Fat Transfer
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Fat transfer, also known as fat graft, lipomodelling, or fat injections, is a surgical process in which a person's own fat is transferred from one area of the body to another area. The major aim of this procedure is to improve or augment the area that has irregularities and grooves. Carried out under either
general anesthesia General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general ...
or
local anesthesia Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It ...
, the technique involves 3 main stages: fat harvesting (extracting adipose fat), fat processing (processing the extracted fat), fat injection (and then reinjecting the purified fat into the area needing improvement).


Applications

Autologous fat transplantation is a widely used treatment modality because of its biocompatible properties and availability of fat for transplantation. The technique has become increasingly popular in recent years for soft tissue augmentation and volume replacement in both reconstructive and aesthetic plastic surgery.


Breast reconstruction

Breast reconstruction is the surgical process of rebuilding the natural shape and look of a breast, using autologous tissue, prosthetic implants, or a combination of both. The procedure is most commonly performed in women - as part of their treatment - who have had
mastectomy Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer have the operat ...
or surgery to treat
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a r ...
. A doctor harvests fat from one or more areas of the patient's body where excess fat is available and grafts it to the breast for breast reconstruction surgery after a mastectomy or
lumpectomy Lumpectomy (sometimes known as a tylectomy, partial mastectomy, breast segmental resection or breast wide local excision) is a surgical removal of a discrete portion or "lump" of breast tissue, usually in the treatment of a malignant tumor or brea ...
. As the procedure uses the patient's own fat, the structural fat grafting for breast reconstruction surgery is a more natural process than implants and creates a smooth, more symmetrical, look.


Breast augmentation and correcting asymmetry

Fat transfer breast augmentation is a natural solution to restore shape and volume to the breasts, which may have been lost due to factors such as aging, pregnancy/breast feeding, or weight loss. Breast asymmetry can be corrected using the fat transfer procedure, and both the breasts will have the same shape and size.
Breast augmentation Breast augmentation and augmentation mammoplasty is a cosmetic surgery technique using breast-implants and fat-graft mammoplasty techniques to increase the size, change the shape, and alter the texture of the breasts. Augmentation mammoplasty is ...
and correction of asymmetry using fat transfer is considered to be an overall safe procedure. Any major weight gain or loss could have an impact of the procedure results because the fat transferred will behave like the fat in any other body part. The procedure is associated with certain risks such as
fat necrosis Fat necrosis is a form of necrosis characterized by the action upon fat by digestive enzymes. In fat necrosis the enzyme lipase releases fatty acids from triglycerides. The fatty acids then complex with calcium to form soaps. These soaps appea ...
or death of fat cells, a risk related to any type of fat grafting surgeries. Another risk is fat reabsorption, wherein the body may reabsorb the fat used (up to 50%) in the fat transfer augmentation procedure.


Gluteal augmentation

Fat transfer in gluteal augmentation, also known as
buttock augmentation Gluteoplasty (Greek ''gloutόs'', rump + ''plassein'', to shape) denotes the plastic surgery and the liposuction procedures for the correction of the congenital, traumatic, and acquired defects and deformities of the buttocks and the anatomy o ...
with autologous fat grafting or gluteal lift (currently marketed as the "Brazilian butt lift"), represents one of the most rapidly evolving and increasingly popular operations in aesthetic surgery. This is a "dual-benefit" body contouring procedure, because fat is harvested from areas with surplus body fat to enhance contouring using liposuction. This fat is purified and prepared for transplantation into the gluteal region to increase buttock volume. The technique that can be performed under general and local anesthesia can also create an improvement in buttock shape, along with enhancing.


Facial rejuvenation

The regenerative potential of lipofilling and the role of adipose-derived stem cells (ASCs) contribute to good results in facial fat transfer. In traditional techniques for facial rejuvenation, surgery was used involving the excision of muscle, skin, and/or fat. In contrast, modern techniques focus on using fat grafting to add volume to the "empty" facial compartments. Now, with more comprehensive understanding of facial aging constituents such as fat atrophy and ptosis of the facial compartments, fat grafting is considered a plausible facial rejuvenation technique, especially of the eyelids.


Hand rejuvenation

Structural fat grafting can be an ideal option to treat the signs of aging or other appearance-related issues – such as prominent-looking veins and tendons, loss of fullness, thinning skin, arthritis and wasting of the hand. The procedure involves manually harvesting fat from one or more locations on the body via liposuction and placing it around the back of the patient's hand, and sculpting it into a smooth, uniform layer for an ideal appearance. To "fine tune" the results, additional fat transfer or injection of dermal filler products can be performed. Autologous fat transfer serves as a filler in the hand rejuvenation procedure. Besides, it also rejuvenates the soft tissue and skin on the posterior side of the hands.


Rhinoplasty

Autologous micro fat transplantation is often used to correct a low dorsum and a short nose.


Scars and burns

Scars and burns caused due to various reasons such as injuries, chicken pox, acne, sun or radiation exposure, and more can be repaired with structural fat grafting. The procedure harvests fat from one or more areas of the body and places it anywhere on the body where tissue has been damaged. Structural fat grafting can improve the quality of aged and scarred skin, reduce pain and itchiness, heal radiation damage, treat chronic ulcers and reduce the appearance of scars on the face and body - including dimpling and deep depressions, resulting in thicker, softer, healthier skin.


Complications

To ensure survivability, the fat graft should not be manipulated too much and it must be quickly reinjected. Possible complications are swelling, bruising, hematoma formation, paresthesia or donor-site pain,
hypertrophic scar A hypertrophic scar is a cutaneous condition characterized by deposits of excessive amounts of collagen which gives rise to a raised scar, but not to the degree observed with keloids. Like keloids, they form most often at the sites of pimples, b ...
ring, infection, contour irregularities, and injury caused by the cannula to the underlying structures.{{Cite journal , last1=Yoshimura , first1=Kotaro , last2=Coleman , first2=Sydney R. , date=2015 , title=Complications of Fat Grafting: How They Occur and How to Find, Avoid, and Treat Them , url=https://pubmed.ncbi.nlm.nih.gov/26116944/ , journal=Clinics in Plastic Surgery , volume=42 , issue=3 , pages=383–388, ix , doi=10.1016/j.cps.2015.04.002 , issn=1558-0504 , pmid=26116944


References

Plastic surgical procedures Transplantation medicine Implants (medicine) Cosmetic surgery