The History of Fat Grafting and How It Can Be Used

Fat grafting is a relatively common plastic surgery procedure today, but the technique only became widespread fairly recently. This procedure has a wide range of applications, and Dr. Deschamps-Braly uses it in both cosmetic facial and gender affirming surgeries. Before you schedule your consultation at the Deschamps-Braly Clinic, continue reading to learn more about the history of fat grafting.

Early Fat Grafting Procedures

The first fat grafting procedure was performed in 1893 when a German plastic surgeon, Gustav Neuber, transferred fat to the eye region from the arm to correct a patient’s scarring. Later, in 1895, Dr. Viktor Czerny transferred a lipoma to a patient’s breast to restore symmetry after a partial mastectomy.

Unfortunately, these early fat grafting procedures carried high risks, so the technique was used infrequently in the 100 years following these surgeries. Modern liposuction techniques had not yet been developed, meaning that extracted fat varied greatly in quality and results were inconsistent or difficult to predict.

Beginning in the 1990s, Dr. Sydney Coleman of New York City began publishing papers to describe standardized techniques for fat transfer. These techniques made the procedure, from the fat extraction to processing to injection, much safer with superior results. Thanks to Dr. Coleman’s techniques, fat transfer’s popularity and applications have only increased since the ‘90s.

The Fat Grafting Procedure

Fat grafting is completed in three steps. First, donor fat is extracted using liposuction. This is usually applied to areas such as the abdomen, back, thighs, or upper arms. Next, the removed fat is prepared for transfer through a process of decanting and centrifugation. This removes any excess fluid, debris, or dead cells from the adipose fat cells that are appropriate for transfer. When this is complete, the fat is injected into the treatment area in small droplets. This helps to ensure that the transferred fat can establish an appropriate blood supply and the grafted fat will survive. Even with proper injection techniques, not all transferred fat will establish the necessary blood supply, meaning that some fat cells will die and be naturally metabolized by the body. For this reason, your plastic surgeon will typically inject a slightly larger amount of fat than is necessary to achieve your goal results. Fat grafting is performed under general anesthesia or IV sedation in a hospital or surgical center.

Fat Grafting for Cosmetic Facial Surgery

Fat grafting has a number of uses in facial plastic surgery. Generally speaking, most cases that could apply to dermal fillers can also apply to facial fat grafting. For example, fat grafting can be used to restore lost volume in areas such as the cheeks or temples due to the natural aging process. It can also be used in a lip augmentation. The major benefit of fat grafting compared to dermal fillers is that results are permanent. Once the transferred fat establishes a blood supply, it will remain in place long-term. The results also tend to be very natural-looking, though natural results can also be achieved with the right dermal filler.

Fat Grafting in Gender Affirming Surgery

In addition to purely cosmetic applications, fat grafting can be useful in a gender affirming surgery. In particular, the technique can be used for facial feminization surgery (FFS). Fat transfer to areas such as the cheeks or lips can create a more traditionally feminine appearance by increasing a rounder or fuller effect in these areas. Many FFS patients try dermal fillers in these areas prior to their surgeries, and fat grafting can allow them to enjoy these results long-term.

Schedule a Consultation

To learn more about facial fat grafting and whether the procedure will suit your goals, schedule a consultation with Dr. Deschamps-Braly. Call the Deschamps-Braly Clinic in San Francisco at +1-415-877-6585.

In addition to fat grafting, dermal fillers are an alternative treatment option to consider when adding facial volume. Dermal fillers can be placed in the same areas of the face as the patient’s own fat, including the lips, cheeks, temples and tear trough, as well as other facial areas. In the case where a patient doesn’t have a significant amount of body fat to harvest for fat grafting, dermal fillers can supplement the volume that wasn’t achievable during the fat grafting surgery. Some patients are hesitant initially about undergoing fat grafting, as it is a more permanent solution. Dermal fillers allow patients to do a “trial run” and preview their fat grafting results. Dermal fillers are reversable and are metabolized naturally by the body over time, so the commitment factor to the final outcome is much lower. Some patients are not candidates for surgery, and in that case, dermal fillers allow them to enhance facial contours and add volume to the face to achieve their aesthetic goals.

+ posts

Dr. Deschamps-Braly is a board-certified plastic and craniofacial surgeon specializing in facial plastic surgery, orthognathic (jaw) surgery, and craniofacial surgery for adults and children. He is also one of the world’s foremost leaders and innovators in facial gender confirmation surgery.