Your own fat can be used to improve the appearance of your body. Fat can be moved from an area where it is less needed (for example, the thighs or abdomen) to an area that has lost tissue volume due to aging, trauma, surgery, birth defect, or other causes. The result is an increase in tissue volume at the site where the fat is placed.
In general, the fat transfer procedure occurs as follows. Before the procedure begins, the body site where fat will be removed may be injected with a fluid to minimize bruising and discomfort. The surgeon will then remove the fat one of two ways: with a narrow surgical instrument (cannula) through a small incision, or directly through a larger incision. In some cases the fat will be prepared before being put back in the body. For example, the fat may be washed, filtered, or centrifuged (spun). The fat is then placed in the desired area with a smaller cannula or needle, or directly through an incision. Some of the fat that is transferred will not maintain its volume over time. Therefore, the surgeon may inject more than is needed in order to achieve the desired end result. In some cases, more fat may need to be transferred to maintain the desired result. Depending on the scale of the procedure, fat transfer may require a local anesthetic, sedation, or general anesthesia.
Risks of Fat Transfer Procedures
Like any procedure, fat transfer involves a certain amount of risk. It is important that you carefully consider the risks and potential benefits before undergoing this procedure. Although the majority of patients do not experience complications, you should talk with your plastic surgeon to make sure you fully understand the risks of the procedure.
Possible risks include:
Bleeding – Although unusual, you may experience bleeding during or after the procedure. Should bleeding occur, you may need emergency treatment to drain accumulated blood (hematoma).
Seroma – Although unlikely, it is possible for fluid to collect at the site where the fat was removed. This is usually treated by draining the fluid with a needle.
Infection – Infection after this procedure is unusual. Should infection occur, additional treatment including antibiotics or surgery may be necessary.
Scarring – All invasive procedures leave scars, some more visible than others. In most cases, wounds heal well after this procedure. In rare cases, abnormal scarring may occur in the skin and the deeper tissues. Additional treatments including surgery may be needed to treat scarring.
Change In Appearance – Typically, the transferred fat loses some of its initial volume and then remains stable. In some cases, more treatments are needed to maintain the desired appearance.
Firmness And Lumpiness – Most transferred fat results in a natural feel. But in certain cases, some or all of the fat may become firm, hard, or lumpy. If some of the fat does not survive the transfer, it can lead to fat necrosis (death of transferred fat tissue). This can cause firmness and discomfort or pain. In rare cases, cysts may form at the site where the fat is transferred. Surgery may be required to correct such conditions.
Asymmetry – A fat transfer procedure will not necessarily create a symmetrical body appearance. Factors including skin tone, fatty deposits, bone structure, and muscle tone may contribute to normal asymmetry in body features.
Long-term Effects – Changes in the shape or appearance of the sites where the fat was removed or placed may occur as the result of aging, weight loss or gain, or other circumstances not related to the fat transfer procedure.
Pain – In very rare cases, chronic pain may occur after fat is removed or transferred.
Tissue Loss – In rare cases, the tissue where the fat is placed may be injured by the procedure, resulting in loss of skin and surrounding tissue. This may require surgery for treatment.
Risks Of Fat Transfer To Breasts – Fat transfer can be used to improve the appearance of breasts reconstructed after cancer treatment, to improve the appearance of breast deformities, and to enlarge breasts for cosmetic reasons. There is currently limited information about the long-term implications of such procedures. Fat transfer to breasts may make it more difficult to detect breast cancer. Since transferred fat may become firm and create lumps, it may be necessary to have radiological studies (mammogram, ultrasound, or MRI) performed more regularly to be sure these lumps are not due to cancer.
Damage To Deeper Structures – Deeper structures such as nerves, blood vessels, or muscles may be damaged during the course of this procedure. In rare cases, this damage may be permanent.
Unsatisfactory Results – Unsatisfactory results, including visible deformities, loss of function, abnormal healing, skin death, or loss of sensation, may result from this procedure.
Allergic Reactions – In rare cases, local allergies to tape, suture material, or topical preparations can occur. Systemic allergic reactions (reactions in other parts of the body) are more serious and may result from drugs used during the procedure or prescription medicines. Allergic reactions may require additional treatment.
Complications From Surgical Anesthesia – Both local and general anesthesia involve risk. Complications including injury and even death can result from all forms of surgical anesthesia or sedation.
Serious Complications – Although serious complications have been reported, these are very rare. Serious complications include (but are not limited to): fat embolism (a serious or life-threatening condition that can result when a piece of fat finds its way into the bloodstream), serious infection, blindness or loss of vision, or death. Blood clots in the veins of the arms, legs, or pelvis can also result from fat transfer.
Pulmonary Complications – Pulmonary (lung and breathing) complications may occur from blood clots or from the partial collapse of the lungs after general anesthesia. Should this occur, you may require hospitalization and additional treatment. Pulmonary embolism, which occurs when the main artery to the lungs is blocked, can be life threatening in some circumstances. Fat embolism syndrome occurs when fat droplets are trapped in the lungs. This is a very rare and possibly fatal complication of fat transfer procedures.
Need For Additional Surgery – In some situations, it may not be possible to achieve optimal results with a single procedure. Multiple procedures may be necessary.
While every effort has been made to provide accurate and complete information, the risks listed above are not exhaustive. Your surgeon can provide you with additional information based on your particular case and the current state of medical knowledge.