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FAT GRAFTING

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SUMMARY

  • Fat grafting is an involved, detailed procedure that requires planning, instruments, and expertise that may be gained by expert training and experience.

  • Fat transfer can create an entirely new shape or replace volume that was lost.

  • Choose donor sites ahead of time if possible, ideally body areas that show minimal change with weight loss.

image Beginner Tips

  • Avoid injecting fat into the forehead.

  • Fresh fat is best. Avoid using refrigerated or frozen fat.

  • Avoid using needles for fat injection.

  • Inject only thin strands of fat at a time.

image Expert Tips

  • If the grafting cannula enters the oral cavity during injection, withdraw and do not use that cannula again to transfer fat.

  • Avoid lumps in the face by injecting small volumes and molding the area after injection.

  • Make significant overcorrections when placing fat in the body.

  • Perform only slight overcorrections in the face, and watch for symmetry.

image Don’t Forget!

  • Unlike facial fillers that can be purchased and are readily available to be injected, fat must be harvested from a separate donor site on the patient during a separate procedure.

  • Some patients may find that filler injections are more convenient for them, and may not want the inconvenience of undergoing a small liposuction procedure prior to being injected.

image Pitfalls and Cautions

  • Be careful in the infraorbital area and do not overcorrect.

  • Not only does fat have to be specially prepared, but it is not always smooth or easy to inject. Cannulas and syringes often become clogged, and fat transfer can be messy.

image Patient Education Points

  • Communication is critical, as patients must understand both the possibilities and the limitations of fat grafting.

  • Most patients prefer some degree of overcorrection, as even in the best case scenario approximately 25% of grafted volume will be lost.

  • Make sure you know exactly what shape the patient wants when they request buttocks augmentation.

image Billing Pearls

  • It may be cost-effective for patients to combine fat transfer with scheduled liposuction, as the added cost may be significantly less than performing the two procedures at different times.

  • Patients may prefer to freeze excess fat for future transfer, as this may lead to significant cost savings and improved convenience; this must be weighed against a possible decline in fat quality after freezing and thawing.

INTRODUCTION

Fat transfer, or the grafting of autologous fat from one area of the body to another, is a useful skill for any dermatologic surgeon who performs liposuction, body contouring or sculpting. Not only is fat transfer an effective method of providing a natural filler for facial aesthetics, but it can also be used for filling defects that occur during liposuction, correcting naturally occurring asymmetry and depressions, and remediating postsurgical depressions and scars.

For physicians performing facial rejuvenation, fat grafting is an important tool for ...

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