FACIAL FAT GRAFTING

Dr Chia Hui Ling

Facial fat grafting takes a small amount of your own fat from another part of the body, purifies it, and injects it into areas of the face that have lost volume with age or that could benefit from softer contouring. It is a natural alternative, or complement, to synthetic fillers, using tissue your body already recognises as its own.


•      Restores volume to areas such as the cheeks, temples, or under the eyes using your own tissue

•      Can improve the quality and texture of the overlying skin over time

•      Results can be long-lasting once the transferred fat establishes its own blood supply

•      Offers a secondary benefit of light contouring at the donor liposuction site

•      Very low risk of allergic reaction, since the material is your own tissue

•      Volume loss in the cheeks, temples, or lower face

•      Adequate donor fat available elsewhere on the body

•      Good general health, suitable for a combined liposuction and injection procedure

•      Realistic expectations that some of the transferred fat will be reabsorbed

•      Non-smokers, who tend to retain and heal transferred fat better



Not all of the fat that is injected survives long-term — a portion is naturally reabsorbed by the body over the first few months. Because of this, a degree of initial overcorrection is typical, and some people choose one or two smaller top-up sessions to reach their preferred final volume.


NANOFAT

Using specialized instruments, fat cells are filtrated out from fat grafts to retrieve nanofat. The injection of nanofat into the skin and scars has been shown in studies to improve skin quality and elasticity. The places suited for nanofat injection include scars and facial skin, especially thin skin around the eyes and lips. The proposed mechanism behind nanofat is the presence of mesenchymal stem cells. Containing no mature fat cells, nanofat is not used to build up volume, but may be combined with classic fat grafting, for its stimulating effect on stem cell differentiation and tissue regeneration.

TREATMENT

The procedure is usually done under local anaesthesia with sedation, or general anaesthesia if larger areas are involved. Fat is harvested through gentle liposuction, most commonly from the abdomen, thighs, or flanks, then processed to isolate the healthiest fat cells before being carefully injected in very small amounts through a fine cannula, layer by layer, for an even and natural-looking result.



•      Procedure typically takes 1 to 2 hours depending on the areas treated

•      Swelling and bruising occur at both the donor site and the injected areas, usually for 1 to 2 weeks

•      Treated areas often look fuller than intended at first, due to swelling and planned overcorrection

•      A portion of the fat is reabsorbed over 3 to 6 months, after which the true final volume is assessed

•      One or two top-up sessions are sometimes needed to reach the desired lasting result

•      Strenuous exercise and direct sun on treated areas should be avoided in the initial weeks


  • Preparing for Surgery

    Avoid blood-thinning medications, anti-inflammatory drugs or herbal supplementations as they can increase the risk of excessive bleeding during surgery, unless indicated by your doctor.

  • Surgery

    Using liposuction, fat is aspirated from other parts of the body, commonly the tummy or thighs.  The fat harvest is processed using the surgeon’s method of preference, such as the Coleman’s technique, Lipokit or Puregraft.  The prepared fat is injected into the face via small puncture wounds.

  • Post-Surgery Care

    There will be swelling and bruising after injection and most of this will resolve at the end of a week. Your surgeon may advise against facial treatments and massages for a few weeks. With the resorption of fat over time, the facial contour after fat transfer will stabilise around 3 months.

FAQs

How much of the injected fat actually survives?

This varies from person to person, and a portion is always reabsorbed by the body in the first few months. What remains after that point, typically assessed around three to six months, is generally considered fairly stable long-term.

Is fat grafting safer than synthetic fillers?

Using your own tissue avoids the small risk of allergic reaction associated with some synthetic fillers, but fat grafting carries its own distinct risks, including donor site issues and fat necrosis. It is a different risk profile rather than simply a safer one.

How long does the procedure take?

Most facial fat grafting procedures take one to two hours, depending on how many areas of the face are being treated.

Will I need touch-up sessions?

Some people do, particularly if they want to fully replace the volume that is reabsorbed during initial healing. This is usually planned as a possibility from the outset rather than a sign anything went wrong.

Where does the fat come from?

Commonly the abdomen, thighs, or flanks, wherever there is adequate donor fat available and convenient to access.

How soon will I see the final result?

Initial swelling makes the area look fuller than the eventual result, so it is best to judge the outcome only once swelling has settled, typically around three to six months later.


COMPLICATIONS AND MANAGEMENT

Because this procedure involves two sites, donor and recipient, the possible risks span both areas.



•      Swelling and bruising at both the donor and injection sites

•      Uneven fat survival between the two sides of the face

•      Lumpiness or irregular contour if fat is unevenly placed

•      Infection

•      Fat necrosis or small firm lumps under the skin (uncommon)

•      Under-correction or over-correction, sometimes needing further treatment

•      Fat embolism, a very rare but serious risk if fat is inadvertently injected into a blood vessel

•      Minor contour irregularity at the donor liposuction site