13 Things I Wish I Knew Before Fat Transfer
- Last updated: 2 months ago
Fat transfer, also called fat grafting or fat injection, is used to increase volume in body parts, including the cheeks, lips, breasts, and butt. 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 doctors and community members that you may find helpful.
1. Fat transfer can enhance many parts of the body.
Fat transfer can add fullness to the face, breasts, and butt. On the face, fat transfer can enhance the cheeks, lips, or hollows under the eyes. Breast fat transfer provides an alternative to implants. To enhance the hips and butt, liposuction removes fat from the stomach and fat transfer redistributes it in a Brazilian butt lift, or BBL.
2. How to choose a doctor for fat transfer.
It’s important to choose a doctor with extensive experience in fat transfers. “A more experienced surgeon may be a better choice, specifically, one who can say 'no, I can not achieve what you want,' ” says Dr. Darryl Blinski, a Miami plastic surgeon, in a RealSelf Q&A. “That is experience or surgical maturity.”
”If you are considering fat grafting surgery and think you may have found the right physician for you, before you go any further you need to review as many photographic examples of that physician’s work as possible,” says Dr. Michael Law, a Raleigh, N.C., plastic surgeon. ”A doctor can make a multitude of claims about their training and experience on their website and in online forums, but the one thing that really matters to you as the consumer of these services is an objective demonstration of your surgeon’s skills.”
3. What to discuss at your consultation.
Doctors say that while many patients are happy with their fat transfer results, it is important to have realistic expectations. Community member Good face gone bad shares the following recommendations in a RealSelf review:
- Have the doctor draw a picture, pointing out exactly where the injections will go, so you aren't surprised where they end up.
- Establish expectations: Ask what constitutes swelling vs. final results, and what the plan is if you aren't satisfied with the final results.
- Look your doctor's entire practice. Do you like what you see? They've often had something done, and you may be able to see his/her work in real life.
- Ask to see several of the doctor's before and after photos. Don't just fall for "stock" photos or carefully selected picture books.
4. Fat transfer procedure takes a long time compared to fillers.
Fat grafting takes a long time because there are two parts: The “harvesting,” or removal of fat from one area of the body, and the injection of the fat into another area. It’s a more complicated procedure than an injection of dermal fillers. Facial fat transfer is typically done under local anesthetic and involves only a small amount of fat. Other kinds of fat transfer like Brazilian butt lift usually require general anesthetic.
5. There will be swelling and bruising.
Fat transfer results in discomfort to two body areas: Where the fat has been harvested, typically on your stomach or thighs, and where the fat was injected.
“You should expect a bit more temporary bruising and swelling with the fat grafting than with the fillers,” says Dr. David Shafer, a New York plastic surgeon, in a RealSelf Q&A. “This is due to the fact that the fat should be injected into multiple levels and directions for a smooth, even look.”
6. Plan on recovery taking at least two to three weeks.
Recovery takes about two to three weeks, but it depends on what body part is injected and your age. For facial fat transfer, “bruising may be expected for seven to 10 days, swelling is worst for the first three to four days, subsiding by seven to 10 days, and much improved by three weeks,” says Dr. Otto Placik, a Chicago plastic surgeon, in a RealSelf Q&A. “Pain is minimal. Donor sites may be bruised for 10 to 21 days.”
In our fat transfer community, some people have found that pills containing Arnica montana help reduce their downtime. Always check with your doctor about what pain killers and supplements you should take, or avoid.
“To help reduce my swelling my doctor recommended me using Arnica montana pills, which are available at most nutrition stores,” says community member Misty H. in a RealSelf forum. “Arnica should not be taken by people with high blood pressure. My surgeon also recommended putting hydrocortisone cream on the area as well. Eating pineapple is also supposed to help reduce the swelling. You might want to check with your doctor before doing any of these things.”
Related Q&A: Fat Transfer: How Long is the Recovery Period?
7. Patience is required.
Even after the swelling and bruising goes away, it takes several weeks to a few months to see final results.
“At 5 days you cannot judge anything," says community member Alice345 in a RealSelf forum. "My swelling and bruising actually increased for a few days after surgery. It was around two to two and a half weeks that my swelling and fat absorption reduced by 50%. At one month or so, it reduced another 25%, and the remainder is going down ever so slowly. Three months really seems to be the magic number.”
8. You may need multiple injections to get the results you want.
Fat transfers are complicated because some of the injected fat will survive, but some will die. Doctors cannot predict what amount will survive.
“An unavoidable reality of fat grafting is that the degree of fat survival cannot be completely predicted nor can it be guaranteed,” says Dr. Michael Law, a Raleigh, N.C., plastic surgeon, in a RealSelf Q&A. “Fat survival will vary somewhat from patient to patient, and from procedure to procedure.”
As a result, you may need to have an additional procedure performed to add or remove fat.
“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,” says community member sameboat in a comment on a RealSelf review. “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.”
9. Fat transfer results can last for many years.
Although fat transfer results can be unpredictable, the good news is that once your doctor has achieved the look you want, you can have it for years. It depends on the part of the body: Areas that move less, like the mid-face and cheek, will retain the injected fat for longer than areas like the nasolabial folds around the nose and mouth.
“Patients often ask how long fat grafts last,” says Dr. Thomas Lamperti, a Seattle plastic surgeon, in a RealSelf Q&A. “While [they are] very surgical technique dependent, long-term results are certainly possible. Once the grafts take hold and ‘blossom’ over the first 12 to 18 months, the results should be evident for many years.”
10. Fat transfer can be combined with PRP and stem cell enrichment.
Some doctors use platelet-rich plasma (PRP) to improve the results of fat transfer. PRP is found in the blood. As part of the procedure, the doctor draws your blood with a syringe, extracts the PRP, then mixes it with the fat that is transferred.
The benefit is that it may increase the amount of fat that survives the transfer. “There are still more studies to be done but there is some evidence that the platelet rich plasma does increase the fat that stays for the augmentation,” says Dr. Johnny Franco, an Austin, Texas plastic surgeon, in a RealSelf Q&A. “When 1000 cc are being transferred, an increase in 10–15% of fat makes a significant difference.”
Stem cells are found in the fat; in some procedures, the doctor enriches the fat with additional stem cells. “Fat grafts will take without cell enrichment, but they take better with cell enrichment,” says Dr. Jeffrey Hartog, an Orlando, Fla. plastic surgeon, in a RealSelf Q&A. “The problem is that the process adds to the cost, and the fat from which the cells are processed is discarded—so one has to have extra fat available. The stem and regenerative cells are also considered to be responsible for some of the other benefits of fat grafting that have been observed, like improvement in skin quality, improvement in radiation damaged skin etc.”
11. Lumps are a common side effect.
Sometimes there are lumps after fat transfer. Some doctors recommend massaging the area, but others prefer that their patients don't. Be sure to check with your doctor to find out. Doctors often advise waiting until that area of the body has stabilized, as the lump may get smaller with time. If it does not even out on its own, the excess fat can be removed by micro-aspiration using a fine tube called a cannula.
Your doctor can also inject the fat with a steroid; however, this can have undesired results. “Steroids can cause atrophy of tissues (sinking in), veins to appear on the skin surface, and possibly have a greater effect on the native tissues than the fibrous tissues of fat injection, so the injections should be carefully delivered,” says Dr. Brent Moelleken, a Beverly Hills, Calif. plastic surgeon, in a RealSelf Q&A. Another option to remove the lump is an injection of 5-Fluorouracil, aka 5-FU. Finally, the most invasive option is for the doctor to manually remove the lump through a small incision.
Related Q&A: Tear Trough Area Lump After Fat Transfer.
12. Fat transfer is difficult under the eyes.
Some areas are more difficult to get a good fat transfer result than others, and doctors say that the under-eye area is particularly tough. One reason is that the skin of the lower eyelid is thin and delicate, so any irregularity shows through. “One of our most common reason for performing revision lower eyelid surgery is palpable and visible lumpiness from prior fat injections,” said RealSelf Q&A.in a
“If they are suggesting that you have fat grafting around your eyes, question them extensively about their experience and ask to see several before and after photos of their patients,” says Dr. David Shafer, a New York plastic surgeon, in a RealSelf Q&A. “Injecting fat in the lips and nasolabial crease is fairly routine. However, injections around the eyes can lead to big problems in inexperienced hands.”
Despite the difficulty, doctors also say that when done correctly, fat transfer leads to a natural look of fullness for under the eyes. For this reason, some doctors prefer fat transfer over dermal fillers for the under-eye area.
13. Are the long-term results worth it?
With a RealSelf Worth It rating in the 80s, fat transfer can yield desirable results. As with any procedure, research it carefully and consult with more than one doctor.
“The results are absolutely fantastic if you compare my thin before-face and the fullness of it now,” says community member d to the j in an update 1.5 years after an initial RealSelf review. “The fat is here to stay. So worth it.”
“For any of you following my story, I am a year and a half out from my initial bad fat transfer surgery and have gone through a fat removal process that involved the right doctor, 5-FU injections, micro-lipo, and time,” says community member Good face gone bad in an update to a RealSelf review. “For the most part, this has been successful. I will say that even after the micro, it took about seven months more for me be able to say that most of the fat is gone.”
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