Fat Graft

Fat Graft

 

Fat grafting, also known as fat transfer, is a process where fat is transferred from one area of the body to another area. The aim is to use the fat graft to improve or augment the target area. In essence, fat grafting is a process that involves three steps:

  1. harvesting the fat by liposuction technique (see Liposuction) from a donor area
  2. purifying the fat
  3. injecting the fat into the target area

Fat grafting enjoys the benefits of abundant supply, ease of harvesting, and generally low rate of complications.

 

Fat graft is composed of fat cells and the stromal vascular fractional (SVF). The SVF is consists of adipose-derived stem cells (ADSCs), vascular endothelial cells, fibroblasts, and a variety of immune cells. Fat graft fills up and enhances the target areas where tissue volume has been diminished or lost due to aging, trauma, or congenital anomaly. Besides, the SVF component in fat graft has a regenerative property that enhances fat graft survival and brings about regenerative changes in the treated area. The therapeutic benefits of fat grafting are well documented in the healings of wounds and scars.

 

After the transfer process, most of the fat graft will undergo revascularization and incorporation into the new site. However, a certain percentage of the fat graft may undergo resorption and get reabsorbed. Generally, the revascularization and incorporation process will take about six months to complete. The fat graft that is successfully incorporated will remain long term in the body.

 

Proper techniques of harvesting, purification, and injection can significantly improve the results of fat grafting. Specialized instruments such as MAFT Gun© can deliver ultra-tiny fat droplets to the precise locations in tissue planes, thus enabling accurate placement and enhancing the fat graft’s survival, leading to desirable and enduring results.

 

 

 

Common applications of fat grafting:

  1. Face: to restore youthful appearance by adding volume to hollow or wrinkled areas such as the cheek, temples, nasolabial folds. Fat graft can also be used to enhance areas such as the lips and forehead to make them look fuller and more supple.
  2. Periorbital area: Fat graft can correct the hollow upper eyelid and tear trough below the eyebag.
  3. Breast: fat graft can be used for breast augmentation (see Breast Augmentation by Fat Graft), correct breast asymmetry, repair tissue damage, and correct scar deformity from previous breast surgery.
  4. Buttocks: fat graft is used in Brazilian buttocks lift (see Buttock Lift)
  5. Scar: to improve the contour, texture and color of scars
  6. Hands: to restore the wrinkled dorsum of the hand

 

 

 

Preparation

  1. Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.
  2. Stop smoking at least one week before surgery. Smoking is harmful to wound healing and increases the risks of other post-operation complications.
  3. Stop the following medications and supplements from one week before surgery until one week after surgery.
    1. All supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, and other ingredients that increase bleeding during the procedure. Other supplements, traditional medicine, and herbs, in which ingredients are unknown, have to stop as well.
    2. Medicine that increases bleeding during the procedure such as aspirin, NSAIDs, and warfarin. However, you may need to consult your physician who prescribed the medication before you stop them.
  4. On the day of surgery, wear simple and comfortable clothing. Do not wear any makeup. Do not wear any jewelry and metal objects on the face and body.

 

 

Procedure

Duration: 1 to 3 hours

Anaesthesia: Local anaesthesia for most cases. Large areas such as buttocks may require general anaesthesia.

Hospitalization: not required except the cases that require general anaesthesia

Recovery*: Back to work in 3-5 days, light exercise after one week, heavy exercise after 4 weeks. * The actual speed of recovery depends on the size and extent of the fat grafting and may vary from person to person.

Technique: the procedure consists of 3 steps:

  1. Fat harvesting: fat graft is harvested from a donor site, usually the thighs or tummy. Harvesting is usually done manually using low-pressure syringe suction to avoid damage to the fat cells.
  2. Fat purification: the fat is separated from the unwanted elements such as oil, dead cells and blood cells by centrifuge and filtration.
  3. Fat injection: the fat graft is injected meticulously to the target site in ultra-tiny droplets using a fine cannula or special injector such as MAFT Gun©.

 

 

 

Post-operative Care**

  1. What to expect: Swelling usually peaks on the second to third day after surgery and will gradually subside after that.
  2. Avoid direct pressure and hot contact on the target areas.
  3. General care:
    1. Elevate the head during sleep to reduce swelling.
    2. Avoid smoking for at least one month. Smoking increases the risk of wound complications and adversely affects the survival of the fat graft.
    3. Adequate rest and sleep are helpful for a speedy recovery.
    4. Be relaxed and calm. Contact the clinic if there are any queries.
  4. Medicine: Finish the oral antibiotics as prescribed. Take the painkiller as prescribed when necessary.
  5. Wound care: Clean the wound with a clean cotton tip soaked with sterile water/saline. Apply antibiotic ointment. No dressings are required.
  6. Physical activity: Avoid heavy physical activity and exercise for at least one month.
  7. Follow-up: Come back one week after surgery for suture removal and review.
  8. Emergency: If there is heavy bleeding, a rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

 

 

** The instructions in this list are only for general guidance. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.

 

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