Fat Transfer Boston | Boston Fat Grafting

PROCEDURE FOR FACIAL FAT TRANSFER

Facial fullness between the cheek bones and lips provides a youthful appearance.

Volume loss in this area and the facial compartments accentuates grooves such as the nasolabial folds and marionette lines and results in a concave facial contour. These areas can be rejuvenated and facial volume restored with autologous fat grafting or fat transfer.

A fat transfer can also restore facial symmetry or improve facial harmony. Other reasons for a fat transfer include history of facial trauma or facial operations, history of radiation, or a history of congenital or craniofacial anomalies such as cleft lip and cleft palate. Dr. Sullivan and Dr. Taylor both have fellowship training in craniofacial surgery and have published extensively on their experience with facial plastic surgery. A fat transfer is typically performed under general anesthesia in the operating room. In certain situations small volume fat grafting can be performed in the office with local anesthesia.

PROCEDURE FOR BREAST AND BODY FAT TRANSFER

Patients with a history of breast cancer, surgical scars, breast asymmetry or just a desire for fuller breasts and natural breast augmentation might consider fat grafting to the breasts.

Fat transfers can be performed to correct areas of soft tissue depression from other scars or trauma. A fat transfer relies on the grafted fat getting a new blood supply to survive, which limits the volume of fat that can be transferred. This also explains why the volume of graft take is not entirely predictable. Despite these limitations, fat grafting has been one of the most significant innovations in both aesthetic and reconstructive surgery, and is very powerful.

PROCEDURE FOR FAT TRANSFER TO THE HANDS

Hand rejuvenation with fat transfer is another procedure performed by Dr. Sullivan and Dr. Taylor. While surgical and non-surgical facial rejuvenation is usually considered to be the most common procedure with advancing age, the hands can also show signs of aging and betray how one feels. Patients who have experienced facial rejuvenation with facial fillers or fat transfer may also be interested in hand rejuvenation.

With the same methods used for facial fat transfer, and often in the same procedure, the hands can also be rejuvenated by filling the deep depressions, concealing the prominent veins and tendons, and restoring tone to the wrinkled skin. Adding volume with fat transfer softens the appearance of the back of the hands without the need to injure the veins with sclerotherapy or laser treatment. Micro liposuction is used to remove fat from unwanted areas such as the tummy and the fat is then carefully instilled into the back of the hand with micro cannulas so there is no need to make incisions or use stitches. Swelling and bruising are the most common side effects following hand rejuvenation, and these usually resolve within a few days.

Fat Transfer At A Glance

WHAT FAT TRANSFER DOES

Restores facial harmony
Improves projection, shape and fullness
Rejuvenates face, breast and body

DURATION OF FAT TRANSFER RESULT

Years
Staged procedures 6-12 months apart

LENGTH OF PROCEDURE

1 Hour

TYPES OF ANESTHESIA

Local, Sedation (sleepy) or General Anesthesia

RECOVERY

Comfortably at home
Most swelling resolves – 2 weeks

TIME OFF SCHOOL OR WORK

3-5 days

TIME OFF ACTIVITIES

Activities of daily living – 1 day
Light exercise – 3-5 days
Full exercise – 2-3 weeks

Frequently Asked Questions

Where will you take the fat from?

In Boston fat transfer patients have fat removed from the abdomen, flanks, and inner thighs, as they are ideal donor sites, though occasionally we may also access the buttock.

How much fat can you transfer?

Unlike the use of an implant, we can only transfer as much fat as will revascularize. This limits the amount of fat grafting which can be performed in each setting. In the breasts, for example, fat transfer is usually less volume than “one cup size in a bra”. The volume of transfer to breasts may be an average of 75 to 125 cc to each breast - some may consider 200 cc to be approximately one cup size in a bra. But depending on the situation, we have found it a powerful enhancement in facial, breast and body surgery.

Can a fat transfer be repeated?

Yes. Fat transfer can be performed more than once. We typically like to wait three to six months between rounds of fat transfer.

What are the risks of a fat transfer?

Intravascular injection, or embolization is the dreaded risk of fat grafting (as with the injection of fillers). We take every known precaution to avoid this, but because the fat is injected through tiny stab incisions, the risk cannot be completely eliminated. Unpredictable graft take is also a concern with your fat transfer Boston plastic surgeons, Dr. Sullivan and Dr. Taylor will discuss this with you prior to surgery.

FAT GRAFTING AFTERCARE INSTRUCTIONS

In the week before your operation:
- Consider eating pineapple, it may help reduce bruising
- Consider supplementing with Arnica montana, it may help reduce bruising
- Complete household chores and prepare meals for the first few days of postoperative recovery
- Follow preoperative instructions with eating, drinking, and medications
Postoperatively, get out of bed and walk (with assistance) every few hours after your operation to decrease the chance of postoperative problems such as blood clots.
Practice 15-20 deep breaths every hour to keep your lungs open.
After Fat Grafting, it is important for you to have someone available to stay with you for the first 24-48 hours, as you may feel drowsy. You may require help the first few times you get out of bed.
Please take your medications as directed by Dr. Taylor or Dr. Sullivan to manage discomfort or symptoms.
- Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours
- Ibuprofen (Motrin) 800 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours
- Gabapentin 300 mg every 8 hours for 7 days
- Vitamin C 500 mg daily for 50 days
- Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though many patients may not need it
- Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day
- Zofran 8 mg every 8 hours if needed for nausea
- Scopolamine patch will be placed behind the ear on the day of surgery and can stay for 3 days
Eat a light diet for 2-3 days and avoid spicy food. Some suggestions to ease abdominal discomfort or indigestion after surgery:
- Drink water or warm liquids
- Prune juice to prevent constipation
You may shower or sponge bath the day after the Liposuction operation with assistance and wash your skin as you normally would with soap and water. Avoid soaking in a bath where fat was harvested by liposuction, although It will not hurt to splash water from a shower on the wounds. Gently pat dry after washing.
You may wear a compression garment where fat was harvested. A garment may be helpful for 6 weeks, and thereafter as needed for comfort. The garment helps control swelling and fluid build-up. You can take it off to shower. Alternatively, you could wear a Lycra or Spandex garment for compression, comfort and support.
Where fat is harvested by liposuction, most wounds will be closed with buried absorbable sutures and skin glue. The skin glue forms a barrier to water. Please do not remove the glue, it will fall off on its own after a few weeks. Do not apply any lotions, potions, ointments, creams or solutions (e.g. no hydrogen peroxide or alcohol) as they can be harmful to the fragile healing tissue.
Where fat is instilled, there will be no stitches or dressings, only very small puncture sites. These may have a tiny amount of drainage or form a small scab. No treatment or wound care is necessary.
Do not smoke or expose yourself to smokers or nicotine as skin and wounds can be compromised.
Infection is uncommon, though please call Dr. Taylor or Dr. Sullivan immediately at any sign of infection which would be signaled by fever, increased pain, new redness or swelling.
If you had your lips enhanced, vaseline ointment or lip balm may be applied to the lips three times daily for the first three days following injections to the lip areas.
Maintain normal oral hygiene and tooth brushing.

ACTIVITY

For the first few days following Fat Grafting, raising your blood pressure and heart rate can cause bleeding. Stress on your muscles near areas of liposuction or vigorous exercise could cause bleeding and swelling. We recommend walking 15 minutes 2 to 3 times per day and gradually increasing activity tailored to your recovery.
Please do not drive until turning the steering wheel can be done safely and without pain (usually 2 to 3 days). Do not drive while taking pain medications such as oxycodone.
Do not sleep on or apply significant pressure to the areas that have been augmented by fat grafting.
Massage therapy to the areas of liposuction and fat grafting can help increase circulation, soften firm areas under the skin, and enhance lymph drainage. Please wait at least 3 to 4 weeks after Fat Grafting surgery to start massage to avoid increased swelling.

GENERAL OUTCOMES

Moderate swelling and bruising is to be expected. Bruising may last for a few days to weeks and will move down your body due to gravity.
Where the fat is harvested by liposuction, you may find that your clothes are tight and may not fit as easily for at least 6 weeks after the operation. A feeling of tightness is also to be expected. Please be patient, the swelling and feeling of tightness will gradually subside over the following weeks to months.
The body retains fluid with swelling in response to the surgery. The swelling may persist for 6 weeks or more before it slowly decreases. A change in facial, breast, hand or body contour is the goal of fat grafting. Please be patient.
Most people experience muscle and tissue soreness, as opposed to sharp pains, for about 5-7 days after.
Tingling, itching, and numbness of the skin are all normal after liposuction and fat grafting. Tingling and itching are signs of healing and will resolve. Sensation usually returns gradually and slowly over weeks to months. Some changes in sensation may be permanent. Please be patient and avoid resting against hot surfaces, which can injure or burn the skin.
Transferred fat and scars can take one full year to mature. You may notice fluctuation in volume of transferred fat. Microport sites from liposuction may become red, raised and firm for several weeks to months before becoming soft, flat and pale. Avoid Vitamin E as it can irritate the scar. Mederma has no proven benefit and is not worth the expense. Silicone cream or skin moisturizer with sunscreen and gentle massage may be helpful.
A small amount bleeding from the incisions is expected. Please call our office (617-492-0620) if you have:

Continuous bleeding
Significantly more swelling on one side when compared to the other
Worsening pain
Significantly more swelling on one side when compared to the other
Shortness of breath

It is important to be seen by Dr. Taylor or Dr. Sullivan after your Fat Grafting operation. They will see you in follow-up appointments at 1 week, 3 to 6 months, and 1 year or as often as needed post-op. Call Taylor and Sullivan Plastic Surgery to schedule your appointments at (617) 492-0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492-0620.

Download our FAT GRAFTING AFTERCARE INSTRUCTIONS.

CONTACT US TO LEARN MORE ABOUT FAT TRANSFER

Dr. Sullivan and Dr. Taylor, board certified plastic surgeons in the Cambridge and Boston Mass area, will carefully consider your goals and evaluate your potential for fat grafting. If they feel you are an appropriate candidate, they can tailor a minimally invasive procedure to your needs. They strive to deliver the best fat transfer Boston has to offer. Sometimes fat transfers are combined with other procedures such as breast lift or facelift.

Fat Transfer in Boston