Fat Injections

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As we age, we lose the normal fat content under our skin which results in laxity and a less supple appearance to our skin. The injection of fillers has become very popular because it replaces some of the lost volume.

One of the downfalls of fillers is that most of the more popular types of fillers, the hyaluronic acid injectables (Juvederm and Restylane), are temporary and last at best only a year.

Fat injection is quickly becoming a very popular method of replacing volume in the face, hands, buttocks and in other areas affected with aging because some of the fat remains permanently. Fat injections have a natural appearance, a soft feel and can replace lost volume better than thinner fillers.

Fat transfer is called “autologous” because it is transferred from one part of the body to another in the same patient. There is no risk of rejection or allergy because it is a natural tissue and is simply being moved from one part of the body to another. It is a reliable and safe method of augmenting areas which could benefit from volume replacement. Fat transplantation is not a new procedure but has different long-term outcomes depending on how the procedure has been perfomed over the years.

The current method of fat transfer and involves the use of very precise instrumentation with hand-held suction removal into specific syringes which are then centrifuged to remove any extra fluid. The fat transfer is performed with very delicate movements to prevent injury to the small, delicate fat cells. The fat cells then require the surrounding tissue to supply blood through a new blood vessel which forms in response to the transplant. This blood supply allows the fat to survive for an indefinite period of time.

It is estimated that 30 to 40% of fat that is injected lasts permanently. One of the reasons that the fat can grow its own circulation once it is transplanted which then allows it to surviveis partially due to the growth factor content of the fat cells. Recently in the Plastic and Reconstructive Surgery Journal (March 2009)(1) the authors found significant quantities of numerous growth factors which stimulate blood vessel growth and survival of the fat cells.

This is a very interesting and exciting study because the growth factors present with the fat transplants appears to promote blood vessel growth and cell turnover resulting in a longer-lasting result with improved survival of the fat transplants. Other research is being performed to determine the possibility that the fat transplant grafts include adult stem cells which may reproduce after transplantation.

Fat transplantation will become more popular as its benefits are researched. The fat transplant grafts are soft and supple and have a very natural feel. Most patients are happy to have the fat removed from areas that have excess fat such as the abdomen. This procedure is done under anesthesia at an outpatient surgery center.

The areas that are injected require more time to heal than areas that are injected with fillers and the patients should account for approximately 30 to 40% of the fat staying permanently. Fat injections are frequently done with facelift procedures to enhance the fullness of the cheeks and soften the nasolabial fold (the line adjacent to the mouth). Fat injections to the hand and soften the appearance of the skin in this region to give a more youthful appearance.

There are many methods of improving the appearance of aging skin. Frequently one of the reasons for an aged appearance is the lost of fat deposition under the skin. Fat injections will help to rejuvenate some of the signs of aging and can be used in conjunction with a medical grade skincare and lasers for less invasive skin rejuvenation than other surgical procedures.

(1) Content of the Growth Factors bFGF, IGF-1, VEGF, and PDGF-BB in Freshly Harvested Lipoasirate after Centrifugation and Incubation. Pallua et. al. Plastic and Reconstructive Surgery Vol 123, No 3, March 2009 826-833.