Fat Transfer / Fat Grafting

What is Fat Transfer (Micro Fat Grafting)?

Fat Transfer, Micro Fat Grafting, and Fat Injection are synonymous terms. They are used to describe a technique that utilizes fat from one part of the body as a natural filler for another part of the body or the face, resulting in a more youthful and enhanced appearance.

Fat Transfer is an important component in facial rejuvenation. A lifting procedure (e.g. Facelift) will re-elevate and tighten sagged tissues, but will not restore the fullness lost with aging. For this, Fat Grafting is necessary.

The most common areas for Facial Fat Grafting are:

• Cheeks
• Lips
• Nasolabial folds (smile lines)
• Marionette lines (corners of mouth)
• Upper eyelids
• Temples
• Lower eyelids

Our Toronto plastic surgeon—Dr. Lawrence Tong—is highly skilled and experienced in performing fat injections and he can help you achieve your aesthetic goals with this innovative procedure.

Who is a Candidate for Facial Fat Grafting?

The ideal candidate for Fat Transfer is in good general health and has reasonable expectations about what can be achieved with this procedure. Patients who undergo Fat Grafting in the face can be any age.

Younger patients tend to use fat injection as a means for plumping an area that can benefit from volume augmentation:

• For fuller lips
• For the appearance of higher cheekbones

Older patients tend to use Fat Grafting to restore areas that have lost fat due to the aging process to correct:

• Deep smile lines (nasolabial folds)
• Deep lines at the corners of the mouth (marionette lines)
• Hollowness of the upper eyelids
• Hollowness of the lower eyelids
• Hollow temples
• Sunken cheeks
• Thin lips

Dr. Tong also performs Fat Grafting in the body, such as for Buttock Augmentation (Brazilian Butt Lift) or Breast Augmentation as an alternative to implants.

Benefits of Fat Grafting

Fat is natural filler that can be used for augmentation or restoration. The fat is taken from your own body, so there is no concern about rejection or transmission of disease.

Fat can be harvested wherever there is excess fat; the most popular places are from the abdomen, love handles, and outer thighs. Facial fat grafting does not require much fat to be transferred (usually 30cc or less), therefore harvesting is easily accomplished even when a patient is quite thin.

Some amount of resorption (the transferred fat melting away) does occur. Dr. Tong utilizes techniques that optimize the degree of fat survival, but none are 100% effective at preventing resorption. Patients should assume that some resorption will occur. If the procedure does not yield enough fat survival, the surgery can be repeated.

Fat Grafting has also been shown to improve the skin’s quality and texture over areas that have been grafted. The exact reasons for this phenomenon are not well understood, but are believed to be related to the abundance of stem cells that are found within the grafted fat.¹

How to Choose the Best Plastic Surgeon For You

Incisions for Fat Injection

For the patient, Fat Transfer involves two steps:

• Harvest
• Grafting

Fortunately, both steps require only very small puncture wounds in order to allow for small blunt needles to pass. Each puncture is less than 1 mm in size. Once the incisions have healed, they should almost be invisible.

Facial Fat Transfer Procedure

Dr. Tong performs Fat Transfer to the face under general anesthesia or IV sedation. During the time you are under general anesthesia, you will be asleep and completely unaware of the surroundings. Dr. Tong performs your surgery in the CPSO accredited private surgery centre, within a few blocks of his office located at 7 Thomas Street in downtown Toronto.

Dr. Tong begins the Fat Transfer procedure by harvesting the fat. A small blunt needle (harvest cannula) is used to remove the fat in a process similar to Liposuction. In contrast to liposuction, it is done by hand, using a small syringe instead of a liposuction machine. Once enough fat is harvested (typically one to two ounces), it is processed and prepared for surgical transfer. Dr. Tong takes the prepared fat and meticulously introduces the fat into area(s) of need, placing tiny amounts at a time to achieve a natural, non-operated look. Spreading and spacing of the fat within the native tissue is one of the keys for optimal fat graft survival. A small degree of over-correction is done as a means to compensate for expected fat graft resorption. The cheeks, upper lids, lips, temples, and smile lines tend to be the most popular area for facial Fat Grafting. After the Fat Transfer, you are gently awakened from anesthesia.

Recovery after Facial Fat Transfer

You will be allowed to go home following surgery after the effects of anesthesia have largely worn off, accompanied by your friend or family member.

At home, sleep in a reclining chair or use multiple pillows to keep your head elevated when you sleep. This helps decrease facial swelling. During the healing process, it is very important to minimize touching, placing pressure, or manipulation of the areas of grafting. Pain is typically mild. Pain medication will be prescribed and can be used during this time. You should try to rest and relax as much as possible during the first week. You may do non-strenuous activities such as reading and watching television. You may have bruising in the first 1-2 weeks and there will be moderate swelling.

You will see Dr. Tong one week after your surgery to check your progress. As the first few weeks go by, your facial swelling will subside. The majority of patients return to (non-strenuous) work at 7-10 days. Dr. Tong will likely allow you to start light exercise (e.g. walking for exercise) at 1-2 weeks after surgery. Avoid strenuous activity until 4-6 weeks after surgery.

Some of the transferred fat will melt away during the first 6-8 weeks. Beyond 6-8 weeks, the remaining fat present will likely survive for the long term. The fat will change with changes in your weight, and lose volume with the normal aging process. After the initial postoperative visit, you will follow up with Dr. Tong at 6 weeks, and 6 months after surgery. Post-operative photos will also be taken at these visits. If deemed necessary, repeat fat grafting can be performed 3 months (at the earliest) after the prior surgery.

Your Fat Transfer Consultation

Patients should have all the information about their surgery options before making a decision. Do your research carefully. During your private consultation, Dr. Tong will make sure that you are informed about all aspects of the Fat Transfer surgery process. The initial consultation may take over 45 minutes to complete. Our goal is to educate you about plastic surgery. You will never be rushed or pressured to make a decision about surgery. We know that the educated patient will make better choices about their surgery and their surgeon.

To learn more about how Micro Fat Transfer Surgeon Dr. Lawrence Tong can help you, set up a consultation with Dr. Tong in Toronto by giving us a call at (647) 723-0827. No physician’s referral is needed. You can also let us give you a call; just fill out our contact form and we will call you on the same or the next business day.

¹ Bellini E, Grieco MP, Raposio E. The science behind autologous fat grafting. Ann Med Surg (Lond). 2017;24:65-73. Published 2017 Nov 10. doi:10.1016/j.amsu.2017.11.001. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694962/. Accessed November 18, 2020.