In recent years, improvements in surgical harvest and injection techniques have resulted in increased interest in fat transfers. Autologous (your own tissue) fat is the ideal filler because host reactions, carcinogenic responses or other major adverse reactions are rare and because it is readily available and inexpensive. Being minimally invasive, the procedure is low risk. Moreover, there is good evidence that the harvested fat cells contain a subpopulation of adult stem cells, which appear to promote capillary bed formation, and are believed to contribute to a rejuvenated appearance beyond their simple filler role. Dr Farhadieh continues to be interested in the scientific research and clinical applications of adult stem cells in the fields of plastic and reconstructive surgery.
As with all surgery, however, there are limitations; these include unpredictable and variable rates of fat absorption and the need for overcorrection during the initial surgical procedure. Injection has to be carried out with care, and direct injection into vessels of the face must be avoided. In aesthetic surgery, Dr Farhadieh often uses fat injections in preference to artificial soft tissue fillers and believes in the tangible benefit gained from introduction of adult stem cells into anatomical sites. For reconstructive purposes, especially in addressing small contour deformities, Dr Farhadieh has utilized fat transfers extensively.
Most of our facial rejuvenation procedures involve routine harvest and injection of fat. The most common site of fat harvest is the lateral abdominal wall and it rarely leaves any evidence at the site of harvest, except for a small incision at the site of cannula insertion and temporary bruising.
Frequently Asked Questions
Fat injection and transfer is often a supplementary technique employed as part of an overall rejuvenation plan. The need for anaesthetic and possible overnight admission is determined by the principal primary surgery.
No, the fat is harvested through stab incisions and they heal with no or minimal scarring. There will be some bruising but this will resolve within the first 2 weeks.
This can vary from patient to patient, however in the vast majority of patients the bruising settles within the first 7–14 days.
The absorption is unpredictable so in the clinical setting, overcorrection during the primary surgery is recommended. Where large replenishment is required, such as breast reconstruction contour deformities, multiple transfers are often needed.
Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.
1. There are some general risks associated with ANY operation, which include:
a) Infection in surgical wound(s) with resultant redness, pain and possible discharge.
b) Possible bleeding in surgical wound(s) with swelling or bruising.
c) Secretions may accumulate in the lungs and cause a chest infection.
d) Deep vein thrombosis.
e) Death is possible during or after an operation following severe complications.
f) Smoking significantly increases the risk of complications. Therefore, you should completely stop smoking at least 4 weeks prior to surgery, and refrain from smoking for at least 4 weeks.
2. The following facts, risks and complications apply specifically to THIS operation:
a) It is possible, though unusual, to experience a significant bleeding episode during or after surgery. Should post-operative bleeding occur, it may require emergency treatment to drain accumulated blood or you may require a blood transfusion, though such occurrences are rare. The collection of blood that occur under your skin following surgery is referred to as a haematoma. Increased activity after surgery can lead to increased chance of bleeding and additional surgery.
b) Infrequently, fluid may accumulate between the skin and the underlying tissues following surgery, trauma or vigorous exercise. Should this problem occur, it may require additional procedures for drainage of fluid.
c) Antibiotics are given during and after the operation, which will minimise the risk of infection. The rate of infection following liposuction and liposculpture surgery is very low, but if infection were to occur, it would be treated with the usual techniques. In severe cases, treatment would involve being admitted to hospital for intravenous antibiotics.
d) Bruising and numbness at the fat donor site is normal and usually temporary, but the severity can vary with each patient. Bruising will heal on its own.
e) The risk of increased bruising or swelling can be reduced by abstaining from medications such as aspirin, anti-inflammatory drugs, or other blood thinning agents, for at least 2 weeks prior to surgery. (See Pre-op Medication Info sheet).
f) Postoperative pain experienced varies between individuals. You will be given plenty of pain relieving medication following your surgery and this should keep you comfortable.
g) It is common to have intermittent mild discomfort, or intermittent sharp pains in the first few weeks after surgery, as the swelling resolves and the nerves recover.
h) Wound disruption or delayed wound healing is possible. Some areas of the skin may not heal normally and may take a long time to heal. Areas of skin may die. This may require frequent dressing changes or further surgery to remove the non-healed tissue. Individuals who have decreased blood supply to tissue from past surgery or radiation therapy may be at increased risk for wound healing and poor surgical outcome. Smoking may have a greater risk of skin loss and wound healing complications.
i) The incisions will result in scar formation. Dr Farhadieh will endeavour to keep the incisions as small as possible, and these scars will soften and fade with time. You will be instructed as to how best care for scars to optimise results. (See Scar Management Advice sheet).
j) Contour irregularities and depressions in the skin may occur after surgery. Visible and palpable wrinkling or pitting of the skin can occur, and cellulite may not improve. Additional treatment including surgery may be necessary to treat skin contour irregularities.
k) You may experience complete resorption. Complete resorption means that the “fill” dissipates completely and in this case, a repeat transfer could be considered. The fat is your own tissue, so rejection does not occur with these transfers.
3. Realistic Expectations: The aim of fat transfer surgery is improvement rather than perfection. You should not undertake fat transfer surgery unless you accept the possibility that you may wish to have, or need to have, further surgery at some time in the future. Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained. The more realistic your expectations as to results, the better your results will appear to you. Some patients never achieve their desired goals or results, at no fault of the surgeon or surgery.
