Understanding Fat Grafting: Is It Reliable?

With the New Year upon us, many will resolve to exercise more or start a diet in order to lose those excess pounds or fat we’ve accumulated over the years. Too much fat in the wrong place leads to a flabby tummy, ‘love handles,’ full thighs, a fatty neck, etc. But fat isn’t always a negative thing. In fact, in the right amount, fat makes our face have a youthful richness, helps give fullness to a woman’s breast, and produces a youthful, round bottom. With fat, just like real estate, it’s about location, location, location.

At the Emory Aesthetic Center, we offer a technique called autologous fat transfer or fat grafting to help improve appearance, address early aging, and just make you feel better about yourself. Below are some common questions to help you make an informed decision if you are considering undergoing this type of procedure.

What is Autologous Fat Grafting?

Fat grafting is a relatively new technique that is growing in popularity each year due to the beautiful, natural results it produces. A fat grafting procedure transfers fat from areas in which you have excess fat, and injects it into areas that may be lacking in volume. People who are dissatisfied with the volume and contour of the buttocks, face, hips, breasts, or abdomen can have their own fat transferred to these areas, improving the appearance of both areas in the process.

What are the Common Areas on the Body for Fat Grafting?

The most common areas for fat transfer are the face, breast, buttocks and hands. In the face, fat transfer can be done alone or combined with chemical peels or excisional techniques such as a facelift. Fat is typically placed in the cheeks, nasolabial folds (smile lines), and even hollowed temples. Very little volume is needed to improve these deficient areas. Fat can also be used instead of implants to augment the breast or buttocks. These procedures require larger volumes of fat grafts and in some cases, require more than one surgical stage to get the desired result.

How is a Fat Graft Performed?

First, the fat has to be harvested and depending on where we are planning to graft the fat, the harvesting method is different. For the eyelids or face, we use tiny little cannulas or tubes to remove the fat. For areas such as the breast and buttocks, the tubes are much larger. The second step involves preparing the fat. Generally we use a sieve or strainer so that the supernatant fluid – the clear fluid that separates from the fat after the settling – is drained and the fat itself is left for grafting. That fat, we call micro-fat. The fat is then carefully injected in multiple tissue planes of the targeted area so that it receives plenty of oxygen and nutrients so it can develop a new blood supply. The fat that survives provides the soft tissue volume to address areas of need. The fat that does not survive is absorbed.

How Reliable are Fat Grafts?

The most challenging part of fat grafting is the ability to predict how much of the grafted fat the tissue will take. How much do we inject? How much will be retained? Because it is much easier and more convenient to reinject than it is to remove over-grafted fat, I tend to over correct by a very small amount, about 20 to 30 percent, knowing that not all the grafted fat will take. With experience, a qualified cosmetic surgeon will know that within his or her hands, how much of that fat will survive, so it’s less likely that a patient will have to come back for a second time of re-grafting.

Emory Aesthetic Center

If you look in the mirror, and see fat that you wish were somewhere else, fat grafting may be a great procedure for you. Come meet with one of the expert cosmetic surgeons of the Emory Aesthetic Center. We can discuss your goals and see if fat grafting alone or in combination with other procedures is right for you.

About Dr. Nahai

Foad Nahai, M.D., F.A.C.S., Maurice J. Jurkiewicz chair in Plastic Surgery and Professor of Surgery at the Emory University School of Medicine, has taught for over forty years. He is certified by the American Board of Plastic Surgery where he served as a director of the board for six years.

Not only Dr. Nahai’s patients, but also his peers, benefit from his incomparable wealth of experience. His contributions to the field of plastic surgery make him a highly sought-after presenter, both domestically and internationally. He has developed and implemented many procedures, some of which he has been invited to demonstrate live.


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