Fat Harvesting & Transfer
Body fat has been widely debated on an emotional, cultural, artistic, socio-economical and medical level. Fat harvesting and transfer from one body region to another is known as lipofilling. The lipofilling and fat transfer is a well-known procedure in cosmetic clinics in Dublin. Its revival is due to recent technical innovation in fat cell survival and purification, a process kknown as nano fat . Fat is invariably harvested from unwanted areas and put to good use where it’s needed.
Ageing is responsible for subcutaneous fat tissue loss and skin elasticity. These defects or deficiencies typically result from the loss of a volume of fat tissue. The lipofilling procedure utilises the patient’s own fat tissue to address or treat other areas in their body. This eliminates the risk of a foreign body reaction. Fat is readily available in nearly all patients. The process carries minimal discomfort to the patient and the lipofilling procedure can easily be repeated if necessary.
Excess amounts of fat tissue are found all over the human body, and may easily be obtained through low pressure liposuction and transplanted to a target location. Fat can be harvested from the abdominal region, the inner part of the knees, the upper legs or buttocks. Most scientific data indicate that fat harvested from the saddle bags yields the most viable and potent cells. These cells are thought to be abundant in Stem Cells. Stem Cells isolated from fat tissue obtained by liposuction and are found to be capable to become different types of tissues.
In humans the fat is stored in different compartments in the body:
1- Under the skin. The fat layer under the skin is easily accessible using the liposuction technique with minimal discomfort for the patient.
2- In the abdominal cavity
3- The bone marrow
The lipofilling procedure can be performed under local anaesthesia through the VASER Lipo procedure. The VASER Liposelection has revolutionised fat harvesting under safe and reliable results.
The Lipofilling Procedure
There are three important steps in the lipofilling procedure:
1- Liposuction. The subcutaneous fat tissue is harvested using the liposuction device and specific cannulas to avoid major trauma to the harvested cell populations. VASER Liposelection applies a mild ultrasound energy to the fat in the area to be harvested and in order to loosen and disrupt their attachments. Liposuction is then performed applying gentle aspiration on the fat tissue in order to avoid major cellular disruption and disintegration. Liposuction of the harvested cells is made under specific pressure to keep them viable.
2- Centrifugation. Once enough fat tissue or is harvested, the next step is performed to increase their survival rate in their new environment. This is the centrifugation of the fat tissue. After the centrifugation, three layers are obtained out of which the middle layer is the concentrated lipoaspirate material and only the middle layer is used for injection or lipofilling.
3- Lipofilling. The last step is the actual lipofilling procedure. The middle layer of the centrifuged fat tissue is collected and is injected. For the lipofilling procedure a specific range of cannulas available each of them with specific designs targeting different parts of the body.
The injected harvest finds itself in a hostile environment. They’ve been disrupted from their native environment and need oxygen and nutrients to survive. They can survive through two processes called “diffusion and revascularization”. Good patient health is essential for a successful revascularization. This process is strongly inhibited in smokers and patients with chronic illnesses. Smoking has a negative effect on the small blood vessels.
Areas Suitable for Lipofilling
The main reasons for adding structure to the face is to replace volume loss and to enhance facial features and or proportion. The common goal of both of these indications is to create a more aesthetically appealing proportionate face. Dr Kahlout at Castleknock Cosmetic Clinic Dublin has been performing this procedure since 2008.
As we age and lose the fullness of youth, the hard structures of the face physically get smaller and gaunt develop. The skin remains the same size, but without the support of the underlying structures, the skin eventually retreats into wrinkles. As the missing structure under the skin is restored, the wrinkles will diminish.
Enhancing Facial Proportion
With ageing, the cheeks chin, jaw, forehead, etc. decrease in size. The fat, muscle and connective tissues atrophy or waste away, leaving behind unsupported skin. As the support underlying the skin disappears, the skin falls into wrinkles and folds. As the cheek becomes smaller, bags under the eyes become more prominent. As the jaw line and chin lose their prominence, jowls appear. As the youthful fullness of the brow and upper eyelid dissipates, an empty sack of skin is left behind.
Since shrinkage of the subcutaneous tissues is the primary manifestation of ageing, replacement of the atrophied tissue with “Structural Nanofat or microfat grafting technique” is an obvious method of rejuvenation. Diffusely augmenting the structure of the forehead, cheeks, mouth, chin and jaw line restores the fullness of youth.
Brow, Upper Eyelids & Temples
A definite fullness of the brow, upper eyelid, and the temple region is essential for a healthy and sensual appearance. Fullness characterizes the young brow, cheek, and temple. As the fullness of youth disappears, the structures underneath emerge. In the upper face, it is the shape of the skull and the rims around the eyes. The blood vessels are no longer hidden by fullness and become more visible. The muscles of facial expressions are more visible because the youthful fullness no longer impedes their natural tone. This creates a frowning or surly appearance in many older people. The eyebrow descends with loss of fullness from the forehead, temple, and brow. As fullness disappears from the upper eyelid and brow, their eyes may become more deep set and skeletal. In others, the lack of fullness results in an empty sac of skin hanging where the fullness once was present.
Chin and Jawline
A sculpted, well contoured jaw line is the hallmark of a youthful appearance. Actors, models, and athletes are admired for their sharply defined jaw lines. It is the loss of the fullness in the jaw line and chins that heralds the first signs of aging. As the underlying fullness is reduced, the face deflates. The skin remains the same size, but without the underlying fullness and support, the emptied skin drapes around the underlying structures of the face. Structural micro fat grafting technique can play a significant role in reversing these aging changes.
Nasolabial Folds / Marionette Grooves
The nasal labial folds and marionette grooves convey powerful emotions. Ageing can generate negative and fixed changes in facial expression. As the face ages, it loses its fullness associated with youth. As the skin around the mouth loses its fullness, the unsupported skin sinks into fold, wrinkles, and creases. As these folds become more pronounced, unintentional emotional expressions can become fixed on the face.
Cheek bones & Eyelids
Lipofilling using “Structural microfat grafting technique” to the cheek and lower eyelid can restore fullness, soften wrinkles and crow’s feet, decrease pore size and lighten lower eyelid darkness. A further indication for fat grafting to the cheeks is adjustment of facial proportions. This is most often seen in a younger person who desires more angular cheeks, but it can also be someone who has atrophy associated with acne scarring or ageing. This technique can also be useful for disguising obvious silicone implants, minimizing the appearance of bulging eyes, correction of facial lypodystrophy and congenital deformities.
The primary indications for lip augmentation are ageing and a patient’s desire for an adjustment of facial proportion. As a person ages, the lips lose their fullness. The goal of lip augmentation is to create attractive, pouty lips. The changes that occur with the ageing of the lower lip are dramatic. Along with the decrease in volume of the lower lip, wrinkling of the upper lip is almost always much worse. Restoring lip fullness through lipofilling will result in a return of a more youthful appearance.
A full, taunt neck is one of the signs of youth and beauty. With age subdermal fullness disappears and the skin texture gradually deteriorates, leaving behind unsupported, crepe skin. When structural fullness is added to the neck, it provides underlying support to the skin to restore a more youthful fullness.
Correction of Acne scaring
Aging and acne both erode the structures under the skin to leave behind an emptier sack of skin which is suitable to filling and restructuring with your own fat. The years of smouldering infections and abscesses associated with acne destroy the normal supporting elements under the skin. The resulting acne scarring of the skin is merely the “tip of the iceberg.” The subcutaneous structures devastated by chronic acne must be restored to enact a healthy appearance to these ravaged faces. Acne scarring treated by only altering the skin is incompletely treated. Restructuring immediately under the skin restores texture to the skin. As important, replacing the volume of tissue loss in the forehead, cheeks, jaw line and chin due to chronic acne can restore a normal proportion of the face.
Various body proportions can be enhanced by lipofilling. The grafted fat can be used to enhance your buttocks, define your abdomen, create your waist, and improve scars and many other clinical indications.
Hands are one of the most visible unclothed areas of the human body and also one of the first areas to show visible signs of ageing. The back of the normal hand is not a repository of fat and the attractive young hand is full not fat. The key to the successful hand rejuvenation of the ageing hand is to create an integrated layer of fat grafts over the back of the hand that makes the skin look and feel thicker with a slight youthful fullness. The back of an attractive, healthy appearing hand has a slight fullness that obscures veins and tendons but does not hide them.
Liposuction is the most commonly performed plastic surgical procedure in the world. It can however sometimes produce superficial surface irregularities, what is known as iatrogenic liposuction deformities. the most common complication of liposuction. Some of these are exaggerations of pre-existing irregularities, some are cellulite, and some are newly created. The thigh and abdomen are particularly prone to these irregularities. They are challenging deformities and require a three-dimensional visualization of the problems and solutions.
Fat is harvested in small pieces by liposculpture. The donor sites of choice are the natural fat deposits where volume reduction may be of aesthetic benefit, such as the waistline, the abdomen, the hips, the inner aspects of the thighs and the knees. When necessary, fat may also be aspirated homogeneously from the anterior and lateral aspects of the thighs.
During lipofilling the fat is filtered and re-injected under the skin of the breast and below the breasts through small incisions of only a few millimetres.
The capacity of the breasts to take up fat can be enhanced by an external tissue expander which enlarges breast volume by gentle suction. For one month before and one month after the procedure, domes with a soft border are applied over the breasts at night and during week-ends. A small pump provides light negative pressure, which makes the breasts gradually expand.
Breast augmentation with autologous fat is a recent surgical technique. It has been introduced about ten years after lipofilling to other areas of the body such as the face and the buttocks. One woman out of nine is confronted with breast cancer in the course of her life. Therefore, extra care and diligence were appropriate to introduce fat transfer to the breast.
The cost of lipofilling depends on the amount of fat needed and the extent of the procedure.
Small Area from €3000 (example: undereyes or cheeks)
Medium Area from €4500 (example: calves)
Large Area from €7500 (example: buttocks)
Breast Lipofilling from €9500-€12500)