Who are the best most experienced doctors for fat grafting?

    I transfer fat to the face, the breasts, the buttocks, the hands, the feet, the calves, for liposuction revisions, to fill traumatic defects, etc.  I would look at before and after pictures and reviews to come to a decision.Kenneth Hughes, MDLos Angeles, CA

Fat Grafting: A word of caution: this is a delicate surgery that requires a fair amount of experience with fat grafting, and meticulous surgical technique. In experienced hands a smooth, youthful and aesthetically ideal  contour can be achieved. Make sure your surgeon can show you numerous photographic examples of facial fatgrafting.Structural fat grafting is the placement of fat - harvested using a syringe aspiration technique from a remote location on the trunk or thighs – into an area of hollowness or soft tissue deficit using small syringes and small blunt cannulas. As needles are not used, fatgrafting is technically not an ‘injection’. The key to success with structural fat grating is the meticulous placement of small amounts of fat (tiny globules) diffusely throughout the area that is being enhanced. If the fat is placed diffusely and the technique is minimally traumatic, there is no possibility of the graftedfat migrating to another locationFat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements are possible. Frankly, many surgeons have not devoted the time or attention to expertly perform fat grafitng. The surgeons who are able to acheive the best results perform fat garfting often and enjoy this procedure. It is essential to view dozens of before and after images taken weeks and months after this procedure. Great results make eople look young and natural. Avoid fat grafting from physicians with results like look over-filled. 

While I am biased, I would say that a plastic surgeon is generally by far the most qualified physician to do fat grafting. That being said, there are many doctors who perform transfers, and, in general, the more experience someone has had, the better they are going to be. I would recommend asking how many fat transfer procedures a particular physician has done, what the revisionary rate is, what percent of patients require a second session of fat grafting and, finally, what percentage of patients have needed fat removed or had some type of minor complication. I think all of these are good and fair questions to ask. Fat transfer and fat grafting follow the same principle as grafting other tissue. As plastic surgeons, we have extensive training in the procedures used in grafting all kinds of different tissues including fat, bone, cartilage, skin, etc. While other medical specialty physicians may have some of these as part of their training, plastic surgeons are required to have extensive knowledge in this field. A board-certified plastic surgeon has the most extensive amount of training in these types of procedures, can offer all appropriate alternatives, has the ability to perform the procedure with the patients under general anesthesia, has the ability to bring someone to the surgery center or hospital and is trained to handle the most severe complications should they happen. I hope this helps.Best of luck,Mats Hagstrom, M.D.