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Fat transfers, also called fat grafting, is a surgical procedure that removes fat from one area of the body and places it in another area to increase fullness and to restore lost volume.
Fat transfers work well in conjunction with a facelift. As people age, they lose fat from areas of the face, resulting in an older appearance. The areas where the best results are typically seen are the nasal-labial folds (folds around the mouth), marionette lines (lines by the corners of the mouth), cheeks and lips. Fat transfers can also be used for a buttocks lift or to correct contour irregularities of the breast after breast cancer reconstruction.
When you come in for your initial consultation, you will meet with Dr. Maloney and Lindsay, the clinical coordinator. Maloney Plastic Surgery is one of the only practices in Tucson, Arizona to offer VECTRA 3D (three-dimensional) technology to our patients. One of the first things we will do at your consultation is use VECTRA imaging technology to take a 3D image of your face or buttocks depending on where we are doing the fat transfers. The exciting part about the VECTRA technology is we can perform “fat transfers” on the 3D image and show you how the operation will look on your face or on your buttocks in 3D!
After VECTRA imaging, Dr. Maloney will determine if you are a candidate for the procedure. Dr. Maloney will determine if your operation can be done in the office or if it needs to be done at the surgery center. This will depend on the amount of fat to be removed and the number of areas fat is being transferred to. Dr. Maloney will discuss details of the surgery, show you before and after photos and answer any questions you may have. Lindsay will review surgical fees and financing options.
If you choose to have surgery, you will return for another consultation about 2 weeks before your scheduled surgery. At this appointment, Dr. Maloney will review the surgical plan with you, go through consent forms, review your VECTRA preoperative photographs and give you your prescriptions.
Lindsay will go over all of your surgical instructions and give you a packet of information so when you leave this appointment you are ready for surgery.
After meeting with Dr. Maloney and choosing a surgical date for your procedure, plan for your care and recovery after surgery. You will need to arrange a ride to and from the surgery center or office the day of surgery. Arrange for someone to stay with you for the first 24 hours after you go home. You should take 3 days to 3 weeks off work after surgery depending on the type of work you do (speak to Lindsay, the Clinical Coordinator, if you have questions and for additional information). If your employer requires paperwork for time off, please obtain it ahead of time and bring it to our office.
If you smoke, you must quit a minimum of 2 weeks before surgery. We suggest 6 to 8 weeks, but 2 weeks is the minimum. Smokers heal slower and can have wound healing problems. Smoking will decrease the chances of transferred fat gaining blood supply and therefore the surgical plan may require adjustments. Smoking may require modifications to the surgical plan.
If you take aspirin or other medications that may cause bleeding, stop taking them 3 weeks before surgery to reduce the risk of bleeding. If you take diet pills (prescription or over-the-counter) or Metformin (a common diabetes medication), stop 1 week prior to surgery to avoid anesthesia risks. All medications, herbs, vitamins and dietary supplements you are taking should be carefully reviewed with Dr. Maloney prior to surgery. If you are under the care of a physician for any health issues, we may require surgical clearance from your physician and/or cardiologist.
At your pre-operative consultation with Dr. Maloney you will be given a map to the surgery center and your prescriptions. Have these prescriptions filled before surgery so they are at home when you need them. Pick up some bags of frozen peas or corn to use as icepacks after your procedure. Sleep with your head elevated for the first few days to keep swelling and bruising to a minimum. Stay hydrated and have plenty of water or sports drinks at home. Consider mixing sports drink and water 50/50. You should also take a stool softener because narcotic pain medication and anesthesia may make you constipated.
If you are having surgery at the surgery center:
The morning of surgery you cannot have anything to eat or drink after midnight. This includes water. Do not wear any lotions, deodorant or make-up on the day of surgery. Do not wear any jewelry to the surgery center.Wear comfortable clothes that are easy to put on and take off. A shirt that zips or buttons up the front is preferable, as are loose workout pants or sweat pants. Bring your photo ID when you check in to the surgery center. You will then be taken back to the preoperating area where Dr. Maloney will discuss the surgical plan, answer any additional questions you have and mark the surgical site. You will also meet the anesthesiologist and ask him/her any additional questions you may have.
If your procedure is in the office:
Take your prescribed pain medication 1 hour before surgery. Wear comfortable clothes that are easy to put on and take off. Upon arrival, you will be taken to the procedure room where Dr. Maloney will mark the surgical site and make final preparations for surgery.
Surgery takes 1 to 2 hours, depending on how much fat needs to be removed and transferred. At the surgery center, the anesthesiologist will put you to sleep for your safety and comfort. In the office, local sedation is used. Dr. Maloney will inject a tumescent fluid (lidocaine, saline and epinephrine) and perform “low suction” liposuction to remove fat. The fat will then be put in a centrifuge and separated from the fluid and oils. Once the fat has been separated, Dr. Maloney will numb the areas he is going to inject the fat into. Using specially designed cannulas, he will begin injecting the fat into the areas that have lost volume. Dissolvable sutures are then used to close the incision. You will wake up in the recovery room and be ready to go home in about an hour (in the office you will be released more quickly since you were not put under).
A small dressing will be applied over the area where the fat was removed. It is normal to ooze fluid from the incisions. Rest and eat a healthy diet, high in protein, for successful recovery. You should also avoid alcohol and refrain from smoking. All surgeons recommend early and frequent ambulation after surgery to reduce the risk of blood clot formation in the legs and to speed up recovery time. You may be stiff and sore when you first get up and walk around, but the more you are up walking around the better you will feel. You will be swollen after surgery as we always overcorrect the area, knowing a portion of the fat will be absorbed. Any bruising can last a few weeks. It takes about 3 weeks to see results, so be patient during the healing process. You may remove your dressings and shower 1 to 3 days after surgery, depending on what the office tells you. Return to the office for your first postoperative exam 1 to 3 days after surgery. A low-grade fever is not uncommon after any operation. If you have any questions during the recovery phase, please call the office any time, day or night.
After the procedure the areas that have lost volume will be corrected.
Fat transfers have both aesthetic and health risks, and it is your personal decision whether the benefits outweigh the risks. The most common risk is the need to have the procedure repeated because the body absorbs the fat. This happens in about 10% of patients. Other risks include scarring, bleeding, infection, asymmetry, excessive firmness or changes in skin sensation. There are also uncommon, but more complicated risks such as deep-vein thrombosis. For a full list of risks, go to plasticsurgery.org.
Dr. Maloney is a Harvard trained, board certified plastic surgeon who returned to his home town of Tucson, AZ to open Maloney Plastic Surgery in 2002.