Fat transfer, also known as “fat transplantation” or “microlipotransplantion” (take your pick!), is the use of your own fat for use as a filler and as a tissue rejuvenator.

It is the most promising and exciting area of plastic surgery today. Also, it is the only permanent filler that is considered safe by all standards.  The reason that I am devoting a complete discussion to this procedure is that it is applicable to most aspects of cosmetic and reconstructive surgery, including facial contouring and even breast augmentation and scar modification. Fat is present in most of us in abundant quantities.  When properly and carefully injected, this fat survives well and becomes a permanent part of that area.

Although fat transfer has been used in surgery since the late 1800’s, its reputation has been tarnished by improper technique and less-than-good results.  However, in the early 1990’s a Dr. S. Coleman introduced the “micro parcel” principle, which is key to the survival of the injected fat. In this process, fat is placed in extremely tiny amounts from different directions, which allows each of the small parcels of fat to develop a sufficient blood-supply to survive permanently. This results in much improved graft survival and infinitely better results.  It has now truly come of age.

This procedure, while conceptually simple, requires a great deal of precision and patience. Fat is usually removed from the hiproll areas or the thighs, processed in a centrifuge to separate the useful fat, and then is injected with special blunt-tipped needles (called “cannulae”) in extremely small quantities, called “microdroplets”, into the deficient areas. If the fat is introduced in too-large droplets, as with previous techniques, then the body cannot nourish the fat deep inside the droplets. If, however, the droplets are small enough, the body can provide them with nutrients. Done properly, and with great patience and skill, fat transfer survival is generally quite good.

In addition to the contouring effect, recent studies have shown that fat is the richest source of what is known as “adult stem cells.”  Stem cells are capable of differentiating (or turning into) a variety of different tissues, such as muscle, bone, cartilage, collagen, nerve, and blood vessels. Please understand that we are talking about adult stem cells, which come from within your own body, and not embryonic stem cells (to which there are many ethical and moral complications).

This field is in its infancy, but done properly, fat transfer give us the tools to perform almost miraculous things.