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  • How Does Fat Transfer Work?
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Hi, I'm Dr. Dan Shapiro. I'm a plastic surgeon certified by the American Board of Plastic Surgery. I've been practicing in Scottsdale, Paradise Valley area since 1992, and I only perform cosmetic or aesthetic surgery.

I think one of the most significant advancements in the last 10 to 15 years in plastic surgery is the advent of fat transfer or fat transplantation. One of the things to really know about fat transfer, in understanding how it works, is I think it's very technique-dependent. It really depends upon who is performing the fat transfer. I feel lucky that I've been doing this for 15 years now in terms of the fat transfer, and I feel that I've done so many cases that my technique has really evolved, and I have really great longevity with the fat transfer itself in terms of the results.

People want to know how does fat transfer work, and, as I alluded to, it really is transplantation. What we are doing is taking fat from one area of the body. We extract it with a very small cannula, usually from the abdomen, the flank, or the thighs. I take that fat with a very low-pressure syringe. I take the fat that is removed, and then I spin it in a centrifuge to concentrate all the elements that are within that fat. Those are fat cells, there are growth factors, there are stem cells. We want those to maintain their integrity.

We spin those very lightly in a centrifuge, and very delicately that fat is handled, further purified, and put into very, very small one cc syringes. One cc is not very much.

After that, I use a very small cannula. Usually it's less than a millimeter in diameter, so that's very, very fine. I take that fat and very gently put it into multiple layers wherever I'm working. The theory is that we are trying to make, if you will, multiple little pea pods of fat, so all that fat will be exposed to surrounding blood supply and gain its own blood supply.

Therefore, we are not trying to just take it as a filler like other facial fillers or other body fillers. We're trying to take that fat, incorporate it in the tissues that I'm using to get more volume. For instance, if there's some hollowing beneath the eyes, I will very delicately put that fat in and allow that fat to get its own blood supply, so it's a long-lasting filler.

In many areas of the face where I inject the fat, almost all of that fat will stay, so it's a permanent filler. Other areas where there's a lot of motion like the lips or around the mouth, sometimes that fat will dissipate, but we hope maybe about 50 to 70% retention rate.

I think it's very important that you understand how fat transfer works, how it is technique-dependent, and it has to be handled very delicately. I think that the ultimate result is phenomenal. I think that you can use fat in almost anywhere in the body, and it really incorporates its own properties into that tissue, whether it be a Brazilian butt lift, where we inject fat in the rear end, into a man's pectoralis muscles. I often will use fat transfer to fill in any defects that have resulted from previous liposuction.

Once again, fat transfer is such an integral part of my facial rejuvenation now that I do it in every case. I find it very valuable, and I think it has very much been the missing link for the growth of plastic surgery. Thank you very much.

How Does Fat Transfer Work?

Dr. Dan Shapiro calls fat transfer one of the most prominent improvements in plastic surgery in the last 10 to 15 years. In this video, he goes in-depth about how the fat is relocated and the many uses of a fat transfer.