Fat Grafting: A "Permanent" Filler
 
Cosmetic Surgery: Promises and Pitfalls™

 
PROMISES

Fat grafting offers improvement of appearance in patients who have lost the subcutaneous (beneath the skin) fat as a result of aging, surgery or injury. As a result of the new fat grafting techniques it can restore the face or other part of the body to a more normal, more youthful and/or attractive appearance.

PITFALLS

• The concept of fat grafting, adding volume under the skin, is a relatively new and exciting procedure but it is one that continues to evolve.
• The technique of fat harvesting (removal), fat processing, and grafting (re-introducing) of the fat varies with each surgeon, and is anything but standard.
• The results with this procedure widely vary and are dependent on surgeon, technique, etc.
• The biggest problem is the survival of the fat grafts which determines the duration of the effectiveness of the volume correction related to the fat transfer. Some volume is lost due to the presence of fluid (water and liquid fat) in the fat that is absorbed by the body with resulting loss of overall volume and a potential recurrence of the original deformity.
• Damage to the fat cells in the harvesting process can result in a failure of the cells to "take" (live) as a graft. Once again, this can result in a failure to produce a satisfactory long term result.
• Stem cell fat grafting, which you may have seen currently in cosmetic surgery ads, is more marketing then reality. Producing stem cells from fat, is an intricate and costly process, which is limited to the sophisticated labs, and requires a large amount of fat to produce a small amount of stem cells.
   

OUR APPROACH

Over the past several years we have followed with interest the Plastic Surgery Literature related to Fat Grafting. We have tried several published techniques, but have been disappointed with our long term results. Two years ago, we began using the Body Jet liposuction technique which is a less traumatic - meaning: more gentle - liposuction device: it uses jets of water to aid in removing the fat. We have been impressed that it may improve grafting results. Several published studies from USA and from Germany suggest that fat removed with Body jet is of better quality and potentially better long term results. More on Body-Jet Liposuction (a.k.a, "Aqua Shape™") Information »

While our results with the Body jet device used for harvesting of the fat grafts have been encouraging, this use of water does add fluid to the fat. We are now combining the Body jet harvesting with Cytori advanced filtration system, which removes both water and liquid fat from the grafts. This simple addition should improve our long term grafting results.

Our primary areas of fat grafting are the face, hands and reconstructed breasts. We have been impressed with our early results and will follow our patients to see long term effectiveness. Often a second grafting is necessary, but once the fat has "taken", the results should be relatively permanent. We avoid the use of this technique for cosmetic breast augmentation since it is only effective for a very small increase in size. Also, we have a concern about injecting fat into breast tissue as that has a high risk of cancer. Aging hands, depressed scars, depressions from over-aggressive liposuction, etc., can be improved with fat transfer.

Before and after pictures: It is our policy not to show our patients' photos on the Internet. Numerous pictures are available on other sites: some are good, some show little improvement, and some show deformities related to this procedure (see below for a typical search engine result). Pictures used for marketing can be misleading and imply a certain warranty regarding results.

The following pictures are examples from random internet sites… but, we wonder if they are helpful to you as a potential patient?

For more information on why we don't place our patients' photos online, please click here: Promises and Pitfalls of Cosmetic Surgery: Before and After Pictures »
 

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