Fat grafting requires that fat be harvested from another part of the body and then be transferred - most often to the breasts or face. The harvest site is usually the abdomen, but may also be the thighs (harder to get to). The tissue is harvested by liposuction, so there can be improvement to the harvest site, as well as worsening. Thus, harvesting should be done very carefully - just as if it were an aesthetic only liposuction procedure. Not all patients who need fat grafting are also good candidates for liposuction. You can indeed see sagging skin and irregularities. This is more acceptable in the breast cancer reconstruction setting as the area is considered a donor site. In the aesthetic setting, patients are reasonably more concerned. The best approach is to take only as much fat as needed for a particular procedure (may need to leave some for a secondary procedure, anyway) and to have a well consented patient. Aggressive liposuction of the abdomen with abdominoplasty can be a good solution. Face grafting patients require small enough volumes that a donor site problem is unlikely unless the patient is particularly thin.
