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13 Things I Wish I Knew Before Fat Transfer

  • 3 years ago

In our fat transfer community many people look back on their experiences and say, "I wish I had known..." some information prior to undergoing treatment. Here are 13 tips from RealSelf community members that you may find helpful. Feel free to add your own in the comments! --Sharon


1) Fat Transfer Has Many Different Uses

Friends teased me that if I had more fat in my face, I wouldn't have so many wrinkles. Fat transfer made a big difference for me. My hands and face were injected with fat taken from my abs and hips. [by Cottontop]

My injections were to fill out skin after a failed attempt at a corrective mini lift. [by tgal]

I had stubborn belly fat and I also wanted a nice butt, so I decided to go with the lipo and fat transfer to the buttocks. [by shenika]

2) Choosing a Doctor

Don't go for the most charismatic doctor. Go for the critical perfectionist who seriously discusses the cons and takes the time to analyze your face and its current imperfections. Make sure that your plastic surgeon is also an expert in removing the fat. Don’t assume that because they can put it in, they know how to take it out if you hate it. Be patient. If you think it takes a long time to find the right doctor, listen to me: It takes even longer and more emotional energy to find the right one to fix the problem! [by Good face gone bad]

The most important aspect about this procedure, I think, is your choice of doctor because everyone does it differently. I was blessed to have the most amazing surgeon... so smart, so confident, and he really knows what he's doing. He made me feel safe and was so nice during the moments when it got a little ouchy and I momentarily felt like, "Uh oh, what have I gotten myself into." [by Nina New York]

3) What to Discuss at Your Consultation

  1. Have him/her draw a picture of exactly where the injections will be so you aren't surprised where they end up.
  2. Establish expectations. Ask how long you will be swollen and what constitutes swelling versus final results. Ask what the plan is if you aren't satisfied with the results.
  3. Look at his/her staff. Do you like what you see? They've often had something done and you may be able to gauge how conservative or extreme the doctor may be. Don't just fall for "stock" photos or carefully-selected picture books. [by Good face gone bad]

4) About the Procedure

My doctor used topical Lidocaine on the areas to be treated, and although I could have taken something like Vicodin or Percoset for the residual pain during the procedure, I decided not to. I probably should have. The length of the procedure, from "harvesting" the fat off my thighs to putting it into my face, felt like an eternity. Two hours might not seem like a long time, but when you're lying there having various needles going in and out of your thighs and face like a sewing machine (and that includes the topical Lidocaine) it's not a pretty picture. Then again, I wouldn't expect something so great to be able to be achieved in just twenty minutes with no suffering, so it was well worth the pain, discomfort, and time. [by Nina New York]

It wasn't just an injection here and there like when I've done fillers. The doctor used my 18-year-old picture to map out my procedure beforehand, and then did about 40 injections into the muscle. He said he used over 60cc of fat. [by Dallaslissette]

5) Post-op Pain, Swelling & Bruising

My face is just a little tender, but not painful. My only sore part is where the fat was harvested from. Normally the harvest area isn't sore; it was for me because I don't have much body fat and the doctor had to work hard for an hour to get enough to do the job right. [by Misty H.]

The recovery is a little hard. The bruising and swelling is tough, but it's not that painful. My thighs hurt and my face hurt the next day. I took one pain killer and since then Tylenol has been fine. I wore sunglasses to work and told everyone I had a torn retina and had to get a little laser surgery. The rest of my face didn't look too bad, so they bought it. [by Nina New York]

It took more than six weeks for the bruising to clear. In the end it was worth it as I loved the outcome. It looked so natural and everyone said I looked younger and refreshed. To me it was worth all the bruising and swelling. [by Houston423]

My face was swollen for approximately two weeks; however, it was more obvious to me than anyone else, as no one asked if my face was swollen during this time period, and I was with family and friends on more than one occasion. [by Cottontop]

I had my upper and lower lids done with fat transfer taken from my thighs. My upper lids are fine now and look very good, but both lower lids are still 40-50% swollen, respectively, and bruised. Even my doctor is surprised at how swollen I still am. I've had repeated injections of steroids throughout this past year, but to no avail. [by yours2love]

6) Tips for Recovery

One thing that really helped me was to take arnica. I also took a lot of Vitamin C and Vitamin D on the advice of a friend. They also gave me this IPL under the eyes to speed the healing of the bruising and that helped. [by Nina New York]

Arnica -- cream or beads -- don't work for me. Neither did the tea bags, cucumbers, lots of water, trying NOT to have a couple of glasses of wine a few nights a week, not much salt and wetted seaweed (my idea). The doctor gave me a week's work of steroids to ingest for the swelling. A steroid shot would have altered the fat and I didn't feel comfortable with that. [by yours2love]

7) How Long Does It Take to See Results?

It really does take several weeks for the fat to take its permanent shape. You will see a lot of improvement with time. Until then you can try make-up to cover the area or wear glasses. Once you have given it some time and if you think you still do not like the results, you may be able to reverse the effects. [by sameboat]

You have to be patient. This could take months before you know the end result. The challenge is that most fat transfer doctors and some patients who have had success with this strange procedure want you to believe that you should only be swollen for two weeks, maybe a month. No one sets the expectation for the "monster look." I didn't have any bruising, but I'm at seven months and I finally think the swelling is done, but I'm honestly not sure. It still seems to change. [by Good face gone bad]

8) You May Need Multiple Injections to Get the Results You Want

I had strange bags of fat under my eyes after my fat transfer and my doctor didn't tell me that was normal or a possibility after fat transfer. I only found that out after my first fat injection. He did tell me "most people have two injections" but I didn't realize that was because the results of the first injection could be uneven. Since that time I have gotten a follow up fat injection that has smoothed the area and improved the look. I am also going to do a third injection to finish filling in the hollows. [by sameboat]

Be prepared to have to go through this procedure more than once. Think about it. Even with the best injector, do you really think the body is going to keep the exact right amount (on both sides)? If asymmetry bugs you... beware. [by Good face gone bad]

9) Longevity

I had fat grafting in my hands. For around two months it looked great but after three months it was totally gone. It was an absolute waste of money and not worth all the excruciating pain. Surely there must be a permanent filler which would be more promising? [by secrets]

I am proof that fat lasts -- I have had it since 1993. I have even had some cut out because there was too much put in! I think technique is crucial. I think the reason it lasted on me was because I was in my 20s and I think there are more stem cells present at that age. [by michhy]

Most fat injections are absorbed into your system over time. Only about 10-20% stays. [by Vickisue]

I have heard that fat transfer does not work well in areas with a lot of movement like lips and hands. The movement doesn't allow the fat to re-vasculate to survive. [by Misty H.]

I had my lower lids done with fat transfer at age 63. I am now 67 and it still looks pretty good. [by Houston423]

It's been a little under a year since I had the procedure and I'm still happy with the results. Yes, my face has settled somewhat and perhaps my cheeks don't look as full as they did the first couple of months, but I still feel good and look good and get lots of compliments. I will add, however, that I also do get Botox regularly for forehead wrinkles and crow's feet. [by Nina New York]

10) Stem Cells & PRP

The doctor I went to also activated the stem cells in my harvested fat with PRP. PRP is platelet rich plasma. His nurse got extra blood during my pre-op blood test and then they mixed it into my transferred fat. This was an important step for me because everything I've read says that it's highly technique-driven to get good, lasting results. And most of the time, the problem was in fat cell survival. With PRP-transferred fat, doctors were estimating a 90-95% fat cell survival. [by Dallaslissette]

For all this stem cell talk, I didn't get it. In addition to the broken capillaries, minor injection site marks and rippling at the donor site, my skin looked stretched and had an orange peel appearance when the swelling finally went down. [by Good face gone bad]

11) How to Get Rid of Lumps

You can massage the area and that helps with any lumping or evening out. [by Vickisue]

I wouldn't do anything too quickly until you have really researched this. If you still have a lump, then you might consider consulting a reconstructive surgeon who has experience with fat transfer. I'm having 5FU injections that are helping the lumps I have. It's a process. Stay away from steroid injections. [by Good face gone bad]

12) Fat Injection Reversal

If you are completely desperate, you can opt for steroid shots or be patient and let the swelling resolve and get subsequent corrective fat transfer procedures. The danger of getting the steroid shots is that you will erase the potential benefit of the fat transfer (once the swelling subsides). [by swollen_eyes]

I've been told I have to go without fillers in order to have another doctor go in and do a fat transfer correction. I don't want steroid injections. I'm already using the Kenalog cream against my better judgment for fear of more skin thinning. The alternative I'd consider is micro-lipo. I'm going to try to continue to supplement with fillers at this point. For now, I need to wait it out. I feel like a fool for being so vain and wasting so much time and money on this. [by Good face gone bad]

I had undereye hollows filled with fat transfer but I have a lump under my right eye. I told my doctor to remove it and he tried with some sort of liposuction needle but said that nothing came out. Massage didn't help so the doctor had to make an incision and take out those lumps. Unfortunately he couldn't get all of it out so now he put some Juvederm around them to blend with the surrounding area. [by europe555]

13) Are the Long-Term Results Worth It?

It looks like little "ant hills" under the skin. You can see it a lot more under fluorescent overhead lighting. [by Houston1534]

I don't want to sound arrogant, but my face looks flawless. The fat is perfect and my skin is like porcelain. I really feel like I am privy to some top secret surgery. [by Northville]

I really liked my face. In hindsight, the minimal "refreshing" I wanted was something that at my age should have been done with fillers. [by Good face gone bad]

Comments (2)

It is terrible to read about the people who have had less than ideal, and in some cases awful results with fat transfer. In the right hands, on the right patient, the results are natural, beautiful and lasting. It used to be that "bad" facial plastic surgery was characterized by people with hollows above and below the eyes and windswept cheeks. I have done a lot of fat grafting to correct those results. The new trend in "bad" plastic surgery are faces stuffed full of fat, silicone, volume or some other kind of filler. It makes people look bizarre and unnatural. With the transfer of any living material, whether it is fat grafting or the grafting of solid tissue like dermis/fat or fascia/fat, it is intended that some of the transferred material gets revascularized and survives. The majority of the transferred living tissue that does not get revascularized is broken down by the body's natural scavenger cell system. Meticulous surgical technique, patience and attention to detail are required on the part of the surgeon to maximize the proportion of the grafted tissue that persists as living tissue, regardless of what type of tissue the surgeon is transferring. I have seen no cases of palpable oil cysts or chronic inflammation in any patient for whom I have performed structural fat grafting, and have had no cases of postoperative infection. As with any cosmetic surgery, meticulous technique and attention to detail on the part of the surgeon can produce beautiful, natural-appearing results - whether it's a facelift or fat grafting or a breast augmentation. In the right hands, structural fat grafting of the lower lid / cheek junction can produce a natural-appearing, and youthful contour. In inexperienced or impatient hands the result can be lumpy and even disfiguring. So make sure that the surgeon you are seeing is board-certified, has a lot of experience with fat grafting, and can show you photographic examples of the surgery in which you are interested. The lower lid / cheek junction is a challenging area, as the skin is thin and the orbital rim (bone) is immediately below. So there is less margin for error compared to thicker soft tissue areas like the cheeks and jawline. It is certainly not an area for a surgeon to start with if he/she is just learning fat grafting surgery. With lower lids a surgeon cannot afford to 'overdo' it, for if you overfill this area (because you expect that some of the fat will not persist) you may be left with excessive fatty fullness if most or all of the fat survives. So when treating this area I feel it is critical to add fat up to the point where the contour looks ideal, then stop. If most of the fat survives, great; if it does not then you come back 3 to 4 months later and add some more (by 3-4 months any non-vascularized fat has been reabsorbed). I let all patients having lower lid / cheek fat grafting know that there is a pretty good chance that they will need/want a secondary fat grafting procedure to enhance the result in this area. I have never regretted taking a cautious and conservative approach with this area. For any of you who have experienced unfavorable results with fat grafting, there are plastic surgeons who can help you. Take your time in your search and ask a lot of questions. Start by looking at lots and lots of before and after photos. For those considering fat grafting, you came to a great place for information. There is much to learn from the people who share their stories and from physicians sharing their knowledge.
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I am one week and one day after midface lift, upper and lower eyelids, fat transfer and laser resurfacing, Also neck tightening with lipo under the chin. From nose/cheekbones up, looks fantastic. Skin is calming down from the laser. But around the mouth are deep creases and folds of loose skin that have appeared as my swelling has diminished.Will any of this resolve as new collagen is produced? I was told to massage these areas upward toward the cheekbones.3x daily. I.go back in 2 wks; she says she can add filler to these areas if necessary. Very depressing as it's so obvious. (by itchy)
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