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Fat grafting, also referred to as fat transfer or fat injection, involves transferring fat from one area of the body to another, more desirable area–so as to improve or augment the area where the fat is injected. The process of fat grafting involves removing adipose fat by liposuction, processing the fat, and then reinjecting the purified fat into the areas requiring improvement. Common sites for injection are the buttock, hip, breast or face. Fat injections to the buttock, also known as a Brazilian Butt Lift (BBL), can create a perkier, larger, and more rounded contour. Patients may seek to add volume to the hips to help create a more feminine silhouette and an improved waist-to-hip ratio. Breast fat grafting can correct asymmetry, add volume, improve scar deformities, and help repair damaged tissue after radiation therapy. Facial fat grafting can restore a healthy, youthful appearance to the face by adding volume to hollowed out (temples, teartrough, undereye), flattened areas (cheeks) or wrinkled areas (nasolabial folds, marionette lines).
Good surgical candidates for fat grafting must have a donor site or sites with enough fat to safely harvest and inject into the desired areas; good donor sites include the stomach, hips, flanks, thighs, arms, bra roll, or back. Patients who are too thin or have a low body mass index may not be good candidates for this procedure. In addition, patients with loose skin over the recipient site may not be good candidate. Patients who seek to combat facial aging or to augment small breasts, flat buttocks, or narrow flat hips may all be good candidates. Patients desiring fat injections to the buttocks should be prepared to avoid sitting and laying on their backs for any extended periods for up to 6 weeks following their procedure.
Fat grafting is done as an outpatient procedure with iv sedation or general anesthesia. First, liposuction is conducted to harvest fat from the patient’s donor sites. Small incisions, about ¼ inch long, are made near the zones being suctioned. A diluted solution of local anesthetic is infused into the fatty tissues, in order to numb the area and to reduce bleeding. Then a thin, hollow tube or cannula is used to separate and suction out the desired fat into a special container, where it is minimally processed for reinjection. The reinjection to the recipient site is then performed through tissue beneath the skin, known as subcutaneous tissue. This is done to maintain a healthy blood supply and to create an optimal survival rate for the fat. The small incisions are then closed with a suture, and absorbent pads and a compression garment are placed over the treated areas.
A patient’s recovery will vary depending on the sites that have been injected. Generally, the areas that receive liposuction can drain fluid for one to two days. Patients may require pain medication for the first two or three days. Recovering patients can resume driving within four to seven days, and can often return to work within three to five days. Patients can generally resume normal activity and exercise by two to three weeks. Patients will be required to massage the affected tissue for a significant period of time following the procedure. If the patient’s buttocks or hips are injected, they should avoid sitting for extended periods of time to avoid creating flat spots.
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