With the recent recognition of the importance of soft-tissue fillers, fat grafting has assumed an increasingly important roll as both an adjunctive and a primary procedure in aesthetic surgery.
Numerous body areas are amenable to fat grafting to restore a contour to its normal and former appearance.
The abdomen and medial thighs are the most commonly chosen donor site (liposuction).
Reabsorption occurs in all cases of fat grafting. Based on the current medical knowledge, we estimate that 30 to 40 percent of the transferred fat will not establish an adequate oxygen and nutrient supply. There are some important steps to be taken in order to improve the outcome of fat grafting and reduce reabsorption. First, patients should be healthy enough to undergo this procedure. Heart disease and diabetes will impair oxygen delivery. Increasing age and lung disease also reduce oxygen in the tissues. Second, patients should avoid smoking for a minimum of 6 months before surgery, as this can significantly reduce oxygen delivery, and increase the risks of fat reabsorption. In patients where liposuction was performed previously, the removal of fat cells from areas of scar tissue is likely to yield more damaged cells.
Placement of fatty tissue will create remarkable swelling in the recipient tissues. The patient should be prepared for a significant recovery period. Even though most patients are presentable at 2 to 4 weeks, they should be prepared for some minimal swelling lasting up to 16 weeks.
Fortunately, the complication rate with fat grafting is extremely low compared to most open surgical techniques. However, complications such as damage underlying structures (nerves, muscles, glands, blood vessels) and infection can occur.
The most common complications of fat grafting are related to aesthetic appearance, such as too much or too little