The technique is very labor intensive.
Properly done, the fat has to be harvested manually, not with high suction as this may damage the cells. That takes longer to perform.
Secondly, the harvested fat has to be processed correctly. It has to be decanted, then centrifuged. Washing the cells, which is a shorter process, does not get rid of sufficient numbers of nonviable cells and impurities, and at the same times decreases attachments of stem cells to fat cells. Centrifugation takes longer, but it increases the concentration of stem cells as well doing a better job of separating viable fat cells from nonviable ones.
Finally, the fat has to be injected in very minute quantities, requiring hundreds of small injections.
It requires a setup that the casual surgeon is not likely to invest in. I have many specialized cannulas, centrifuges, use up hundreds of syringes per case, etc. In addition, I have a staff of several techs thoroughly familiar with the technique.
In this sense it is like hair transplantation. The concepts and techniques are well known, but it requires a trained staff and specialized setup to do well. I know how to do hair transplants, but am not set up to do them, so I won't do them.
Ask the surgeons you interview how many cases they have done and to show you post op pictures.
