Procedure

Fat transfer, also referred to as fat grafting and lipofilling, has become widely accepted as the optimal means of soft-tissue filling in all areas of the body, including the face, breasts, hands and buttocks.

The method involves the strategic replacement of body's own fat resources to add volume in areas lacking it, as well as simultaneously rejuvenate the overlying skin.

The procedure involves the removal of fat from areas where it is either unnecessary or unwanted via liposuction, and the re-injection of it into other areas of the body for augmenting, healing or rejuvenation purposes.

Between 50 and 70 per cent of fat cells survive the transfer process meaning the results are permanent, and such is the organic ('autologous') nature of the donor material and the minimally invasive nature of the procedure, recovery times are minimal.

The Cadogan Clinic are specialists in this innovative field, and host the leading conference in the UK on the topic each year. Having performed hundreds of such procedures, we are the leading centre of excellence in the country for this treatment.

What is fat transfer to the body?

Fat transfer to the body is the surgical process by which fat is transferred from one area of the body to another. The technique involves extracting adipose fat via liposuction (providing an additional contouring benefit), processing the fat, and then reinjecting purified fat into another area resulting in cosmetic enhancement. The surgical goal is to improve or augment the area where the fat is injected.

Fat grafting involves three steps:

  • Extraction of the fat from the donor area with liposuction
  • Decanting, centrifugation and processing of the fat 
  • Reinjection of the purified fat into the area needing improvement

First, fat is extracted from a donor area using liposuction techniques. This is best accomplished by manual methods, using thin liposuction cannulas to make minor incisions that leave minimal scars. This is typically done under general anaesthetic, but can be done under local anaesthetic for smaller volumes. The fat is then processed to separate oil, excess fluid and blood from the viable adipose fat cells. Finally, the fat is reinjected in small droplets to the target site.

Fat grafting is most commonly performed by plastic surgeons, as liposuction is a primary component of the procedure and it is vital that the fat graft 'takes' in its new site.

In the UK, fat grafting should be performed in a facility or hospital such as the Cadogan Clinic that is inspected at regular intervals by the Care Quality Commission (CQC), to ensure patient safety and best practices, by plastic surgeons who are on the specialist General Medical Council register for plastic surgery.

At a glance

  • Surgery Time: 1 to 2 hours
  • Hospital Stay: 2 to 3 hours
  • Time Off Work: 1 week (if needed)
  • Reasonably Mobile: Immediately
  • Washing: Shower after 1 days 
  • Driving: 1 week 
  • Bras & Garments: night and day for 4 -6 months
  • Exercise Including Gym: 4 - 6 weeks
  • Sexual Activity: 2 weeks
  • Full Recovery: 2 weeks
  • Sleeping Position: Sleeping on back recommended for 2 weeks

Why do people have fat transfer

Fat transfer is a safe, short and highly effective surgical procedure to enhance the contours of the body via combination of liposuction and lipofilling.

The combinative dual effect of both the liposuction (contouring of the donor site) and the lipofilling (contouring of the treatment site) enables a highly impactful body contouring action.

In the matter of just an hour or so, a stubborn legacy contour can be transformed into an entirely new and modified silhouette.

Who is suitable for fat transfer?

Fat transfer or fat grafting is a highly personal procedure and should only be undertaken if you feel strongly that you would benefit from either the volume enhancing or rejuvenating properties of fat transfer in one or more areas of your body.

You may be a suitable candidate for fat transfer surgery if:

  • You are in good psychological and physical medical health
  • You are at your ideal body weight
  • You have a positive outlook and realistic expectations of what can be achieved via surgery
  • You are seeking to improve the contours of your body via a combination of both liposuction and volume enhancement 
  • You are seeking to rejuvenate the appearance of your overlying skin 
  • You are looking for longer lasting results that can be achieved by dermal filler 
  • You are looking for a more natural looking breast augmentation, using fat either as an alternative or adjunct to the traditional implant technique

What to expect

CONSULTATION 

The first step for all of our fat transfer patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation. At the consultation you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible given your existing anatomy.

Your surgeon will take you through the options available to you, and which is the most preferential for you given your stated ambitions. Having established this, several key measurements will be made and standard clinical photography will be taken.

One of the key considerations at consultation for fat grafting involves making an assessment of the volume of fat required—approximately twice the volume of fat needed for injection needs to be harvested as the volume is reduced by half during preparation.

Donor sites (where the fat is taken from) will also be assessed and agreed on with you. This may involve taking fat from more than one area; typical donor areas for fat grafting are the flanks, abdomen, lateral thighs ('saddle bags') and inner thighs, but fat can be taken from anywhere with excessive deposits.
Finally a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding what to expect in the post procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.

If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two week 'cooling off' period.
Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.

PRE – PROCEDURE

If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure.

Before admission the following behavioural changes are recommended / required:

  • In the 6 weeks before your procedure we recommend smoking is discontinued as patients who smoke have a higher risk of healing more slowly and complications (see FAQs)
  • In the week before your procedure you must cease taking Aspirin or any medication that contains Aspirin
  • In the 6 hours prior to surgery you must not consume food or any drink, other than small sips of clear fluid (e.g. still water, black coffee, black tea) which are allowed up to 2 hours before admission

We advise all of our fat grafting patients that smoking is a particular contra-indication to this procedure (even more than with other surgical procedures) as fat viability is materially reduced after transfer in smokers, and the effectiveness of the procedure is significantly reduced.

DAY OF THE PROCEDURE

On the day of your procedure we ask that you arrive for your admission an hour before the agreed start time of surgery. At this point a nurse will come and record blood pressure and other relevant vitals, you will meet with your anaesthetist and your surgeon who will make the final mark-ups.

The procedure itself takes place under general anaesthetic over the course of one to two hours. Depending on how much volume is being transferred, this procedure may take place under general or local anaesthetic. The fat is first removed via liposuction, then prepared via a centrifuge in order to separate the fat from blood and other oily fluids, and then re-injected to the treatment site with a needle and syringe. The injections are given through tiny holes in the skin, so stitches are not usually needed. If a large area is being treated, your may require 2 or more sessions.

POST PROCEDURE & RECOVERY

You should not feel much pain during the procedure, but you may have some for a few days or weeks afterwards. You'll be given painkillers if you need them.

Following the procedure, you will recover in our ambulatory recovery rooms for between two to three hours, dependent on the scale of the procedure. Once our specialist nursing team are happy that your initial recovery is complete and you are safe to return home, you will be allowed to leave the Clinic accompanied by a friend or member of your family.

Once home you will have access to our dedicated on-call nursing team 24 hours a day, 7 days a week. This team of specialists are dedicated to your comfort and pain control, and are there to field any questions you may have in the immediate post operative phase.

We ask that you come in and see our nursing team 1 week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.

We ask that you come in to see your surgeon after 6 - 8 weeks for a final check up.

Why come to the Cadogan Clinic

The Cadogan Clinic is the leading centre of excellence in the UK for fat transfer and fat grafting techniques.

Each year we host a leading global faculty of the top global practitioners in this cutting edge field at the Royal Society of Medicine in London to discuss and debate the latest innovations in the fat transfer sector.

Our fat grafting conference runs over two days of lectures, talks and roundtables, and represents the largest conference of its kind in the UK with 150 leading specialist delegates from 25 countries including the USA, Belgium, France and Israel.

What are the side effects and risks

Fat grafting is a safe procedure, but it is common after a surgical fat transfer to experience:

  • Bruising and swelling
  • Temporary numbness
  • A small amount of scarring 
  • Loss of some of the fat from the injected area during the first few months

As with all surgical procedures, fat grafting carries some risk and it is possible that you might experience:

  • Nausea 
  • Bleeding or infection 
  • Poor healing of incisions and scarring
  • A collection of blood underneath the skin (haematoma)
  • Death of fat tissue (fat necrosis) or embolism

Your surgeon will discuss these risks comprehensively at your consultation and explain how likely these risks and complications are, and how they would be treated.

Frequently Asked Questions

Your consultation is designed to be perfect opportunity to ask all the pressing questions that you have to your consultant, ahead of making a decision on surgery. It is vital that you are fully informed before making your final decision, and the consultation is therefore a key part of the education and decision making process.

Some good examples of questions to ask, include:

+ Am I a good candidate for this procedure?
+ Do you think my goals are realistic given my existing anatomy?
+ Will I require a single surgery or multiple surgeries?
+ Can I see some before & after pictures of fat transfer procedures you have done previously?
+ How long will my recovery take?
+ Is it true that Cadogan offers 24/7 on call nursing service?
+ What can I expect in terms of bruising, swelling and scarring?
+ What are my options if I am unhappy with my results?

After your surgery, you will be asked to come in for a post-operative appointment to come back and see our nursing staff at the Clinic between 1 and 2 weeks after your surgery. At this point your incision sites will be reviewed, and your preliminary healing will be assessed.

After 6 weeks your surgeon will personally review your progress – again at the Clinic - and make sure you are recovering as expected. In addition, they will remove any stitches and advise you on the need for further dressings.
Throughout the recovery period you will have full access to our 24/7 on call nursing service, and full access to the Clinic and our post-operative facilities.

Our aim is to make you feel as comfortable as possible during the entirety of your recovery period.

As your anaesthetic or sedation wear off you will wake up in our recovery facilities at the Clinic. You may feel a little drowsy but this often wears off within a few hours. After several hours in recovery, you will eat and hydrate. At that point, you will be allowed to leave the Clinic by our nursing staff.

It is common to feel a little pain and discomfort in the immediate aftermath of surgery. This will wear off in due course. Our 24/7 on call service is open to all patients for any question or query they may have at this time.

You will not be able to drive yourself home after the surgery. You should arrange for someone to pick you up and take you home. In addition, you will need to ask someone to stay with you for the first 24 hours after your procedure.

One of the major benefits of fat transfer is that recovery is typically very swift and patients can be back at work and active very shortly after the procedure. Whilst the extent of such activity should be gradually phased in, you should be back at work within a week and exercising within two weeks.

We always advise that you return to low impact activities first like walking and cycling before you are able to reintroduce more strenuous activity such as lifting heavy weights and doing intense aerobic activities.

Final results are typically first seen six or so weeks after your procedure, with ongoing improvements beyond this point likely as the healing process fully completes over the coming 12 to 18 months.

Your surgeon will be able to give you specific guidance at your consultation.

Certain lifestyle factors can increase the risk of complications during and after your surgery. These include smoking, drinking alcohol, being overweight and taking drugs (for medical or recreational use.)

The most common impact of smoking before your surgery is that it increases your chances of developing an infection and inhibits your body's natural healing processes. We insist that all patients stop smoking and using nicotine products at least six weeks before surgery. Reducing alcohol intake is also strongly advised. This is particularly important for fat grafting surgery in which the fat's viability post-procedure is materially reduced in a smoker population.

Your doctor will discuss your current BMI and drug use at your consultation and advise you further on this.

Between 50–70% of the transferred fat is retained long term, with final results visible by 6–12 weeks once the swelling subsides and non-viable fat is reabsorbed. The procedure may be repeated at 3-monthly intervals to achieve the desired volume increase.

Not only is the fat relatively easy to harvest via liposuction, but the transferred fat is biocompatible, non-allergenic, non-toxic and relatively easy to obtain in meaningful volumes.

More recently surgeons have used the therapeutic and rejuvenating benefits of fat grafting in the healing of wounds and scars, as well as fat's ability to repair damage to breast tissue following radiation treatment.

The rejuvenative effects are due to the high concentration of mesenchymal cells present in the fat tissue.

This natural 'autologous' resource is therefore readily accepted in the treatment area, is easily topped up and can provide additional rejuvenating benefits.

Fat Transfer to Face

Fat transfer (fat transplantation) uses processed fat from your own body to re-contour and restore volume to facial areas that have become sunken with age, thereby rejuvenating your face and restoring a more youthful appearance. This may be achieved using the fat transfer technique.

Go to Treatment

Natural Breast Augmentation

Natural breast augmentation (enlargement) is an effective alternative to traditional breast implants. Using fat-transfer techniques, the breasts can be enhanced without the use of foreign implant materials.

Go to Treatment

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