Fat Injections

Body Contour Deformities after Surgery

Contour irregularities can occur after body contour procedures such as abdominoplasty surgery, body lift surgery, and most commonly after liposuction procedures. Fat injections can be placed in over-treated liposuction areas while liposuction can be used to compensate in areas of under treatment.

Brazilian Buttock Lift (BBL)

Buttock augmentation can be performed with buttock implants or in a more natural way by fat injection, when fat cells (adipocytes) are harvested from other areas of the body and inserted into the buttocks to provide augmentation in this desirable area. Commonly, it is done in conjunction with liposuction of the abdomen, hip area (flanks), and even the thighs. The goal is to provide a nice shapely buttock region balanced with a fine waist to bring out the natural feminine curves.

Breast Augmentation Deformities

The main indication for fat injection is for breast implant rippling in very thin patients. This is an alternative to using Acellular Dermal Matrix (ADM). The fat like with other procedures can be harvested from other regions such as from the abdomen and hips.

Breast Reconstruction Deformities

After either autologous (using the patient’s own tissue) or non-autologous (using tissue expanders and implants) reconstruction, several different contour issues may develop. Commonly, the upper axillary region is not well reconstructed using either form of breast reconstruction. This area which was previously treated during mastectomy may be very flat and unnatural. Also, due to soft tissue discrepancy issues, contour asymmetries may be present along the border of the autologous reconstruction and the native chest soft tissues. In addition, after an implant reconstruction, the implant may be very noticeable due to the thinness of the overlying mastectomy flaps. In all these situations various revision maneuvers can be performed to improve the contour. Sometimes an Acellular Dermal Matrix (ADM) is used, and very commonly in the last few years fat injection has been employed with great success. Fat injection may also benefit patients with radiation damaged skin over their implants or autologous reconstruction.

Facial Rejuvenation

Facial rejuvenation techniques have evolved. In the past, skin and soft tissue laxity was treated solely with face lifting techniques. As the understanding of facial aging has improved, it is apparent that not only do patients’ skin lose elasticity and sag, but facial atrophy, more specifically facial fat loss, is a key component to facial aging. This is a reason why facial fillers have become so popular. However, most of these available filler products resorb overtime and last an average of six months to a year. They are great products, and Dr. Wallach uses them frequently. Fat injection techniques have improved significantly as the understanding of how to harvest and inject the fat has been refined. With this in mind, may plastic surgeons have been incorporating facial fat injection into their armamentarium of facial rejuvenation solutions. Sometimes this is used as the sole means of rejuvenation, but many times it is performed in conjunction with face lifting procedures. Some resorption of the fat does occur and repeat treatment may be necessary.

Primary Breast Augmentation

Fat injection techniques have been used by some surgeons to perform primary breast augmentation. This is in lieu of using an implant. This procedure can take 1-2 hours and may need to be repeated as the fat does not take 100%. It can be harvested from available donor sites, most commonly the abdomen and waist. In Dr. Wallach’s practice, the majority of his patients want breast implants as the procedure of choice for augmentation because of the consistent and reliable results, but he will perform primary fat breast augmentation when indicated and upon patient request.

Primary Breast Reconstruction

In a similar way, fat injection has been performed by some surgeons as the sole means of breast reconstruction in delayed cases. In Dr. Wallach’s practice, the majority of his patients want other modalities of breast reconstruction using soft tissue flap reconstruction or tissue expander to implant reconstructions as the procedures of choice because of the consistent and reliable results. He will commonly use fat injection for revisions as a secondary procedure to enhance the results from the initial reconstruction and also to camouflage irregularities such as for implant visibility and for lack of upper pole fullness.

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