Purpose: To improve shape and size of different areas in the body
Length of operation: 1-2 hrs
Anaesthesia: General anaesthetic
Inpatient stay: 1 day or day case
Followup: 1 week, 3 months, 6months and 1 year
Time of work: 1-2 weeks
Recovery: 2 weeks
Risks: Swelling, bruising, scar, infection, bleeding, skin necrosis, asymmetry, further procedures, deep vein thrombosis.
Fat transfer is a dynamic procedure which has gained immense popularity for correcting contour defects in different parts of the body. The technique involves aspirating fat through special small diameter cannulae. The fat is then centrifuged to remove oil and excess water. We are then left with pure fat cells which are gently injected in multiple superficial planes of the body.
The whole concept is based on the concept of ‘structural fat grafting’. Fat cells injected by this special method lie in different tissue planes and are able to get individual blood supply. The end result is that the fat injected persists long term. Any damage to the fat cells or incorrect technique will destroy the delicate fat cells and also prevent them from getting the vital blood supply for sustenance. It is estimated that about 50% of the fat injected survives long term and can be assessed as early as 3-4 months after the procedure. At this point a top up procedure can be planned.
This has obvious advantages in avoiding synthetic injectable materials or fillers and has become Dr Sanjay Azad’s procedure of first choice for facial lipofilling and also for breast contour defects. The additional benefit of fat transfer is the therapeutic effect of stem cells which are present in fat cells. This has an emerging role in tissue regeneration and wound healing. Facial lipofilling, can not only fills defects and improve contour, but also regenerate skin to give a more youthful appearance.
The effect of fat transfer in irradiated breasts can have a similar effect of improving the ill effects of radiotherapy.
The results are generally excellent with high satisfaction rates. In this information system we shall go through the whole procedure, giving you a view of what Fat transfer involves in terms of the operation, hospital stay, recovery and the complications. I am quite happy to see you again for a second consultation, so that you can clarify any of your doubts.
It is advisable to stop smoking for 4 weeks and prior to the procedure. On the day of the operation, the surgeon with do skin markings over the area of interest. The area from where the fat will be aspirated is also marked. Photographs for documentation and teaching purposes are standard and will be discussed. The procedure is done under general anaesthetic and takes about 2 hours to perform. The procedure is done using multiple stab incisions in skin creases. Fat is apsirated is done using fine metal cannulae of different sizes. The incisions are closed with a single stitch each. This is covered by steri-strips and a small sticky dressing.
The fat is then centrifuged and injected into the area of interest using a gentle technique. This process is time consuming fat handling and small injections are a key aspect of the technique.
Some local pressure with a garment or dressings is essentially straight after the procedure (to the donor site) as it reduces discomfort an. While you are in hospital you will have blood tests, fluids through a drip and pain killers. You will feel quite bruised and swollen after the operation and this settles in due course.
Ice packs are used to reduce facial swelling and also a couple of doses of injectable steroids. We take precautions to prevent clots in your calves by putting on stockings and giving you a blood thinning injection. The hospital stay is conventionally 1day and depends on your recovery and additional procedures.
Recovery After Surgery
At discharge, the dressings stay on and you need to attend the dressing clinic in a week time. The dressing is taken down and minimised. You will be given some pain killers to take home. Further dressings may or may not be required depending on the wound. Massage of the area is necessary for certain specific areas only. You will be seen again in 3 months time. Photographs will be taken at this stage.
You should avoid smoking for 4 weeks after the procedure. Recovery is individual, but most patients get back to work and driving in 3 weeks time. Swimming is usually possible at about 8-10 weeks time. The fat transferred area is best assessed at 3-4 months after surgery. Occasionally further procedures may be necessary to get the desired result.
Overall results are excellent but there are some well known limitations, risks and complications which you should be aware about:
- Asymmetry of body parts (as two sides tend to be always slightly different).
- The body is never static and will change with age and weight changes .
- Haematomas (blood clot, which is rare).
- Seromas (collection of body fluid)
- Loss of sensation due to bruising and swelling around the superficial nerves and this is a temporary phenomenon
- Fat aspirated and injected is measured and documented for future reference.
- Further procedures are frequently required to achieve the desired result.