Fat transfer or fat grafting is a technique to use one’s own fat to restore volume lost in the aging process or to correct facial imbalances. As we age, we may see “bags” under the eyes, deep smile lines, loss of lip volume and jowling. Most of these changes are due to volume loss in the face with resulting sag of the overlying skin. Pulling the skin tight does not often rejuvenate – the patient looks tighter, but not necessarily refreshed. Fat grafting can restore lost volume to the upper cheeks, temples, lips, or hands and can even be used to augment the chin.
The procedure is performed under local anesthesia, using a combination of nerve blocks and tumescent local anesthetic. Most people will be given some Valium to help them relax. The fat is harvested using syringes and microcannulas and transferred to small syringes to allow for more precise injection. The preparation time (numbing and obtaining the fat) often takes longer than the actual grafting procedure. The fat is grafted using very small syringes and blunt cannulas. Absorbable sutures are usually placed at each injection port to prevent any fat from coming back out. The injected areas are typically moderately to very swollen immediately following the procedure, and there may be some bruises. Some of this initial swelling will resolve as the anesthetic is absorbed, but there will be some degree of visible swelling for a week or more. This will vary tremendously from patient to patient, as will the amount of bruising. Most patients can expect to be presentable within a week.
Some of the grafted fat will not survive the transfer process, and will be reabsorbed over about three months. All patients should expect a possible second procedure to achieve correction, although many patients will do very well with just one. Any subsequent transfer procedures will be performed after three months. The grafted fat can be expected to last, however, the factors causing volume loss with aging are ongoing. To maintain the fullness, a touch-up procedure can be expected after three to five years, if needed.
Pre-Op: Two weeks before – No blood thinning agents (Aspirin, ibuprofen, etc.), vitamins (especially vitamin E), or herbal supplements! Most prescription medications can be taken. Obtain any compression garments necessary from the donor site(s), especially if you are having liposuction contouring done as well.
The morning of the procedure: wear comfortable clothes, no makeup, and eat a light breakfast. You will need to have someone drive you home as you will be a bit dizzy from the Valium and will possibly have swollen eyelids.
Post-op: You will need to go home, take it easy and use cold compresses (frozen vegetables work well) for 10-15 minutes each hour. You will have a prescription for an antibiotic and a pain medication. Most people will not have a great deal of discomfort. You will be seen in the office within about a week.