Question of the week: using liposuctioned fat for grafting

I want to have fat liposuctioned out of my thighs and stomach, and put into my breasts and face to fill out my sagging skin.

Is it possible to do this instead of having a breast augmentation and facelift?

- patient

liposuction and fat grafting Dr Sharp
Brisbane plastic surgeon specialist Dr David Sharp

Dr Sharp:

Patients also often ask if liposuctioned fat can be injected into other parts of the body, or ‘fat grafted’. The best way to explain my approach to liposuction and fat grafting is that liposuction is all about volume of fat, where as fat grafting is all about quality of fat! I often take small amounts of fat from the stomach or thighs and place these in the face to fill out areas that have experienced volume loss.

Likewise, for slim women who lack fat across their chest to soften the appearance of their breast implants, I often graft small amounts of fat around the periphery of implants, to create a more natural look and reduce the visibility of implant rippling.

Unfortunately it’s not an easy case of liposuctioning large amounts of stomach fat and using it to build breasts that are two cup sizes bigger. This is because liposuction technology aims to remove the maximum amount of fat with the least amount of physical damage to surrounding tissues. And the best way to do that is to break down the fat as much as possible before extracting it. This damages the fat cells and inhibits their ability to regrow when transplanted into another area; so it’s not considered to be ‘good quality’ harvested fat.

One of the biggest downfalls of fat grafting is the fact that some fat always dies off when being grafted to the new site – this can range anywhere from 5% up to 40%. Fat grafting has been around for a long time, but it’s widespread use is a very recent thing and modern medicine is still adapting ways to help reduce the number of fat cells that die when grafted. If large amounts of fat don’t survive the process, fat necrosis can occur. This usually resolves with time, but can cause pain and sensitivity in the area as well as contour deformities and pockets of firmness that are sometimes visible to the eye. Successful fat grafting is a combination of good surgical technique, good fat selection and a good candidate. Patients need to be non smokers, follow a nutrient-rich diet low in processed foods, stay within a normal weight range and closely follow post operative instructions to ensure best possible results.

When I perform fat grafting to subtly enhance parts of the face or body, I use a special fat harvesting kit to strategically extract small quantities of good quality fat, with minimal disruption to the fat cells themselves. In the case of facial fat grafting, the fat is then carefully put through a process that creates tiny ‘nano’ fat that can be injected into the face.

Fat grafting can improve the appearance of an ageing face, but it won’t address all aspects of facial aging, and depending on how much skin laxity you have, you may find that a facelift is unavoidable if you wish to restore your underlying facial structure and skin tightness. It is possible to have liposuction to reduce your unwanted fat deposits, breast augmentation using implants and fat grafting to achieve a fuller breast (a mastopexy may be required if you have significant amounts of sagging breast skin or ptosis) and facial fat grafting with or without a facelift. These procedures can be performed in the one operation, or over separate surgeries. The first step is to consult 2 or 3 plastic surgeons to obtain their opinion about the best procedures and techniques for you and your individual aesthetic goals, so you understand all of your options and the benefits, risks and cost associated with each of these.

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