We all have often thought, “If only I could move this stubborn fat around my waist to somewhere else where it might look better.” That concept today in Plastic Surgery is becoming more of a reality. The process is called fat transfer and has exploded in its usefulness in our Plastic Surgery practice. The technique involves removing fat from where it is in excess, like around the midsection and transferring it to where it may help increase the size or fill in areas where fat has been depleted. Common areas to place fat are for increasing breast size, matching size or shape of breasts, making buttocks larger, and filling out of the face that has sagged with weight loss or age. Several rather new modalities have made fat grafting better over the last few years. We now know that the addition of growth factors from platelets, when added to fat grafts make the fat grafts heartier and more likely to gain a blood supply and survive the transfer. In our office, we have used PRP (platelet rich plasma) as a source of these growth factors for over 2 years now and have seen better results with fat grafting since its implementation. Also, it has been recognized that placing fat into muscle which has a better blood supply makes it easier for the fat to survive. We have used ultrasound now to actually see where the fat goes and place in places that will make it more likely to survive. There have also been fair amounts of research into better ways to both harvest the fat and separate out those components that represent the cells most likely to survive.
At the Salzman Institute of Plastic Surgery in Louisville, KY we have been utilizing these advanced techniques with great success in the last few years. One of the new concepts this fat grafting has helped is in High Definition Liposculpting. The fat is removed from the areas where it is in excess and replaced into where accentuation of natural underlying muscle mass is needed. Under ultrasound guidance, these fat grafts can by placed directly into the underlying muscles safely. We also use this same technique in reshaping of the breast. Rather than relying on breast implants alone, fat usually taken from around the belly and hips can be placed into the breast to enlarge and reshape it. Nice contours of natural feel and look can be accomplished in this way.
Fat, it turns out, can be a nice commodity if moved to a more desirable location with newer plastic surgery techniques.