Autologous Fat Transfer : Current Clinical Applications

The fat transfer procedure are presently being employed for the following clinical applications:

(1) Fat transfer to the hand
A wrinkled, bony hand with large veins, sun spots and deep grooves can reveal an advanced age even though the patient’s face, breasts or body have been surgically rejuvenated. Consequently, plastic, dermatological and cosmetic surgeons have developed techniques to make hands also look younger. A few practitioners use dermal fillers like Restylane and Juvederm but the longer lasting method seems to be fat transfer via injection which is reported to last for years.

(2) Facial fat transfer
A liposuction technique is used to harvest the fat and prepare it for transfer. The fat is then injected into the desired portion of the face. When using a micro injection technique, extremely small parcels of fat are placed into multiple layers of the face. The procedure is most commonly performed under local anesthesia with a light oral sedation.

(3) Lip augmentation
Tiny, punch-like incisions are made at one corner of the patient’s mouth. The surgeon then takes one- to two-millimeter-thick strips of fat from the donor site and gently works them into the upper and lower lips for a plumping effect that is reported to be safer, softer and more natural than lip augmentation with popular injectable facial fillers like Restylane or filler materials like medical Gore-Tex or, e-PTFE (polytetrafluorethylene).

(4) Buttocks augmentation via fat injections
While thin patients must opt for insertion of special buttocks implants to fill out their buttocks, patients who can spare the fat can undergo fat injection in a surgical procedure known as gluteoplasty or Brazilian butt lift. Working through small incisions in each gluteal cheek, the surgeon places fat cells at dozens of levels through the patient’s rear. It’s an exacting procedure.

(5) Breast augmentation via fat grafting
Fat grafting to female breasts can be performed for cosmetic reasons, breast augmentation, to correct breast asymmetry, tuberous breast, a condition in which the adult breasts fail to develop in puberty and result in extremely small, narrow and sagging breasts, or to correct Polands Syndrome, a rare birth defect characterized by underdevelopment or absence of the chest muscle (pectoralis) on one side of the body. It is used to reconstruct breast deformities due to mastectomy, a lumpectomy, a breast implant collapse. Many breast augmentation patients have joked that if they could magically shift fat from one area of their bodies to another, implants wouldn’t be necessary.

Autologous, fat-derived adult stem cells – “mature” cells reintroduced into the same body, as opposed to embryonic stem cells used as an allograft – are showing tremendous plastic surgery-related promise for such applications as postmastectomy breast reconstruction, aesthetic breast augmentation and cosmetic hand rejuvenation, as well as the repair of wounds, scars, burns and radiation-damaged skin.

(6) Correcting asymmetrical breasts
Up to 25% of women’s breasts display a persistent, visible breast asymmetry, which is defined as differing in size by at least one cup size. Ten percent are severely different, with the left breast being larger in 62% of cases. Few surgeons will agree to an augmentation procedure unless there is a difference of at least one cup size.

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