Posts Tagged ‘fat transfer’

Fat Grafting 101: What You Need To Know

lovely-ladyIf you are like me, you spend hours at the gym trying to get rid of it and you diet to prevent it. You know what I am referring to…“love handles”, “saddle bags”, basically the accumulation of fat on certain areas of our bodies. But without fat, our faces would appear drawn and old, our breasts and butt would droop and our hands would look like skeletons. In other words, fat is a necessity and it has its benefits. In the right location and quantity, it is a sign of youth. I am not recommending you hang up those running shoes, but at the Emory Aesthetic Center, we can reorganize this necessary fat to improve your appearance, address early aging, and make you feel better about yourself. I am referring to a technique called autologous fat transfer or fat grafting. Let me answer some common questions to help you make an informed decision when considering undergoing this procedure.

What is autologous fat grafting and how is it done?

Some refer to it as fat transfer or fat grafting, but the concept is not new and has been reported as early as 1893. Modern fat grafting did not develop however until the 1980’s with the popularity of liposuction. Today, in a fat grafting procedure, fat is harvested from the body by liposuction. The fat is gently prepared for injection back into the body, and then grafted into an area of deficit with small needles or cannulas. The fat is carefully placed in multiple tissue planes 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.

What are the common sites of 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. Fat grafts can also be used to correct lumpectomy deformities after breast cancer treatment and contour irregularities after liposuction. Releasing the scar in these instances and filling the deficiencies with fat grafts is a powerful improvement tool.

What is the recovery?

Recovery after fat grafting alone is generally rapid and may only be prolonged if additional procedures are performed at the same time. As an example, fat grafting to the cheeks alone may result in bruising of the cheeks and minor discomfort at the fat donor site (where the fat was taken), but requires no time away from work. If this is combined with a full facelift, then the recovery may require 2-3 weeks away from work. Recovery is also longer if a larger volume of fat is transferred. For example, a buttock lift where 600cc of grafts are placed will require 2-3 weeks of recovery compared to the fat grafting of 10cc to the cheeks where you return to work in 2-3days. After an isolated fat grafting procedure, you might notice a week or two of swelling, possibly more if the volume of grafts is high. The injected areas will likely be bruised and feel firm. The sites where the fat was taken will follow a similar recovery. The incisions are small so once swelling and bruising improve, you can be back to regular activities in a relatively short time.

Are there any complications?

Complications like infection can occur but are rare with isolated fat grafting. Donor site complications such as bleeding or contour irregularities are also rare. An additional complication is “loss” of the graft. This refers to fat not picking up a blood supply and being absorbed over time. Typically we wait to judge the increase in volume for 3-6months after the procedure to ensure that the fat has survived.

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 board-certified physicians 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.

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or call us at 404-778-6880 to schedule a consultation.
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About Dr. Anderson

anderson-ericaErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.

Ask the Doctor: How Do Fat Transfers Work?

Fat TransfersPatients often ask “How do fat transfers work, and do they last?” It is a very good question, and pertinent, too, because fat transfers have become very common in cosmetic surgery over the past several years. Fat transfers have assumed an important role in facial rejuvenation, breast augmentation surgery, buttock enhancement, and the secondary treatment of body contouring deformities, so it is important to understand what is going on.

Fat transfer is a lot like the old real estate saying: It’s all about location, location, location. Most of us have extra fat in areas we don’t want, and the beauty of the fat transfer is that we can remove some of this unwanted fat and relocate it to where we want to enhance volume. Even though this concept is quite simple, the actual way the procedure is performed has taken cosmetic surgeons many years to develop. We are still constantly improving and enhancing our techniques as we get a better understanding of how these techniques affect the survival of the fat in the new location.

The first step in fat transfer is to collect the fat from the donor site. The most common location where we harvest fat is the tummy, but we can use many potential sites, including the love handles, the thighs, and the back of the arms. The fat is collected by liposuction, either using a syringe system or a system with a fat collection chamber. The fluid obtained during liposuction (the aspirate) is then treated to remove excess fluid from damaged fat cells so that concentrated fat is ready to inject. There is significant variability in how surgeons prepare the fat for transplantation. This prepatory step can be as simple as gently straining the aspirate, may involve washing the fat, or may involve centrifuging the aspirate. The prepared fat is then loaded into syringes for injection.

The injection of the fat cells into its new “home” is done using fat grafting cannulas, these are generally small and designed to be gentle on the fat cells. The surgeon injects the fat into many tunnels and layers, as you want the fat to be widely dispersed in the tissues and not to “pool” in one area. Pooling leads to a decreased “take” of the transplanted fat. To explain this further, I like to use the analogy of planting seeds. Like seeds, the fat grafts need to get nutrients from the bed in which they are planted in order to survive. If you plant a full bag of seeds into a single hole in the ground, the seeds in the middle of the “pool” would not be able to get their roots into the dirt and would eventually die. That’s how it works with transplanted fat – if you put too much in one place, the cells in the middle will die and will be absorbed by the body.

When fat cells survive in their new location, they are there forever, and will be of stable size (unless you gain or loose a lot of weight). Cosmetic surgeons love to argue sometimes about the best way to harvest, prepare, and transplant the fat in order to optimize graft survival, and although we’ve made tremendous progress (fat transplantation is now highly effective and reliable – probably in the range of 70% survival), I don’t think we know all the answers yet. Be cautious if you feel you are being sold a “magic solution” for fat grafting, as these are often not backed up by good clinical evidence, at least currently.

One more word of warning relates to “stem cell fat grafts.” Stem cells are a current hot topic in medicine, and indeed stem cell science has tremendous potential to change the way medicine will be in the future. All tissues – including fat harvested for transfer – have stem cells anyway. However there is currently no compelling science to support the clinical claims of any special stem cell fat transplantation techniques in aesthetic surgery, and there is a lot of deceptive advertising to entice unknowing patients. In fact, both the American Society for Aesthetic Surgery and the American Society of Plastic Surgeons have issued a joint statement emphasizing this point.

The physicians at the Emory Aesthetic Center keep up with the latest developments in fat transplantation, and we’d be happy to help you figure out how they can work for you.

404-778-6880
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About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Get Ready for Summer! Join our Live Chat on Body Contouring

Body Contouring ChatWith the warmer weather fast approaching, it’s time to start trading in those hats and gloves for shorts and swimsuits. To help get your body ready for the summer, join Emory Aesthetic Center plastic surgeon, Dr. Felmont Eaves, on Tuesday, March 10, 2014 from Noon – 1PM as he discusses body contouring options that can help improve the shape of your body and tighten excess or loose skin. Dr. Eaves will walk you through both surgical and non-surgical options – including liposuction, tummy tucks, arm or thigh lifts and surgery after weight loss. If the normal effects of aging or childbearing have made you wonder if a cosmetic body contouring procedure is right for you, you won’t want to miss this chat.

Dr. Eaves will answer all of your questions to ensure you are confidently ready to take the next step such as:

  • What are the different types of body contouring options offered to me?
  • What types of results can I expect to see?
  • Are there non-surgical options to firming my body?
  • What can a body lift surgery do for my figure?
  • How long is the recovery time after a liposuction?
  • Does a tummy tuck or body lift leave scars?
  • What is the benefit of having my body contouring procedure performed at a place like Emory Aesthetic Center?

Sign Up

Chat Details:

Date: Tuesday, March, 10, 2015
Time: 12 noon – 1pm EST
Chat leaders: Dr. Felmont Eaves
Chat Topic: Body Contouring: Getting Ready for Summer

Takeaways from Dr. Nahai’s “Facial Rejuvenation” Live Chat

facial rejuvenationThank you to everyone who joined us for the Facial Rejuvenation live chat hosted by Emory Aesthetic Center surgeon, Dr. Foad Nahai. Dr. Nahai discussed both surgical and nonsurgical solutions to help rejuvenate the face, including dermal fillers, Botox®, eyelid lifts and face lifts.

We were thrilled with the number of people who registered and were able to participate in the chat. The response was so great that we had a few questions we were not able to answer so we will answer them below for your reference. You can also check out the chat transcript for a full list of questions and answers:

Is their a technique such as skin tightening that can decrease hollowness around the eyes and decrease the appearance of dark circles?

Foad Nahai, MDDr. Nahai: Sometimes, shadows resulting from contour irregularities, or hollowness, around the eyes can accentuate the dark circles. Fillers may be a solution in these situations. Also, skin care including retinols, skin bleaches, as well as surgical intervention, such as an eyelid lift, may help to improve this.

Is there a difference in the outcome or a reason to use microdermabrasion versus use of a laser on the face?

Foad Nahai, MDDr. Nahai: There is a very significant difference between the two. Microdermabrasion is a lighter therapy and is used for more superficial purposes. Laser resurfacing, however, can range from light and superficial, to heavy and deep. Both are effective for minor skin changes but only lasers can be used for more significant or deeper problems.

How can I get rid of under the eye wrinkles and is there something that can be done to whiten eye sclera?

Foad Nahai, MDDr. Nahai: There are several options for improving eye wrinkles that include creams, facial peels and surgical skin removal or lifting. After examining your skin, a specialist will be able to recommend the best treatment for you. There are eye drops available which can help to improve “blood shot” eyes, but there is not a procedure to whiten the sclera.

I fell a couple years ago, and my forehead hit a curb right above my eye. Of course I had a huge black eye as a result. It has been 2 years and I still have darkness around that eye – a shadow in the same shape as the black eye. Can anything be done to lighten this?

Foad Nahai, MDDr. Nahai: Dark circles under the eyes represent one of the most challenging areas for improvement. The eyelid skin is extremely thin, with minimal if any fat between the skin and muscle. However, there are non- surgical options, such as retinols and skin bleaches, and surgical options that can help provide some improvement.

Question: Is there anything you recommend for the treatment of rosacea?

Foad Nahai, MDDr. Nahai: A variety of topical agents are available to treat rosacea. After an evaluation of your condition by a dermatologist, he/she should be able to advise you on the best treatment options for you.

 

If you missed this informative chat with Dr. Nahai, be sure to check out the full list of questions and answers on the chat transcript. Be sure to visit the Emory Aesthetic Center website for more information on therapies and solutions to keep you looking your best.

Non-Surgical vs. Surgical Facial Rejuvenation: Which is Right for Me?

Facial Rejuvenation OptionsOver the past several years there has been an explosion of options to help your face look better and younger. Fillers, toxins (e.g. Botox®), stem cells, facelifts, fat grafts, skin tightening, and the list goes on and on. With so many options, how can you know what is right for you? Is surgery better, or will non-surgical treatments help you achieve your goals? Do the treatments even work? As you consider your options, understanding a few general principals can help simplify the decision.

First, it’s important to understand that surgery and non-surgical procedures sometimes do different things, but sometimes they do the same thing in different ways. For instance, deepening of the nasolabial folds (the creases from the side of the nose toward the corners of the mouth) can be softened by dermal fillers such as hyaluronic acid (e.g. Juviderm®, Restylane®). This type of injection is performed during an office visit and only takes a few minutes. Surgery, however, can also diminish the folds. Fat grafts can be utilized to soften the folds much like fillers, and often the most dramatic improvement to the folds is when a face lift is combined with fat grafting.

Second, while non-surgical or minimally-invasive treatments are easy to undergo and recover from, they are typically temporary and will need to be repeated to maintain the effect. Neurotoxins (e.g. Botox®, Dysport®, Xeomin®) do a great job of softening wrinkles between the brows, in the forehead, and by the side of the eyes, e.g. ‘crow’s feet’. These injections take only a few minutes to complete, but they typically last about 3 or 4 months and then need to be repeated to maintain the effect. On the other hand, surgical procedures tend to be more long lasting and may never need to be repeated. A brow lift can treat the wrinkles between the eyebrows extremely well, and this improvement is generally permanent.

Third, there are some aging changes that simply can’t be adequately corrected by non-surgical treatments, at least at this point in time. If you have developed significant jowling, only surgery can reliably address this issue. If the brow position is quite low or there is a significant amount of loose skin of the upper eyelids, only eyelid and brow surgery can reliably reposition the brow or eliminate the loose skin of the upper lid. If there is significant skin laxity in the neck, minimally-invasive treatments will not fully correct the looseness, and a neck lift will be required for full correction.

It is also very important to understand that often non-surgical and surgical treatments represent a continuum of effectiveness. Office chemical peels, mechanical treatments, or facial lasers can do a great job if the degree of skin changes and wrinkling is relatively limited. More aggressive lasers or surgical chemical peels, however, can produce more dramatic results when the skin has more established aging. Very often, minimally-invasive treatments are a great option for less severe changes, while surgical treatments are the best for more severe changes. If you are older and have more advanced aging concerns, surgery is more than likely the answer for you, but if you are in your thirties or forties, very often the non-invasive treatments such as fillers, Botox®, and good skin care is the best strategy.

Finally, and most importantly, marketing and hype doesn’t mean that something works. As much as we are always hoping for great, new options, some of the marketed treatments have little or no proven effect. For example, although the potential of stem cells to treat many conditions – including facial aging – is significant, at this time there are not sufficient studies to show that the currently marketed treatments are either safe or effective. Also, just because a treatment is approved by the FDA doesn’t mean that it is better than the older, simpler, or less expensive procedures. The old adage is upheld: If it seems too good to be true, it probably is.

As you work to figure out your best combination of options, remember that the doctors at the Emory Aesthetic Center are trained in both non-surgical and facial surgical solutions to address your aging concerns, and can help you figure out what strategy is best for you. In addition, we can help you develop a long-term, integrated plan to keep your face looking its best, incorporating good skin care along with non-invasive and surgical treatments when the time is right.

Join us for a live chat on Facial Rejuvenation –Surgical and Nonsurgical Solutions on Tuesday, November 11th at Noon to hear more about this topic. Dr. Foad Nahai, cosmetic surgeon, will be available to answer all of your questions. To register for the live chat, click here.

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Dr. Foad Nahai to Host Live Chat on Facial Rejuvenation – Surgical & Nonsurgical Solutions

Facial Rejuvenation Chat Have you considered a facial cosmetic procedure to help you look as young as you feel, or thought about enhancing features you once thought were lost in years past? Join Dr. Foad Nahai of the Emory Aesthetic Center on Tuesday, November 11, 2014 from Noon – 1PM as he discusses both surgical and nonsurgical solutions to help you realize your vision of you. If you are considering dermal fillers, Botox or facial surgery such as an eyelid lift or face lift, join our live chat to ensure you are confidently ready to take the next step.

Dr. Nahai will be available to answer all of your questions such as:

  • What types of results can I expect to see from a facial surgery versus Botox or dermal fillers?
  • Do dermal fillers and Botox injections do the same thing?
  • What is a mini-face lift?
  • Is fat transfer (fat grafting) better than a facelift?
  • Can someone who has had cosmetic surgery be treated with dermal fillers?
  • How long is the recovery period after cosmetic surgery?
  • What is the benefit of having my non-surgical or surgical procedure performed at a place like Emory Aesthetic Center?

Sign Up

Chat Details:

Date: Tuesday, November, 11, 2014
Time: 12 noon – 1pm EST
Chat leaders: Dr. Foad Nahai
Chat Topic: Facial Rejuvenation – Surgical & Nonsurgical Solutions

Fat Grafting: How Your Own Fat Can Be Transferred to Give You the Look and Shape You Want

Body GraftingBody fat…we love to hate it. We try so hard to make it go away. Too much fat in the wrong place leads to a flabby tummy, ‘love handles,’ full thighs, a fatty neck, and in men, feminine appearing breasts. However fat has another side…a positive side. Yes, I said it – a positive side. Fat, in the right amount, makes our face have a youthful fullness, 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.

As our faces age, we can develop somewhat sunken temples, flat cheeks, thin lips, and more hollowed eyes, all related to a loss of soft tissue volume. Not only does this loss of volume affect contours, but it also contributes to making the skin look looser. As women age, they sometimes lose volume in the breast, which also can make the breasts appear droopy (ptosis). In the buttock area, sometimes we are born with flat bottoms, but sometimes bottoms flatten with aging or weight loss.

Over the past several years, cosmetic surgeons have developed better and better techniques for fat transfer. In a fat transfer, or “fat graft” procedure, fat is harvested from the body by means of liposuction. The fat is gently prepared for injection back into the body, and then is “grafted” into position using small cannulas or needles. The fat is placed in the appropriate position and tissue plane so that it gets plenty of oxygen and nutrients as it develops a new blood supply. The fat that survives the transfer process and grows a new blood supply will survive long term to provide the soft fill needed to correct volume deficiencies. The part of the fat that doesn’t survive is simply reabsorbed.

The most common areas for fat transfer are the face, breast and buttocks, although sometimes fat is placed into aging hands. In the face, fat transfer can be done alone or it can be combined with excisional procedures such a facelift, blepharoplasty (eye-lid tuck), or brow lift. Fat is most commonly used to fill out a flattened cheek, deep nasolabial lines (run from nose toward corner of mouth), the groove underneath the eyes, or sunken temples. In the face, only small amounts are generally needed to get the right result. On the other hand, buttock augmentation with fat grafts, often referred to as the “Brazilian Butt Lift,” requires larger volumes, and in some instances, may require more than one surgical stage to get the full, desired result. One area where fat has proven particularly helpful is in the correction of contour irregularities that sometimes occur after previous liposuction procedures. In these instances, moving the fat around to fill in the depressions is a powerful improvement tool.

Recovery after a fat graft procedure is generally rapid, although this depends on if any other procedures were performed at the same time. For instance, facial fat grafts in combination with a full face-neck lift will take longer to settle than facial fat grafts alone. Typically after an isolated fat graft procedure you might experience a week or two of swelling, perhaps a little bruising (but often not), and the injected areas may feel firm for a few days. Since incisions are very small, after the swelling and bruising subside you can usually be up and working out in relatively short time. Complications like infection can occur but this is very rare with fat grafting procedures. Another potential complication is “loss” of the fat graft. In this instance, the transferred fat simply doesn’t seem to grow its new blood supply and hence melts away over several weeks. A good rule of thumb is that whatever volume that you have present at three months after surgery is the volume that you’re going to keep.

Of course everybody is different, and every BODY is different. Let the physicians at the Emory Aesthetic Center talk with you about your goals, your unique situation, and create a plan to fit your specific needs.

Related Resources

Butt Lifts, Butt Augmentation, & Brazilian Butt Lifts – What are the Differences?
Butt Lift & Butt Augmentation
Fat Transfer/Grafting
Body Lifts Chat with Dr. Anderson
Takeaways from Dr. Anderson’s Body Lifts Chat