You are right to be curious about the way the fat is prepared. This is the key to the entire operation and unfortunately poor technique will result in fat that disappears after a few months. The fat is harvested with a modified liposuction technique so that the fat is preserved and not injured. I let the fat settle so that the liquid separates from the fat. Most people stop at this point, but I prefer to spin this fat so that I can isolate that best fat cells even more. This pure fat (and all the surround growth factors, stem cells, and cytokines) are then injected. This technique has worked well for me for the 8 BBLs I do per week. After many years of followup, the fat stays! Make sure to find a board certified plastic surgeon who does at least 6-8 per week and can show you over 100 before and after pictures (of his/her own patients). Avoid doctors who claim to be experts but can only show you a dozen or so photos, or those who can't show you followup pictures from at least 1 year after surgery. You may have to travel to find the best doctor for you.
I use gravity sedimentation to separate the layers and then harvest the fat for injection. This is the least harmful to the fat. Find a
board certified plastic surgeon who performs hundreds of BBLs each year.
Kenneth Hughes, MD
Los Angeles, CA