Must I have general anesthesia for fat transfer or is there an alternative?

Question

I'm 2 months post facelift and fat transfer to eye troughs. I still have some hollowing under my eyes and troughs. My doc says I'd have to go completely under anesthesia for another fat transfer. Is this standard or is there an alternative? I'd prefer fat vs resty but I WONT go under again for a procedure so small. Is it safe to inject resty with the fat already there? Also I have read that resty after a facelift is risky. Something about the filler migrating into the scar tissue? Is this true?

Christopher Kolstad, MD · Answer

Hello,
  Facial fat transfercan be safely performed in the office without sedation. We routinely transfer smaller volumes 10-15mL using a combination of local anesthesia with Valium for relaxation. I tend to think we can achieve better resultswhen the patient is awake and in a seated position then we do when the patientis sedated and laying flat. Because thepatient is awake they can contribute to the results with use of a mirror duringintervals. 
Hope this helps.

Ali Sajjadian, MD, FACS · Answer

Thanks for your question.Both general and local or IV sedation can be used for fat transfer.Please consult with your surgeon to determine the best option for you.Best wishes

Larry S. Nichter, MD, MS, FACS · Answer

If you are an ideal candidate than it should not be a problem doing this as an office procedure under local anesthesia with or without oral sedation. Ideal candidates are in good health, and have excess fat in some parts of the body and too little in other regions. Fat grafting is most often used for the face, breasts and buttocks. Typically, the transferred fat results in a significant increase in volume of the body site being treated and is tolerated well. Dr. Nichter

Richard Baxter, MD · Answer

We routinely do facial fat transfer under local anesthesia. If that is the only procedure being done then there should be no problem.

Sirius K. Yoo, MD · Answer

Micro fat transfer can absolutely be done without general anesthesia.  Sometimes it makes sense to have it done at the same time as another procedure when you are already under general anesthesia.  This is usually when it is being performed as an adjunct, but otherwise, I find it preferable to perform the procedure under mild oral sedation with local anesthesia.  Obviously this is not for everyone, but for the average patient, this is very well tolerated.

Justin Yovino, MD, FACS · Answer

In my practice I perform fat transfer to the face under local anesthesia with only oral sedation. I only use general anesthesia if the patient requests it.

Robert Singer, MD · Answer

Micro-fat grafts can be performed under local, intravenous or general anesthesia. Small amounts usually do not require a general anesthetic or deep sedation. Restylane can be injected after porior fat injections and after a facelift.I would suggest you discuss your concerns with your plastic
surgeon who should ideally be certified by the American Board of Plastic Surgery and a member
of the American Society for Aesthetic Plastic Surgery (ASAPS). Robert Singer, MD  FACSLa Jolla, California

Ronald V. DeMars, MD (Retired) · Answer

Many doctors do the fat transfer under local anesthesia. It's easy to do and takes only a short time and the pain is easily taken away with the local anesthetic. but some doctors just feel better knowing their patient is asleep.

Must I have general anesthesia for fat transfer or is there an alternative?

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Answers (8)

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