical depressions and scars.
For physicians performing facial rejuvenation, fat grafting is an important tool for correcting the facial hollowing and volume loss that occurs during the aging process. Unlike temporary fillers, transferred fat can create a youthful long-lasting natural shape and concomitantly contribute to facial rejuvenation through the action of stem cells present in the transferred fat.