Difference between fat flap and fat cells?

Question

If I had a fat flap for a butt augmentation and then also had lipo 360 with fat transfer to my butt would the fat cells and fat flap all intergrate to look the same? Will you see the flaps? How long does it take for the flap to intergrate? Is fat flaps more dense than fat cells? I am worried about it not all looking the same if you did both fat cell transfer and the fat flap into the buttocks. If flaps were to big is it reversible? If so, how? Who specializes in this? Thanks!

Miguel Mota, MD · Answer

First of all not all patients qualify for a fat flap butt augmentation. This is usually performed in patients that have excess skin with a droopy butt. Both fat transfers and fat flaps work great on the correct patient. Without photos it’s impossible to say if you are. A good candidate or not. The fat flap obviously leaves behind a larger scar, all across the top portion of the butt. A fat transfer will not work if combined at the same time with a fat flaps because the injected fat will possibly migrate to dissected areas and therefore not have the proper blood flow.

A fat flap and fat transfer can be done in different stages or rounds with excellent results. The flap does not intergrate.. it keeps it own blood supply. Both procedures will look the same once healed. The fat flap is a little but more dense but it will still feel like butt tissue. We can actually sculpt it to make is rounder or to make it project more.

All in all both options a great, especially if you qualify, don’t mind the extra scars and if you don’t mind a two stage procedure and the scars. So, I would recommend the BBL first (making sure to avoid lipo of the lower back because this is where we get the fat flap), and then on your second round we can do the fat flap. I’ve done this before.

Best of Luck,
Dr. Miguel Mota

J. Timothy Katzen, MD, FACS · Answer

Hello, Funny40762, in Kalispell, MT. Thank you for your question regarding the difference between fat flap and fat cells. Let’s discuss each procedure individually. A buttock flap is also called a propeller flap. During the creation of the propeller flap, the epidermis and superficial dermis are removed from the upper portion of the buttock. A large paddle of skin and fat is then created at the top third of the buttock. To create this propeller flap, an incision is made above the buttock, and an elliptical or football-shaped area of skin and fat is fashioned on each side of the buttock. Each propeller is then folded into the buttock. The flap consists of the deep dermis (to preserve blood supply) and underlying fat. The fat from the propeller flap can be thinned during the transfer. The flaps can be put into the buttock obliquely or even perpendicularly depending on the patient’s desire and anatomy.
With a Brazilian butt lift or BBL or autologous fat transfer, fat is harvested from one area. The harvesting of fat is similar to liposuction. The fat is then processed, strained, and purified. The fat is then injected into the buttock for augmentation. These are two entirely different and separate procedures, but can be combined.
Regarding your questions, will the fat transferred into the buttock and into the flap integrate and look the same? Yes. Fat can be injected into the flap and will look the same. On ultrasound (not visually), you will still see the dermal layer of the propeller flap, but the fat transposed with the flap or transfer should look the same.
Will you see the flaps? On the outside, you will see the projection of the flap. Only on ultrasound will you see the dermal layer of the flap and the fat underneath.
How long does it take for the flap to integrate? Because it's a flap, the blood supply is not disrupted, and therefore, the flap "integrates" immediately during surgery. 
Is the fat more dense than fat cells? The flap fat is slightly more dense than transferred fat cells.  
Are the flaps reversible? Yes, the flaps can be reversed by either liposuction (to remove more fat from the buttock or flap) or another surgery. The surgery may include using the incision across the top of the buttock to thin the propeller flaps by removing more dermis and fat.
In terms of experts in the area, do your research. Look for plastic surgeons who have many before and after pictures of the propeller or autologous buttock flap augmentation procedure. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. Do your research. Ensure that your chosen plastic surgeon has performed your desired surgery numerous times and has the before-and-after pictures to prove it. Carefully examine their before-and-after pictures. If you cannot find an experienced, board-certified plastic surgeon in your area, consider traveling out of state if necessary. Sincerely, Dr. Katzen. (President of  the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Difference between fat flap and fat cells?

Answers (2)

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