Fat Transfer

What is the history of lipo (fat) transfer?

Lipo transfer was in vogue in the late 1890s into the 1950s, but was abandoned with the discovery of injectable silicon which in turn was replaced by an injectable collagen in the late 1970s. In 1956, Lyndon Peer, M.D., who with others was transplanting fat to re-contour facial and body depressions and deformities, proved that 50% of transplanted fat cells establish blood flow within a few days and survive for a year. Liposuction surgeons in Europe, South America, and the United States have recently been recycling fat with much success. It seems that on average 30–50% of fat transplanted during any given session will survive, depending upon the surgeon, the patient, and other factors as yet not understood.

How did Dr. Binstock learn the procedure?

The French surgeon, Pierre Fournier, M.D., reported to the American Society for Dermatologic Surgery in the spring of 1985 that he had re-injected fat into five hundred patients over a five month period without ill effects. In 1983 and 1986, Dr. Binstock visited with Dr. Fournier in Paris to learn his methods. Dr. Binstock has been refining and perfecting his techniques ever since.

What is lipo (fat) transfer?

Lipo transfer offers a natural filler material, i.e., one’s own fat, that is harvested and re-injected into the individual. It can be used to fill out the lines around the month and between the brows, to restore fullness of the upper and lower lips and eliminate lip lines, to fill in cheeks and build up cheek bones, to strengthen the jaw line and chin, to fill in temple hollowness, and to recontour and position the eyebrows, as well as support the lower eyelids. This technique helps restore facial fat that is lost with aging. It can be combined with liposuction of the jowls and neck to create a more youthful appearance.

Aging hands can also be rejuvenated and filled in, as can body depressions, including the natural hollow occurring between the hip and outer thigh, and to help correct unsatisfactory liposuction results.

How is the fat harvested?

Fat tissue can be easily harvested by using a syringe under negative pressure created by pulling back on the plunger, and then moving the syringe and a micro lipo (fat) extractor back and forth under the skin to withdraw the fat into the syringe, i.e., micro liposuction. In this way, small amounts of fat can be harvested from the abdomen, hip, or thigh, to be re-injected, i.e., micro lipoinjection, into the desired areas.

Fatty tissue also can be collected during liposuction surgery for reduction of facial or body bulges, as liposuction makes available large quantities of fat. The fat is broken into subunits by low pressure suction, offering greater surface area for fat cells to be nourished and supplied when transplanted.

What results might I expect to see?

It appears that each lipo (fat) transfer session results in an average of a 30–50% residual correction and that by doing a series of two to three sessions, it is usually possible to achieve a substantial and often persistent long-term correction. This depends on the body area or facial area grafted as well as on each particular individual. For example, the filling in of cheek hollows and body depressions will often last a long time, while lip augmentation and frown line filling needs touch up more often as aging continues.

What happens to the face as we age?

Aging is multi-factored phenomena with progressive loss of supporting structure and subcutaneous tissue that results in a hollowing out of the temples and cheeks, a thinning of the lips, loss of jaw and chin definition, etc. Pulling skin tighter, i.e., a face lift, only addresses part of the aging process, often leaving the face gaunt and pulled. Lipo filling and contouring uniquely offers the volume of a natural filler substance necessary to improve and reverse this aspect of aging, which is usually ignored. The results can be quite dramatic and a more youthful appearance regained. Fat transfer can often postpone, as well as complement, facelifts.

What is the recovery time?

Both donor and recipient sites may bruise for five to nine days. Swelling may be apparent for one to three weeks. There is some loss of benefit over time even though approximately 30–50% of the grafted cells on average survive. It is easy to re-inject to obtain better contouring during multiple sessions, and as aging continues. Fat transfer sessions can involve small quantities of fat, with little swelling and bruising and less correction per session and the benefits manifesting after many sessions. Or, larger amounts of fat can be injected at one time if one is able to deal with swelling and bruising that may last one to two weeks.

What are the risks?

The risk of infection appears to be 1% or 2%. The risk of total failure due to the fat not taking is also in this range (the fat may be reabsorbed by the body or, very rarely, drains through the skin like a cyst). Other risks include scarring, asymmetry, lumpiness, and embolism, i.e., fat inadvertently being injected into a blood vessel. (Embolism resulting in skin loss, blindness, or stroke, has been very, very rarely reported over the last twenty years in the world’s literature.) We use a blunt tip injector, not a sharp needle, to help avoid this problem. The risks when using dermal and biostimulatory fillers are similar.

Lipo (fat) contouring, via fat transfer, is a unique, exciting means of affecting facial filling and rejuvenation. Unlike dermal filler injections, lipo transfer is not associated with allergy problems, and large quantities can be utilized at each session to recontour and restore facial fullness. Modern lipo (fat) transfer is a breakthrough procedure offering an opportunity to replace the loss of facial fat tissue that occurs with aging.