Fat transfer comes up in almost every body and facial consultation at Southwest Plastic Surgery, usually because a patient wants volume somewhere and has heard that fat can supply it. Dr. Frank Agullo answered the questions patients ask most.

On what the procedure is:

“Fat transfer is exactly what it sounds like. We take fat from one place and move it to another place. So a lot of times, patients get a double benefit. They get to reduce the amount of fat from a place they want to reduce, and they get to augment the amount of fat in a place they want to augment.”

On where it can be used:

“In my practice, we routinely do fat transfer to the face, which can go in the temporal hollows, the periorbital area or around the eye, the nasolabial lines, the lips, the jawline, the chin, and the cheekbone area.”

“We can also use it to augment the breasts or to hide rippling. We can use it for fixing a bad liposuction where there’s a lot of contour irregularities. We can use it to enhance the buttock, the hips, and the thighs. We can also inject it into the muscles to create muscle definition in the biceps, triceps, trapezius, the calf muscles, and even the thighs.”

On how much fat survives:

“In most of the areas that we graft, we can get up to fifty to eighty percent retention. A lot is determined by the patient’s own healing response and circulation, and also if they adhere to instructions, keeping them away from exercise and on a healthy diet.”

“I often use AuraClens, which contains Poloxamer 188, to wash out the fat graft and also strengthen the cell membrane for higher retention rates.”

On candidacy, including for lean patients:

“A good candidate for fat transfer will have a good donor site and sufficient fat to obtain the desired results. Although you may think that lean patients don’t have any fat that they can donate for themselves, there are usually areas where some amount of fat can be obtained. And these areas are usually the flanks and the medial thighs.”

“And in the case that we’ve already removed all the fat that the patient can donate for themselves, or the patient truly doesn’t have any fat to donate, we can use donor fat grafts like Lipoderma or alloClae.”

On recovery:

“Most recoveries are five to seven days. In the face, there will be swelling, and it can take up to two weeks for a lot of the swelling to come down. Final results are usually around six months.”

“In fat grafting to the body, usually we try to avoid direct pressure on those areas. So if it’s in the buttock, no sitting. If it’s in the breast, no laying on your stomach, and this is recommended for two weeks. I recommend no exercise for at least four weeks to give the fat a chance to obtain circulation and integrate before it is stressed with exercise.”

On fat versus fillers and implants:

“Fillers are going to be more palpable, and fat is going to feel a lot more natural, but it is unpredictable in terms of how much retention we can get. The great thing about fat is that it’s free, and we can use as much as we need to correct the deformity, or augment, or sculpt, versus fillers, which have a cost per unit.”

“A lot of times we combine both the implants and fat grafting to create contours, projection, and results.”

On the two misconceptions:

“One of the biggest misconceptions is that all the fat disappears. Patients think that none of it lasts, when in actuality, we do get a fifty to eighty percent retention rate.”

“The other misconception is that the results are instant, but the patient has to keep in mind that swelling often hides the results. It does take about four to six weeks to start seeing the actual retention, volume, and new contours.”

Recovery Support

Because most fat transfers are harvested with liposuction, the donor areas need the same aftercare any liposuction patient receives. Post-surgical lymphatic massage is scheduled as part of recovery to manage swelling and fibrosis in those sites.

Schedule a Consultation

Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery and completed his plastic surgery fellowship at the Mayo Clinic.

Call (915) 590-7900 or text 1-866-814-0038 to book at Southwest Plastic Surgery. #StayBeautiful