Body Surgery

Fat grafting in Vancouver and Richmond BC

What is fat grafting?

Fat grafting is a minimally-invasive surgical procedure that allows the transfer of fat cells from one part of the body to another. It is a highly customizable tool/technique that Dr. Reid uses in a variety of both reconstructive and cosmetic plastic surgery procedures. Similar to liposuction, fat grafting can be performed as a stand alone procedure or as an adjunct to an operation, such as a facelift, breast lift or breast augmentation. Fat grafting is often referred to by other names such as:

  • Autologous fat grafting
  • Micro fat grafting
  • Structural fat grafting
  • Lipofilling
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How does it work?

Although minimally invasive, fat grafting is a surgical procedure and, therefore, requires the use of an operating room in an accredited surgical facility. A comfortable patient experience is ensured by either intravenous sedation or general anaesthesia. When fat grafting is performed as a stand alone procedure, patients are typically discharged home the same day. If performed in conjunction with a surgical procedure, an overnight stay at the surgical facility is often beneficial.

At its most basic level, fat grafting is a three step process.

  • Step 1 - liposuction is used to collect the fat which is to be transferred
  • Step 2 - fat is processed prior to transfer
  • Step 3 - fat is transferred in to the treatment area

How much of the fat survives?

Approximately 50-70% of the transferred fat survives, or grafts, successfully in to the treatment area. The remaining 30-50% is broken down and absorbed by the body. Maximizing graft take requires the application of surgical principles, specialized equipment and new techniques as outlined below:

  • Selecting a donor site - The location of the donor site has no impact on graft take, so Dr. Reid will select areas that are likely to benefit from the liposuction portion of the procedure.
  • Collection - Specialized cannulas (as opposed to standard liposuction cannulas) facilitate the collection of small diameter fat particles.
  • Processing - Once collected, the fat is processed within a closed system so that it can be separated from other components of the lipoaspirate in an atraumatic fashion that helps to maintain fat cell viability and sterility. This purifies the fat which has the dual purpose of enhancing graft take and minimizing inflammation in the treatment area.
  • Grafting - A micro fat grafting technique is used during the transfer process. A specialized cannula facilitates the placement of thin lines of fat in multiple layers throughout the treatment area. Typically, this is a time consuming process whereby Dr. Reid serially adds a small volume of fat while continuously monitoring the change in contour, symmetry and overall cosmetic outcome.
  • Recovery - Even at this stage, attention to detail can effect graft take and overall outcome. Depending on the location of the treatment, there may recommendations regarding activity modifications, specialized support garments and the use of antibiotics.

Artistic principles and Treatment Expectations

The selection of donor sites and the placement of fat grafts requires considerable artistic judgement on the part of the surgeon. During a consultation with Dr. Reid, a shared image of the desired outcome is generated through discussion. There are established ratios and proportions that are universally present in beauty that he can share and that will be blended with each patient's aesthetic goals.

This discussion about desired outcomes is a natural precursor to the development of treatment expectations. There are technical limitations regarding what can be achieved with one session of fat grafting. For example, beyond a certain point, if a surgeon continues to fill the treatment area with additional fat, the percentage of graft take will begin to fall dramatically and the risk of complications. Understanding these limitations will help patients as they compare fat grafting to alternative treatments.

Will one fat grafting procedure be enough?

In cases where a significant augmentation is desired, it may take more than one fat grafting treatment to achieve this result. During a consultation, Dr. Reid can estimate the likelihood of needing one or more procedures to achieve your desired outcome. Facial rejuvenation can often by achieved in one procedure, while treatment of the breast and buttock more commonly require multiple procedures.

Indications in facial rejuvenation

As we age, the volume and distribution of facial fat slowly changes. There are areas of the face that tend to accumulate fat such as the jowls, the submental are and the nasolabial folds, but overall, there is a decrease in the amount of facial fat which is why re-volumizing the face, with implants, injectable fillers or fat, has been a successful strategy for rejuvenation. Areas that tend to lose volume over time and that are commonly treated with micro / structural fat grafting are the:

  • upper eyelid sulcus
  • temples
  • cheeks
  • lips
  • jaw-line

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Indications in body contouring

As with facial rejuvenation, fat grafting is used in body contouring to enhance shape and proportions. Common indications for fat grafting include:

ow long do the results last?

When fat grafts successfully integrate in to the treatment area they develop a new blood supply allowing them to live there indefinitely. The characteristics of the grafted fat will change over time but, like a skin graft, the fat grafts will persist long term.

Potential Complications

As a minimally invasive procedure, the surgical risks associated with fat grafting are relatively low compared to other procedures. It's possible that during your follow-up with Dr. Reid that it may be decided that you would benefit from further treatment to address contour irregularities or asymmetries. Overcorrection and under-correction are also possibilities, in part due to the inherent variability in graft take. Other potential complications include infection and cyst formation.

Alternatives

With regards to facial rejuvenation, alternatives to fat grafting include facial implants and injectable fillers. Dr. Reid's use of facial implants is limited to chin augmentation, and for select patients fat grafting has evolved in to a viable alternative to this time-tested procedure. The most common injectable fillers are temporary products made of Hyaluronic Acid and the long term effect provided by fat grafting is an important distinguishing factor between these two treatment options.

Breast implants and fat grafting are the only methods of augmentation that Dr. Reid uses in his breast and body contouring practice. Fat grafting has not emerged as a replacement for breast implants. In general, the results obtained with fat grafting are more subtle and therefore it should be reserved for patients seeking a relatively small increase in breast size or shape, patients with breast asymmetry or those patients who wish to avoid breast implants.