Fat transfer is a new technique of remodelling that involves transfer of fat from one body area to another, if needed. It combines liposuction (harvesting of fat) from a donor area and a transfer to a recipient one to enlarge your breasts or to treat a congenital or acquired pathological condition in the body.

Indications

The most common indications are to improve breast size, shape and symmetry but it is also used in the face to improve creases and hollows or in the hand for hand rejuvenation. You would benefit from fat transfer if your breasts are a slightly different as to size or shape, if you would like your breasts to be slightly larger and you don’t want implants or if you have had breast surgery in the past and now need some ‘plumping-up’. You also need to have enough spare fat elsewhere to transfer.

The body regions involved and lipofilling

Fat transfer can improve breast size and shape in the right women. In the face, fat transfer can improve deep creases and hollows, in the limbs can improve a skin dystrophy and in the hand can rejuvenate the visible (dorsal) side. Liposuction improves the size and shape of the area of fat deposits from where the fat is removed, like the abdomen, the flanks or the hips.

Preoperative discussion

Before starting any surgical procedure the potential results you are hoping to achieve, in terms of size and shape are deeply discussed with the surgeon that will talk you through the steps. We will go through what fat transfer involves, including the potential risks and complications and the areas of excess fat are marked. Pictures will be taken for documentation.

The operation – general infos

For breast augmentation the operation usually takes 1-2 hours and is performed with you asleep (general anaesthetic). In other regions is performed under local or loco-regional anesthesia. First liposuction is performed to remove the excess fat. The fat is filtered and prepared by centrifugation (high-speed spinning) to separate out the healthy fat. This fat is then transferred to the breast using special cannulae to ‘plump up’ the whole breast or just the area that needs filling. We tend to overfill by about 20% because studies have shown that about 80% of the transferred fat persists long-term.

Postoperative care

When you wake after surgery you will have a drip and pain relief. Most patients go home the following day but same day discharge is available. When the anesthetics wears off you may experience some slight discomfort, which however typically disappears after the first few hours. For breasts augmentation you will need to wear a crop-top until you are comfortable to be fitted for your new bra. Wounds usually heal in a week and you can expect some swelling, bruising and tenderness for 3-4 weeks. The short (5mm) scars from the liposuction can take 6-12 months to settle down. You may notice some tightness on your chest, face or limbs and initially some asimemtry may be present, but this will disappear as swelling subsides and healing occurs. You will be encouraged to mobilise as soon as possible after surgery and return to work and other activities 1-2 weeks later, depending on you, your activities and the amount of liposuction you had done. You should rest from gym work for about 3-6 weeks.

General notes

Fat transfer is not suitable for everyone and all your options should be discussed pre-operatively with you. There is no such thing as risk-free surgery and fat transfer is no different. It is important for you to balance the risks and benefits for you. Swelling can persist for some weeks after liposuction. The scars are short and usually well hidden. Occasionally skin tethering and contour irregularities are seen. Numbness is common and usually improves with time. Potential complications include problems with the anaesthetic (your anaesthetist will talk to you about these), blood clots (deep venous thrombosis and pulmonary embolus), bleeding (haematoma), wound infection and slow healing. Fat necrosis and scarring can be seen after fat transfer in the breasts and may cause problems with mammographic screening in the future. Not all fat cells survive the transplantation process. A slight loss of volume is seen in the first 6 weeks before the situation stabilises. In some cases multiple procedures are therefore necessary. Fat transfer is not for everyone. Breast uplift or enlargement may be a better way to improve breast size and shape.