Fat Injection
Fat injection, also known as fat grafting or fat transfer, can be used to restore depleted tissue volumes or to surgically enhance and enlarge the appearance of facial features. It is a simple, yet powerful technique, to transfer viable, living fat cells from one region of a patients body to another. Although most widely performed for facial work, fat grafts can be employed in almost any region of the body. The grafts are layered into the recipient area so that they are throughout the tissues rather than in a isolated grouping. This has the effect of making the enhancement appear very natural and not "fatty". When performed correctly the transformation is dramatic and permanent.
It is however not a technique designed for the transfer of large volumes of fat (e.g. for breast augmentation), rather it is used for more subtle enhancement of features and correction of depressions. Previous attempts to use fat transfers to achieve a large volume changes prove to be unsuccessful for many reasons.
Before and after photographs
The New Zealand Medical Council has banned New Zealand doctors from using "Before and After" photographs in any form of public communication, including websites. The only permissible use of such photographs under the New Zealand Medical Council rules is during a medical consultation.
Dr Masters will show you examples of previous patient's "Before and After" photographs during your consultation.
Indications
Typical uses of fat grafts in the facial region include the restoration of youthful facial volumes, following age related tissue atrophy and descent; and the selective enhancement of normal facial features (e.g. cheekbone prominence, lip enhancement, etc).
The fat grafts can also be employed to successfully re-establish normal tissue contours and volumes elsewhere in the body. The tissues on the back of the hand typically thin with the passage of time and are a good indicator of a persons age, restoration of volume in the dorsum of the hand helps to disguise many of these age-related changes. Unintentional divots and surface irregularities following liposuction can occur, fat transfers can be employed to restore normal contours.
Operative technique
Unlike traditional liposuction, when harvesting fat for use as a grafts, great care is taken to minimise the trauma sustained by the fat cells and hence maintain their viability. A solution containing local anaesthetic and adrenaline is injected into the donor site to help limit bleeding. The fat is gently harvested by sucking it into syringes using specially designed cannula; it is then centrifuged to separate the viable cells from the nonviable cells and debris. The purified fat is then ready for injection.
The key to a successful fat graft is to only use high-quality viable fat cells and to inject them gently and very small discrete pockets. A special range of injection cannulas has been designed to allow the fat cells to be deposited into their recipient bed in the most atraumatically possible manner.
The recipient site is not over treated, rather the expectation is to achieve almost 100% take of the fat injected, and thus there is no need for over treatment. Depending on the particular location of the injections, it may be necessary to plan for two or more series of fat injections.
All of the harvesting and injecting incision sites are placed in the most discreet areas possible, preferably in creases where available, and are usually no more than 2 mm long.
Where is the Surgery Performed
Depending on the number of areas to be treated and if there are other procedures also being performed, the surgery may be scheduled for either a full operating theatre under general anaesthetic or under local anaesthetic in Dr Masters practice operating room.
Pre-operative Preparation
Dr Masters will provide you with precise instructions well in advance of your surgery to allow you a smooth and stress-free preparation for the procedure. Take the time to read your consent form thoroughly, along with any other written information Dr Masters has provided for you with regard to your surgery. This will allow you to have all of your questions answered prior to the procedure, and ensure there are no unexpected surprises during the post-operative period.
If you are the main domestic executive in your home, or you live alone, you should plan ahead with regard to housework and meal preparation. Do your grocery shopping, cleaning, etc the day before your surgery and plan to have meals that require minimal preparation and/or cooking time.
If you are a smoker, stop smoking at least one month pre-operatively (see the "Policies" page). Do not take any aspirin or aspirin-containing products for at least one week prior to the surgery. If you are on any other medications, ensure that Dr Masters is aware of the medications (including homoeopathic remedies) so that any other medications that require cessation during the pre-operative period can be discontinued.
Post-operative Period and Recovery
The residual effects of the local anaesthetic in both the donor and the recipient sites are still in effect when you go home, and as such, surgical discomfort is minimal. As the local anaesthetic wears off, the use of oral pain-relieving medications that Dr Masters will prescribe becomes necessary. Some patients literally take no additional pain relief; others find themselves in moderate discomfort for a number of days, requiring strong oral pain relief. There is no way to predict how a certain individual will respond to the post-operative discomfort. Although, as a rule of thumb, the smaller the area of grafting performed, the less discomfort the patient has.
Usually there are areas of altered skin sensation initially, full return of sensation is to be expected, however this may take a number of weeks to months.
Most patients would be technically capable of performing their normal day-to-day duties, including work, within two to three days of having the procedure. However the bruising and swelling associated with fat grafting can be quite significant and may necessitate a number of weeks off work if the patient does not wish for their colleagues to know they have undergone the procedure. Exercise is usually discouraged for a number of weeks.
Results
An initial result is obvious at the completion of surgery, the final result however is not seen for at least 3-6 weeks.
Approximare Costs
The cost of the procedure is dependent upon a number of variables including; your medical history, the form of anaesthesia used, the type of operating room used, the amount of fat needed per area treated and the number of sites being treated. Dr Masters will prepare a written quote for you following your initial consultation and examination.
Risks and Complications
Before deciding to proceed with surgery, every patient needs to thoroughly consider the risks, as well as the benefits, of the proposed procedure. During your pre-operative consultation(s), Dr Masters will openly discuss the risks with you so that you can consider them. A full listing of all the potential complications and risks of this procedure is beyond the scope of this website.
There are two broad groupings of surgical risks: those that pertain to surgery in general; and those specific to the procedure being performed.
Generalised surgical risks include:
- Bleeding -- usually occurs within the first 24-48 hours of the procedure and may require a return to the operating room. A quiet, restful post-operative period will help to avoid this problem.
- Bruising - whenever possible, Dr Masters uses medications and techniques that help to avoid post-operative bruising.
- Infection - surgical incisions, even though created in ideal circumstances, can become infected. When appropriate, antibiotics will be prescribed to lower this risk.
- Unfavourable scarring - every surgical incision results in a scar. It is Dr Masters’ role to maximise the quality of your scars and, whenever possible, to hide them in natural skin creases.
Fat grafting, when performed using modern techniques by a fully qualified surgeon who has undergone comprehensive training in their field, should not result in significant complications. Surgery however, even fat grafting, should not to be undertaken lightly; complications can and do occur from time to time. These include:
- Asymmetry - any right versus left asymmetry is usually within the normal levels present in people who have never had an operation.
- Dimpling, rippling, ridges and divots – once again, with modern techniques using tumescent fluid and small cannula, these occurrences should be rare.
- Sensory changes - as discussed above, there can be a period of time where the skin loses sensation. The norm is to have complete recovery of sensation after fat grafting.
- Scarring - as the punctures are so small, troublesome scarring from the cannulas is rare.
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