I have a depressed scar on my cheek. It is a round circular scar. A plastic surgeon recommended Fat Injection. I want to know if Fat Injections are permanent. There seems to be conflicting information about this on the internet.
Are Fat Injections Permanent?
Doctor Answers (10)
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Fat injections are permanent when done correctly
I have been doing fat injections for over a decade and I agree with Dr. Khoobehi--they are permanent when proper techniques are used. There is a lot of conflicting information out there regarding how long fat grafts last . My position is that fat transfers (fat injections) are permanent when the following conditions are followed:
1) proper extraction and processing of fat
2) strict protocol for the patient during post operative period. This is particularly important for fat injections to the buttocks.
Are Fat Injections Permanent
Under the right conditions the fat transfers are permanent. The fat should be taken with low pressure suction and then centrifuged for the correct amount of time. Next, the injections should be done in small aliquots so that neovascularization can take place. Finally no pressure should be placed on the recipient bed. Following these steps should give a permanent result of total take of the fat transfer.
Fat injection results are permanent
Fat injections are permanent. However, not all of the fat may "take" or survive when injected. Certain areas seem to hold up better than others. Most people quote a figure of about 60-70% take in most areas. This is why repeat treatment may be necessary.
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Fat Transfer is Permanent
While you are absolutely correct about the conflicting information, in my experience and recent literature, fat is permanent once transferred. Unfortunately, a certain percentage of transferred fat does not take and additional injections may be needed. There is an excellent article in the January 2009 issue of Archives of Facial Plastic Surgery that shows that at 18 months follow up, fat is still present but there is a wide range of percent of take.
Fat transfer is permanent when done appropriately
When fat transfer is done appropriately, it is permanent.
Injecting fat in scars is unperdictable because the vascularity of the scar is not optimal for fat transfer. Scars can require multiple procedures.
Fat injection information
The web is frought with mixed messages. The doctors who perform this technique often have great results. Technique is everything. I am the inventor of the Viafill system, a system that is designed to maximize the number of live cells for injection. The results in my hands have been durable and smooth!
Fat Grafting can be permanent
A relatively new technique has been developed called structural fat grafting, in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.
Fat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements in facial plastic surgery are possible. If enough fat resorption occurs following a fat grafting procedure such that the desired result is not achieved, a second 'touch-up' procedure can easily be pe"Fat grafting has changed the results of facial plastic surgery dramatically. Traditional facelifts simply do not provide the natural result of microfat grafting," says Dr. Law.
Structural fat grafting can be performed on eyelid hollows, to fill sunken cheeks, for filling sunken hollows under eyes eyes and is often used for blepharoplasty correction when too much skin and or fat has been removed in an eyelid surgical procedure. Some people who have experienced fat loss as a result of procedures such as IPL or Thermage can also benefit greatly from permanent fat injections.
Survival of fat cells
Microfat grafting technique is a very technical procedure that allows maximum survival of the fat transplanted. I would say that the fat that does survive ends by being permanent as it acquires a new blood supply. In the worst case scenario (what I tell my patients), a small percentage of the fat will not make it immediately after injection. I beleive that this is true in large injection cases(buttock augmentation, etc.).
Fat injections can be permanent
The reason for the conflicting answer is the variation in the technique. I been using fat more than 12 years and it has worked for me. The reason for the fat grafting failure is the damage to the fat in the harvesting . I use fat for breast and I have IRB study and NIH study under clinicaltrial.gov (search under fat injection). Ask for patient referal and pictures. Please make sure your surgeon is board certified plastic surgeon.
Longevity of fat injection results
You are absolutely right. There is much controversy in the literature. Certainly some surgeons would claim that their techniques are superior to others and achieve higher success rates.
In reality, it is somewhat unpredictable. Placing fat grafts are not much different than planting seeds. When you want one tomato plant you don't plant one seed, you are told to plant 2 or 3. Same goes with fat grafting; when you desire a certain volume, you implant 2 or 3 times that volume.
In terms of results, everyone differs. This can depend on general health, donor site fat quality, success of fat removal, fat preparation, recipient site, volume implanted, technique of implantation, smoking history, bleeding tendencies, etc.
There is no doubt that even in the most successful cases, a certain percentage of fat will not survive while the remaining portion "takes".
Your question is how much of this fat that takes wil last and for how long? We don't know. You may read that it lasts 3-5 years while others claim it lasts forever. I have seen both cases in my practice. There are many reports of individuals who underwent fat injection 15 or more years ago to their face and then when they gain weight many years later the fat that was in their face responded to the weight gain and enlarged proving that the fat can last a very long time.
I hope this helps.
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.