By Dr. H.V. Satish, Consultant – Plastic & Cosmetic Surgeon, Apollo BGS Hospitals, Mysuru

Fat is a word that evokes different ideas and emotions. It can be attractive on a child’s cheek or irritating on a teen’s waist. In excess, it is dangerous. But now, it can be used to make you more beautiful too! Welcome to the world of Fat Transfer. We have a layer of fat almost everywhere in the body. So there is plenty available in most people. This fat is now being put to use for multiple purposes. This is an exciting new path that is helping many people to look better.

Fat can be harvested using special techniques. A small opening is made in the skin or sometimes even smaller holes can be made. Some drugs are used to make the fat loose and then they are carefully extracted from the body. The openings will close naturally in a short while.

The areas that require injection have to be decided in advance by the plastic surgeon and the client. The areas are marked and these areas may require some form of anaesthesia. The injection has to be deposited slowly in small quantities at each spot and spread in multiple planes. Each fat droplet has to be surrounded by normal tissue which can supply blood to it and keep it alive. Mostly, this does not require any hospital stay or admission but  requires experience, skill and artistry.

Let us look at some areas where fat can make a difference.

Depressions in the surface in any part of the body – Miss ‘N’ had a depression in the face at 2 places, from birth. She wanted it improved without a scar. She was not interested in skin graft or other operations. She underwent the procedure of fat transfer. The depression became level with the rest of her face and she was happy.

Miss ‘A’ was not happy as her lips were thin. She would avoid all photographs. Gradually she started avoiding all functions and parties also. She did not want fillers as they are temporary. She underwent fat grafting. Now she is getting a lot of complements.

Mr. ‘M’ had taken treatment for pimples. But his face was badly scarred making him depressed. He wanted some improvement. He underwent a procedure called subcision. The appearance was much better. He is now looking forward to get married.

Ms ‘W’ had got divorced. She had a problem by birth that resulted in one breast being much smaller than the other. She was used to hiding this with padding. However, after marriage, this led to differences and separation. She wanted correction without scars. She underwent a procedure where fat was transferred to the smaller breast. In 3 months the symmetry was much better and she now walks around without padding. Fat has also found usage in genital rejuvenation procedures.

The good part is that these procedures can be combined with removal of excess fat from some areas to improve appearance also. Instead of throwing fat away, we are using it. Fat has to be processed depending on the area to be injected. It can be thick or thin layer (nano fat injection). This is injected in a planned manner in different depths. The fat that is injected has to get  nutrition from the new area in order to stay alive. This takes some time. In the process, some of the injected fat will not survive. It is estimated that up to 20% of the fat may not survive. This will get cleared off by the body. Hence, the amount of fat injected is slightly more than the estimated need.

Some of the research has shown evidence that fat may contain stem cells. This may lead to other beneficial effects in the area. However, all these are unconfirmed. Stem cell usage is not yet  permitted by the authorities. Fat provides cosmetic surgeons with a tool to help people with visible facial and other defects, which cause depression or uneven surface. It can also be used to increase the size of some parts of the body.

Its good to loose fat, its better to use it!

Advantages

• No significant or noticeable scars seen.
• Natural tissue
• Once it survives, it is almost permanent.
• It feels natural
• It sometimes improves the skin tone also.
• No need for hospital stay
• No threat of reaction to chemicals or foreign body reaction

Disadvantages

• Since fat survival is sometimes less than expected, a touch up procedure may be required
• If done in unprepared setups, infection can be a major issue.