How long do fat transfers usually last? And can PRP help it last longer?

Question

Is the procedure done under general anesthesia or can it be local? How long can it last and what prolongs its half life? Can prp help? I also read somewhere that even if the fat goes away, 1/3 remains. Is this true? Does that mean if it's done multiple times it will last longer?

Kenneth Hughes, MD · Answer

Facial fat grafting tends to have a higher percentage of the fat survive than does grafting in other areas of the body.  Any facial fat that remains after 3 months or so has an established blood supply and will continue to live.  Some of the fat grafted will be lost, but about 70 to 90% of the fat grafted to the face should live. In other areas of the body, about 50 to 75% of the fat injected survives after fat grafting.  This fat will continue to stay with you and will act like the rest of your body's fat.  Occasionally, someone can resorb a great deal of the fat despite optimal transfer procedures.  Sometimes a repeat session will produce a very nice result. In almost all cases, I prefer general over local anesthesia.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles

Siamak Agha, MD, PhD, FACS · Answer

Fat transfer is a permanent correction.  However the amount of fat that survives depends on a number of factors. These include:1) Location of injection. Fat survives better in buttocks than breasts or face2) The fat harvesting method.  The more gentle the fat harvesting, the better the fat cells for transfer3) The injection method.  Micrografting is the method of choice for optimal fat survival.4) There are many other factors at play and ultimately your choice of plastic surgeon and what he does and how he or she does it is as important as any of these factors.

Jason Emer, MD · Answer

Fat transfer results are permanent, but not all fat will survive. Harvesting is important to fat transfer. Yes, I use water-assisted fat harvesting which gives pure fat to transfer and combine with platelet rich plasma (PRP) to get the most viable and sustainable fat cells. This can be combined with Sculptra, depending on treated area, to improve outcomes. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

J. Kevin Duplechain, MD, FACS · Answer

Fat grafting is considered a permanent treatment for autologous augmentation.  It can be performed under local or general anesthesia.   Fat grafting techniques vary, and as such so do the results.  I use a small cannula to harvest, and inject with a 1 mm cannula in most cases.  The fat is placed in a centrifuge and spun for a minute to remove  any blood or serum which is not valuable in the transfer process.   The use of additives such as PRP or other signaling  materials have not been shown to clearly enhance fat grafting results.  However, in situations where a patient is particularly lean, there may be some possible improvement in results.  Simply put, if a patient has difficulty "holding onto fat", an additional substrate such as PRP may have benefit, but we simply don't have  enough experience or ways to consistently measure these results to know the answer.

Dallas Buchanan, MD · Answer

Thank you for your questions. The viability of transferred fat depends on the surgeon technique, the patient factors, the location, and several other factors. Sometimes it can be done under local but I prefer to do most fat transfer procedures under general anesthesia. The fat that survives is considered to be permanent but the percentage that survives depends on several factors as well. Multiple procedures are done to improve volume of fat transferred and viability, not the length of time.Bottom line, make sure you are seeing a local board certified plastic surgeon. Hope this helps!

Afshin Farzadmehr, MD · Answer

Based on my experience of performing fat transfer for over 19 years and having practicing in Plastic Surgery Center of Beverly Hills where the first lipo was performed over 40 years ago I could tell you that fat transfer has a lot to do with surgeons right training and experience and tools in extraction and transfer and placement.  There is no evidence based publications that show PRP has any benefit.  In average up to  60 percent or even more of fat would be permanent which is significant. The art is in distribution and having an eye in aesthetics to determine future progression and changes and advice pre operatively.  The fat is viable and remains permanent after transfer.  Thanks for great question.

Daniel Barrett, MD · Answer

Dear eye72,you didn't mention where you want fat to be transferred. In some cases it can be done under local anesthesia. Fat transfer is considered a permanent solution for augmentation. In most cases 1/3 of transferred fat will be lost. Fat viability depends a lot of surgeon technique. The fat has to be placed back into the body as soon as possible so that it has a greater chance of survival. There are no significant evidences that PRP can increase fat survival rate. If you are considering a fat transfer, I would suggest you to consult a board-certified plastic surgeon. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

R. Laurence Berkowitz, MD · Answer

As this concept of 3 dimensional facial rejuvenation with fat restoration has grown exponentially in the past decade it is highly technique dependent. There are conflicting reports about the value of PRP with fat grafts. The best peer reviewed paper last year in my opinion, showed decreased fat take with PRP due to the inflammation caused by some of the cells that will be added besides platelets.  We have used PRP in our practice for over 15 years and find it indispensable to accelerate wound healing in rhinoplasty and facelift but not added to the fat grafts. There is confusion about how long the fat lasts as well. The fat should survive as long as its programmed life span dependent upon the donor site, however beginning the day after surgery we continue to age and lose more of our native facial fat.  Some of the experts encourage yearly touch ups.  In our practice we recommend waiting about three to five years.

Jon A. Perlman, MD (retired) · Answer

Fat transfer is effective to varying degrees depending upon technique and individual patient characteristics.  I think that PRP is of little proven value and expect anywhere from 50-75% of fat to survive.  I have seen consistently long lasting results from fat transfer to the face in terms of volume restoration and skin rejuvenation.  I think that data will be accumulated in future years confirming longevity after breast augmentation and BBL results that we as yet haven't collected and seen published though I personally expect that the results will be found scientifically to be equally good.Be aware however of reported cases of embolism and death after BBL when fat grafts were placed adjacent to injured deep veins mandating that fat grafts not be placed into or deep in the gluteal muscles IMO.Best wishes,Jon A Perlman MD FACS 
  
Certified, American Board of Plastic Surgery 
  
Member, ASAPS, ASPS
  
Extreme Makeover Surgeon, ABC TV 
  
Best of Los Angeles Award 2015, 2016 
  
Beverly Hills, Ca

How long do fat transfers usually last? And can PRP help it last longer?

Answers (9)

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