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How Can you Tell that Fat has Actually Survived the Transfer? Biopsies?

I am trying to fix some bad fat atrophy on my face and am looking into fat transfer. After reading lots of reports I can't find anything that shows any proof of fat survival. Have there been biopsies or other tests to show the transferred fat survives after transplantation? Or is microsurgery a better option?

Doctor Answers 10

Fat survival after fat grafting is seen in the appearance

Hi there-

You would know that the fat grafted has survived by appreciating the long term change in your appearance...

To better answer your question, however, you should know that there have actually been several well structured and responsible reports of surgeons needing to operate on an area grafted with fat long periods after the grafting procedure (for various reasons) and finding a healthy, living layer of fat where there would normally not be one.

There is no question the technique works, particularly when done by someone who knows what they're doing...

A few words of caution...

  • Unsuspecting fat grafting patients who didn't do their homework or chose their surgeon poorly have paid heavy prices- including loss of their lives.
  • Avoid any surgeon that uses shifty marketing to attract you, like using a catchy name for their liposuction technique or promising you "stem cells" will be used. This behavior should cause you to seriously question their morals and ethics.
  • NEVER choose a surgeon because they are offering you the most attractive price. You are investigating a professional service in which your health and long term happiness are in the balance- and just as with any other professional, the best ones are not likely to be the least expensive.

Orlando Plastic Surgeon
5.0 out of 5 stars 147 reviews

7009 Dr. Phillips Blvd.
Orlando, FL 32819

Proof of fat survival

There is no doubt that grafted fat survives long-term. This has been proven with imaging studies as well with the fact that occasionally patients have over-correction problems where the fat needs to be removed.

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 172 reviews

1110 112th Ave NE
Bellevue, WA 98004

Survival of Grafted Fat

I have done tissue contouring with fat for many years and have a significant gallery of before and after photographs that demonstrate effective, long term results. Invasive procedures such as a biopsy are not necessary. Medical studies using an MRI examination have verified the presence of fat after sculpting with the patients own fat .

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

416 N Bedford Dr
Beverly Hills, CA 90210

Survival of transferred fat?

  There have been multiple studies suggesting long term survival of transferred fat.  Certainly, not all of the transferred cells survive but enough do that there is lasting improvement.  But biopsies to demonstrate fat survival aren't necessary.  If there is a significant change as a result of the procedure, this is all of the proof that you need.  As they say, the proof is in the pudding.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
5.0 out of 5 stars 83 reviews

6025 4th Street North
St. Petersburg, FL 33703

How do we know that grafted fat survives

There have been several studies looking into fat graft survival. Quite recent MRI studies have shown the persistence of grafted fat in the face. The take isn't 100%, but using proper placement volumes reliable results can be obtained. Certainly, a secondary touch up procedure may be indicated after an initial fat transfer has fully healed (in up to 18 months).

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

1101 Madison Street
Seattle, WA 98104

How To Tell If The Transferred Fat Survived

The most common method for evaluating the survival of fat after a fat transfer is evaluating the clinical result.  It may take a few months for all of the swelling to resolve but once you reach that point, if there is increased fullness and the tissues are soft and not painful, then it is very likely your fat grafts have survived.  There have been studies performed using MRI and biopsies to determine the extent of fat graft survival but these are studies and not practical in most patients.

Fa grafting is very much in its infancy as a cosmetic and reconstructive technique.  There are many ways to harvest, process, and transfer the fat and at this point, no one can truly say that their system is the best or the only way to perform fat transfers.  Many fat transfers do require multiple procedures to obtain the optimal result and is something worth talking with your plastic surgeon before you proceed.

Hope this helps and good luck.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.5 out of 5 stars 45 reviews

17300 N. Outer 40 Road
Chesterfield, MO 63005

Fat graft

Long term results and MRI are proof enough that fat does stay. There are evidence by biobsy in the litarature that proof fat does stay. You may need more than one session of fat transfer.

I am not sure why you are thinking of microsurgery for fat transfer? In the past microsurgical transfer of the omentum was used for REOMBERG disease( Hemi facial atrophy). However that fell out of favor because it fall down very easily


Samir Shureih, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 5 reviews

10 East 31 Street
Baltimore, MD 21218

Fat Graft Survival

Most commonly, the clinical result can tell if the fat survived. If the volume of the treated area is maintained after the swelling has resolved and if the area is soft and not tender, then the fat has probably survived. Biopsies and MRI can be done but it is not practical to do so just to determine if the fat survived.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 30 reviews

2333 W Irving Park Rd
Chicago, IL 60618

Several ways to assess fat survival after transfer

There are several ways to assess fat survival. Post operative photos are standard, and taken from different angles, usually at 2 to 6 months. Biopsies are not done usually. A second transfer is often needed, depending on the area treated. I have found adding a product called Selphyl improves fat survival and now use it routinely.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

7301 N Knoxville Ave
Peoria, IL 61614

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.