Fat transplantation (lipoaugmentation, liposculpture) is a procedure designed to correct and restore body shape as well as enlarge some body parts. Fatty tissue for transplantation is taken from patient’s own body. Liposuction and lipoaugmentation are performed at once: fatty tissue is removed from the areas of its excess (belly, bum, hips, back etc.) and transplanted to area, which needs correction or restoration.
Fat transplantation can be used to correct static face and neck wrinkles, rejuvenate hand and decollate area skin, restore breasts after oncology surgery, correct breast asymmetry, augment buttocks, correct traumatic, congenital or other defects in different parts of the body.
Choosing the procedure, patient must always evaluate realistically the expectations and possible complications, as well as plan postoperative period. Aim to follow beauty standard or someone else’s expectations cannot be the surgery goal.
Patient must realize that medicine is not an accurate science, and sometimes despite all efforts of healthcare providers, desired result cannot be achieved.
Liposuction is often performed under general anaesthesia, however sometimes local anaesthesia can be an option.
Before liposuction, discussed body areas (figure 1) are infiltrated with mixture of local anaesthetic and adrenaline to reduce bleeding and facilitate pain relief after surgery. Infiltration cannula is inserted subcutaneously through small incisions, which are later used to insert liposuction cannula.
Fat from under the skin is sucked with cannula (figure 2) using negative pressure. Negative pressure can be created with vacuum aspirator or single use syringe attached to cannula. Surgeon uses pendulum movements to remove fat evenly on different subcutaneous levels. This way it is possible to remove up to few litres of liquid fat.
Before transplantation, removed fatty tissue must be prepared properly: washed, filtered, precipitated, centrifuged. As there is still no unified protocol for fat preparation, different surgeons may do this procedure differently.
First days after surgery rest is recommended, as well as pain relief, when needed. 1-2 months after surgery you may need to wear compressive corset or special elastic pants to minimize swelling in the areas of surgery. Physical activity allowed after surgery depends on extent of procedure. If liposuction was performed on few areas of the body, you might have to refrain from intensive physical activity for up to few weeks, and then gradually get back to usual activity.
For 1-2 months after fat transplantation, you should avoid pressure on transplanted fat (for example, do not lay or sit on a hard surface with the area, where fat was transplanted).
You should discuss with your surgeon wound management and other postoperative recommendations. Result of liposuction is visible only when swelling goes down. This may take up to couple of months. Results are long term, but they depend on lifestyle, physical activity, nutrition and natural biological processes, such as aging.
It is important to keep in mind, that no matter the technique, a part of transplanted tissue is always resorbed. It is impossible to say exactly before surgery which part of transplanted fat will stay.
Surgery risk is increased by smoking, obesity, chronic heart and vascular diseases, diabetes and other endocrine diseases, as well as some other chronic conditions. Before surgery, you must notify the surgeon if you have hypertension, heart and vascular diseases, autoimmune diseases, blood clotting disorders or any other chronic conditions, also if you smoke, have allergies or take any medications and supplements.
Known and common complications
- Formation of fatty cysts (up to 5%)
- Necrosis (cell death) and absorption (transfer to blood or tissue fluids) of transplanted tissue (15-90%)
- Formation of microcalcinates and tissue calcification (calcium accumulation in tissues, causing them to harden) (up to 5%)
- Uneven contour in the area of liposuction or lipoaugmentation (5-100%)
- Excessive skin and/or wrinkling in the area of liposuction (up to 5%)
- Undesirable scarring of surgical incisions, scar hypertrophy (up to 5%)
- Haematoma in the areas of liposuction and nearby (up to 10%)
- Prolonged healing of wounds (up to 5%)
- Infection (up to 2%)
- Asymmetry (up to 100%)
- Fluid collection, prolonged swelling in the areas of liposuction or lipoaugmentation (up to 5%)
- Changes in skin sensitivity (1-5%)
- Prolonged pain (5%)
- Changes in skin colour (up to 3%)
- Need of another surgery (up to 5%)
- Cardiovascular complications (<1%)
- Fat embolism (<1%)
- Drug and medical equipment allergy (<1%)
- Damage to nerves, vessels or other organs (for example, lungs, abdominal organs, muscles) (<1%)
- Other complications, related to particular patient or those impossible to predict