Fat grafting: Is it right for me?

shutterstock_117043642Fat grafting, also known as fat transfer, fat injection, or lipoinjection is a procedure that involves removing a patient’s unwanted fat deposits via liposuction and injecting it into areas of the body in order to correct contour deformities, improve shape, or simply augment an anatomical area.  Liposuction for fat grafting is similar to the popular cosmetic procedure in that regions such as the abdomen, flanks, back rolls, thighs, and knees are often treated.  The suctioned fat is then treated and “purified” for re-injection into areas that lack volume or fullness.  In select cases, a surgeon can use fat to augment and improve the shape of a patient’s breasts, buttocks, or cheekbones.  Fat grafting is therefore becoming a viable alternative to the use of breast, buttock, or facial implants!

The obvious benefit of choosing fat-grafting for your breast or buttock augmentation is that your own fat is taken from areas of your body (leading to improved contour in those areas!) and injected into your breasts or buttocks for a more subtle, natural looking enhancement.  The effects are permanent (if not long-lasting) and eliminate the need for implants, which may eventually require another operation to exchange them.  Fat grafting also requires smaller incisions than implant-based augmentation and can lead to a more natural look and feel.    

Are you a candidate?

There are individual factors that can affect your candidacy for fat grafting.  These can only be determined during consultation.

Here are two examples of why you may not be able to undergo fat injection:

Skin tone and breast or buttock shape Fat grafting  generally requires breasts or buttocks with good skin elasticity and without excessive sagging.  Patients with “saggy” breasts may become candidates for fat injection by first undergoing a breast-lift.  Unfortunately, the ”lift” can’t be performed at the same time as fat injection.  Breast implants, on the other hand, can be placed during a breast-lift procedure.

Weight Slimmer women may find themselves unable to benefit from fat injection because they may lack the excess fat needed to perform liposuction.  That being said, multiple areas can often be liposuctioned in thinner women to harvest the fat required to perform fat injection.

Pros and Cons

As discussed, the advantages of fat injection for breast or buttock augmentation include a more natural look/feel, smaller incisions, and not having to deal with implant-related complications (such as implant rupture, capsular contracture, palpability, rippling, and malposition).

Like all surgical procedures, however, fat grafting has its downside.  For instance, fat which is injected during the procedure never “takes” 100%.  Some will resorb and be eliminated by the body.  The amount of resorption can vary and sometimes lead to a smaller size than the patient desires.  Therefore, for larger augmentations, fat injection must often be repeated a second or even third time.  Surgeons must beware not to inject too much at once because doing so can negatively impact the graft “take” and increase complications.  So, if you are looking for a large augmentation in one surgery, fat injection may not be your best option. 

Uneven fat “take” can also lead to contour irregularities and asymmetry.

Additional risks associated with fat grafting include fat necrosis, oil cysts, bruising, infection, and potential changes in one’s mammogram.  These must be discussed with your surgeon in consultation so that you can make a safe, informed decision.

Fat grafting is a relatively new procedure compared with implants, and is increasing in popularity due to its obvious benefits and ever-improving safety profile.  While the gold standard for breast augmentation remains breast implants, the indications for fat injection to the breast are growing quickly, and more patients are benefiting from this technique. 

Fat injection for buttock augmentation, on the other hand, has surpassed buttock implants as the gold standard.  Its rise popularity is due not only to improved techniques but also a change in cultural norms.  Modern women are often seeking a more “voluptuous” shape than in the past.      

As with all surgical procedures, fat grafting has its strengths and weaknesses.  The key to finding the procedure that works best for you resides in the consultation with your surgeon.  If you are looking for the benefits of buttock or breast augmentation with fat grafting and your surgeon agrees that you are a good candidate, then let your journey begin!    

Thank you,

Dr. Karl Schwarz