Fat Transfer / Fat Grafting
As the face ages it gradually starts to lose volume, a process known as fat atrophy. This tends to accelerate as time passes and can result in an unhealthy, fatigued or prematurely aged appearance. Fat transfer uses one’s own fat cells to reverse this effect, providing both structural support to soft tissues and restoring fullness to the face.
The procedure involves transfer of fat cells (adipocytes) into areas of fat atrophy. Adipose tissue is gently harvested from the lower abdomen, hip or inner thigh using small syringes, processed to garner viable cells and these are then transplanted in thin layers to areas of thinned and sunken tissue. Fat transfer is especially useful for restoring cheek contours and minimising creases and hollowness around the eyes.
Fat transfer has many applications. Cosmetically it is used to contour and energise the soft tissues of the face, but it is also used all over the body to improve the appearance and skin flexibility of trauma/acne scars, surface depressions, accidental damage/burns, and certain congenital conditions.
Aesthetic and structural advantages
By restoring volume to specific areas of the face (the midface, periorbital, perioral and temporal regions respond particularly well), fat transfer not only expands the skin and provides a lift, but also re-establishes the structural support of adjacent tissues. For example, a balanced revolumisation of the fat compartments of the cheek will stabilise the lower eyelid by restoring underlying layers, thereby reducing the tendency for hollowness and the formation of eye bags.
Other physiological benefits - the stem cell effect
The fat grafting procedure also has a number of physiological benefits. For example, there is no risk of rejection or allergic reaction as the fat is taken from the patient’s own body.
There is also evidence that grafted fat contributes to the healing process and improves the condition of the overlying skin, properties which are attributed to the fat’s high stem cell content and its ability to form new blood vessels. Additionally, the effects of fat grafting can last for many years - although the procedure can be repeated if required.
Moderate to significant swelling may be experienced for 2 weeks following the procedure until the grafted fat cells integrate with the surrounding tissue. It is not possible to predict how many of these cells will survive, the extent being determined by genetic factors as well as the inherent characteristics of the tissue into which it is transplanted.
Usually, a 20-60% survival rate is expected. It is Dr Sorensen’s opinion that in order to achieve the best possible results and to avoid overcompensating, it is best to estimate conservatively in the first instance and to follow on with a secondary top-up procedure later if necessary.
Fat grafting can be performed either standalone or in combination with most other facial procedures, including eyelid surgery, facelift surgery and facial implants.
Suitable candidates for fat transfer
Fat transfer is not an age related procedure, and it can benefit most people who experience fat atrophy or desire rejuvenation and soft-tissue restoration. Patients are generally aged from their late twenties up into their sixties, and it is of most benefit to non-smokers with good general overall physical health. It is a minimally invasive procedure and the best results are seen in areas with previous fullness that have since undergone atrophy.
Dr Sorensen's recommended fat transfer techniques
● Structural fat grafting
The most common fat transfer procedure. Small-to-mid sized particles of fat cells are distributed in multiple layers. This method is effective in treating tissues on both the body and the face.
● Enhanced fat grafting
Common phrases such as ‘cell-enriched‘ or ‘stem-cell optimised’ refers to a refinement of the extracted fat. A number of reconstructive and aesthetic treatments benefit from a balanced concentration of cellular components and selective fat distribution.
● Superficial fat grafting
A specialised technique that uses the finest (micro) fat particles placed in a superficial layer below the skin. This method allows a gentle rejuvenation of delicate tissues. It may be used to treat areas such as the back of hands, nose, tear trough, eyelids and lid/cheek junction.
● Microsurgical fat grafting
A specialised technique that uses micro fat particles placed in deeper layers within intricate facial structures such as the periorbit. This method allows rejuvenation beyond what can be achieved with superficial techniques. It may be used to adjust asymmetries or hollowness around the eyes.
● Pearl fat grafting
A specialised technique of fat transplantation. Fat is surgically divided into droplets (pearls) and distributed to localised areas of hollowness. This method is used to restore the deeper contours and shape of eyes and orbit.
● Lipo-dermal graft
The original method of soft-tissue enhancement. Thin sheets of dermis with attached fat cells provide both structural reinforcement and volume augmentation.