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Fat transfers, also called fat grafting, is a surgical procedure that removes fat from one area of the body and moves it to another area. This transfer of fat results in an increase in fullness and restores volume that is typically lost as we age.
As we age, volume is lost in areas of the face such as the nasal labial folds (folds around the mouth), marionette lines (lines by the corners of the mouth), cheeks and lips. Many times fat transfers are used at the same time as a face lift procedure. The face lift procedure repositions the underlying structures and removes the excess skin, but the fat grafting adds the volume that is needed for a more youthful and refreshed appearance.
When you come in for your initial consultation, you will meet with both Dr. Maloney and one of our experienced clinical coordinators. Dr. Maloney will discuss your goals with you and perform an exam to determine if you are a good candidate for the procedure. He will discuss the different areas fat can be injected to achieve your goals. Dr. Maloney will discuss details of the operation with you, review before and after photos and answer any questions you may have. One of our experienced coordinators will review surgical fees, financing options and answer additional questions. If you choose to have surgery with Dr. Maloney, you will return for another consultation about three weeks prior to your operation. At this second appointment Dr. Maloney will review the surgical plan with you as well as go through consent forms, answer questions and give you your prescriptions. One of our team members will go review your surgical instructions and give you a packet of information so when you leave this appointment you are ready for surgery.
Once you have met with Dr. Maloney and have chosen a surgical date for your fat transfers, you should plan for your care and recovery after the operation. You will need to arrange a ride to and from your procedure. We suggest someone to stay with you for the first few hours after your procedure. You should take five days to three weeks off of work for this operation depending on the type of work you perform. For specific questions related to this, please speak to Dr. Maloney’s Clinical Coordinator. If paperwork is required by your employer for your time off, please obtain it ahead of time and bring it to our office. If you smoke, you must quit a minimum of three weeks before surgery. We suggest six to eight weeks, but three weeks is the minimum. Smokers heal more slowly and can have wound healing problems. Additionally, smoking will decrease the chances of the transferred fat developing a new blood supply. This can result in the fat grafts not working and therefore an unsatisfactory result. If you smoke, the surgical plan may need to be adjusted.
If you take aspirin or other medication that causes bleeding, you should stop taking it three weeks before surgery. This is because these medications cause increased bleeding and therefore more bruising, making your recovery longer. All medications, herbs, vitamins and dietary supplements you are taking should be carefully reviewed with Dr. Maloney prior to surgery.
At your pre-operative consultation with Dr. Maloney you will be given your prescriptions. Please get these prescriptions filled before surgery as you will need to begin some of them the day of the procedure. Bags of frozen peas or corn to use as icepacks after your procedure are helpful. Sleeping with you head elevated for the first few days will assist in keeping the swelling and bruising to a minimum. We suggest you begin a stool softener as narcotic pain medication can make you constipated.
The day of the procedure you will take your prescribed pain medication one hour before your operation. You should wear comfortable clothes that are easy to get on and off. When you arrive, you will be brought to the procedure room where Dr. Maloney will mark the surgical site and answer remaining last minute questions.
The operation takes about one hour, but will depend on how much fat needs to be removed and transferred. Dr. Maloney will inject a tumescent fluid (lidocaine, saline and epinephrine) to the area he intends on harvesting the fat from to transfer. Once we are sure you are numb, he will perform “low suction” liposuction to harvest the fat. The harvested fat will then be separated from the fluid. Once the fat has been separated, Dr. Maloney will numb the areas he is going to inject the fat. Using specially designed cannulas, he will begin injecting the fat micro-droplets into the areas that have lost volume. Dissolvable sutures are used to close the incisions.
You will wear a small dressing over the area where the fat was harvested. You may ooze some fluid from the incisions which is normal because of the amount of the tumescent solution needed for the liposuction portion of the procedure. You should avoid drinking alcohol and refrain from smoking. Frequent ambulation is recommended after any surgical procedure to reduce the risk of blood clot formation in the legs and to speed up your recovery. You will be swollen after surgery, especially if we are adding fat to the lips. Our protocol is to “overcorrect” the area, knowing a portion of the fat will be absorbed by your body. There is not a lot of bruising from this procedure, but if it does occur it can last a few weeks. It takes about three weeks to see your results, so be patient during the recovery process. You may remove your dressings and shower the day after surgery. You will return to the office for your first post-operative exam one to three days after surgery. If you have any questions during the recovery phase, please do not hesitate to call the office any time, day or night.
Fat transfers will restore volume that is lost due to aging resulting in a more youthful appearance.
Fat transfers have both aesthetic and health risks, and it is the patient’s personal decision whether the benefits outweigh those risks. The most common “risk” is the need to have the procedure repeated or an unsatisfactory result. This is because a portion of the transferred fat gets absorbed by the body. This does happen in about ten percent of patients. We discuss the need for additional procedures at your initial consultation so there are no surprises. Other risks include scars, bleeding, infection, asymmetry, excessive firmness, or changes in skin sensation. There are also more uncommon, but more complicated risks such as deep vein thrombosis. For a full list of risks, go to www.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.