A fat transfer is a medical procedure in which a patient’s own adipose tissue is taken from one area and transplanted to an area to which the patient would like a decrease in the appearance of wrinkles and shallow areas or an increase in volume (often the lips or areas with wrinkles and fine lines). It is generally a minimally invasive procedure and is a common alternative to popular collagen treatments and BOTOX. Our Beverly Hills fat transfer patients commonly choose this procedure to address the lines between the nose and the mouth, crow’s feet, and forehead wrinkles.
With the increasing popularity of liposuction and the subsequent innovations in liposuction technology, it has become far easier to access fat and remove it from the body. While dermal fillers are often absorbed by the body in an average of less than 6 months, only a percentage of fat from a patient’s own body will be absorbed and more lasting changes can be achieved by fat transfer.
Some of the best and most frequently used donor sites for fat transfer include the inner thighs and lower abdomen.
Our Beverly Hills fat transfers are often performed to augment the cheeks, chin, and lips. Fat can be transferred to many of the same areas usually addressed with BOTOX and dermal fillers and is commonly used by those who are sensitive to or uncomfortable with synthetic treatments. Although reactions to synthetic fillers are rare, the body does not react to it’s own fat cells in the same way.
Studies show that the body may absorb 40-60% of transplanted fat, so in anticipation of this, surgeons generally add more than is necessary. Because of the extra fat and bloating, patients must get plenty of bed rest for the first week and may need to wear compression garments for a month or more as directed by their physician – depending on the area of the body to which fat has been transferred. Many patients are able to resume working after about a week, but should refrain from strenuous exercise for 6 weeks or more as guided by the advice of their surgeon.
Understanding how your body’s natural growth factors can help accelerate the healing process. Improved Fat Graft Volume Retention Through Platelet Rich Plasma (PRP)
Autologous fat grafting, also known as fat transfer or fat injection, has long been a staple of cosmetic and reconstructive surgery. Fat grafts have proven very effective in the reconstruction of soft tissue defects, particularly for facial plastic and reconstructive procedures.
Autologous fat is a versatile medium which offers many advantages: it is soft and pliable, readily available, abundant, and able to be harvested with minimal risk. Despite these benefits, however, there has always been one significant disadvantage associated with autologous fat grafting, the unpredictable and often inconsistent graft survival rate. In order to achieve the desired volume and symmetry, it is often necessary to overcorrect soft tissue volume defects and perform multiple procedures.
Promising new evidence has shown that Platelet Rich Plasma (PRP) can enhance the fat graft survival rate. PRP is a type of autologous plasma that contains a platelet concentration that is five to six times greater than the normal baseline levels, having 1,000,000 platelets in a 5ml volume of plasma.
To harvest PRP, a whole blood sample is obtained from the patient and then prepared in the laboratory. PRP may be used directly in its isolated form or in the form of a platelet gel. For autologous fat grafting, fat is removed through traditional liposuction techniques and the PRP may then be added directly to the graft material in a gel form.
Studies have shown that the PRP enhanced grafts have a higher potential for graft acceptance and retention than traditional fat grafting techniques, along with decreased swelling and bruising in the donor sites. Patients showed continued results for as much as one to two years after autologous fat grafting with PRP. A variety of areas were treated on various patients including the nasolabial folds, lips, malar fat pads, and breasts. Patients will continue to be observed for progress. Nevertheless, results to date are promising and suggest that PRP may offer great potential for autologous fat transfer for use in cosmetic and reconstructive surgeries as well as other surgical areas.
PRP has been used clinically for over a decade. Leading clinicians in specialties such as dental, ENT, Facial Plastic & Reconstructive Surgery, Orthopedics, Cardiovascular, Plastic Surgery, and Wound Healing routinely use PRP to deliver a cocktail of natural, bioactive growth factors.
PRP is the only available product that contains elevated levels of all your natural occurring growth factors. These factors are maintained in precisely the same ratios found circulating in your body. Although recombinant products are available, these products are usually synthetic derivatives of a single growth factor. Fibrin glues are another product readily available to the physician. However, the fibrin glues currently marketed do not contain any growth factors and are virally inactivated derivatives of blood components drawn from other donors.
The use of PRP varies from procedure to procedure. PRP is generally applied topically to the wound site. It can be used to control bleeding in applications such as cardiovascular and orthopedics. PRP is often applied to bone grafts and soft tissue grafts to stabilize the graft material. PRP is used to help fixate bone grafts as well as accelerate bone growth in orthopedic and dental procedures. PRP is also used to seal wounds and accelerate soft tissue healing in facial plastic and cosmetic surgeries.
Historically, the production of PRP at the time of surgery was complex, time consuming, expensive, and required large blood volumes. The process often involved outside personnel and a transfusion of blood products. The recent introduction of small automated, office based PRP systems makes the benefits of PRP practical in the office and outpatient setting. Now, your surgeon or nurse can prepare PRP in parallel with the surgical procedure.
PRP is derived from a small quantity of your own blood drawn at the time of surgery. The PRP is made point-of-care at the time of surgery and under physician’s control. Also, since the PRP is made from your own blood, it is insulated against the risk of disease transmission.
The surgeon draws approximately 50 cc of your blood at the time of surgery. The blood is placed in a specialized centrifuge that spins and automatically separates the red blood cells from the plasma. The plasma is then further centrifuged to concentrate the autologous platelets and hence your natural growth factors. The PRP is then available for your surgeon to use as needed. The entire process takes less than 15 minutes and adds no extra time to the surgical procedure.