Increasing survival rate for fat grafting? (knees, thighs, ankles, wrists)

Is it possible to get fat grafting in the ankles, around the knee area, and thighs or will fat survive well in those areas? My issue is my calves and thigh muscles protrude LATERALLY alot but my knee area dips in in between those areas & is very small. I'd like the lateral sides of the knees to be filled so that area matches my curvy calves & thighs. Also would fat grafting work in ankles/wrists/decolletage? Does the area need to be very vascularized or have muscle in order for fat to take?

Doctor Answers 4

Increasing survival rate for fat grafting? (knees, thighs, ankles, wrists) YES

Your question is really multiple questions and somewhat to address with a simple answer.  First, we have to decide where to get the fat.  Posterior fat in general survives better than fat from other areas, such as the front of the abdomen.  
I have grafted all of the areas you describe in the 25 years that I have been doing fat grafting, except the wrists.  The back of the hands do well, but in my experience need to be done twice to get the kind of results patients are looking for.  Fat naturally disappears from areas where there is joint movement, such as the wrists, and this area would probably have only a small or minimal take, or long lasting result.
The great thing about fat grafting is that we can truly sculpt the body and add and take away fat to get a more pleasing and aesthetic result.
We have been using HBOT treatments (hyperbaric oxygen therapy) for about 8 years in conjunction with fat transfer, and clinically I am convinced that this can assist in the percentage of fat surviving after grafting.  Typically it is about 50% and very carefully controlled studies on natural breast enhancement after mastectomy for breast cancer has confirmed this percentage.  In a paper at the Lipoplasty Society in 1989, I also confirmed this percentage of 50% with a 3-D laser camera.  However with the HBOT I believe that I am betting 60-70% of the volume of the fat transferred surviving.  It need to be done the day of surgery and continue for at least five days.
I hope that this information is useful for you.
Dr. Seare

Carlsbad Plastic Surgeon
5.0 out of 5 stars 19 reviews

Increasing survival rate for fat grafting? (knees, thighs, ankles, wrists)

  If the volume needed is small, fat grafting would be appropriate in those areas.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Fat injection

Fat injection can be performed almost anywhere, but in some areas like the lower legs the area does not expand too well because of the normal skin anatomy and attachment to the underlying structures.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Fat transfer

Fat can be transfered literally anywhere on the body for cosmetic purposes and survival is more related to technique then the area filled. I would make a consultation with a board certified PS to see if what you are trying to accomplish can best be done with fat. Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

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