What is Lipomodelling?
Lipomodelling or fat transfer is a procedure that involves removal of fat from one part of the body and placement of this fat into another part of the body.
How is fat transfer performed?
Lipomodelling is normally performed under a general anaesthetic although it can also be done under local anaesthetic depending on the volume of fat required. The first part of the procedure involves infiltration of the area with a wetting solution that contains local anaesthetic and adrenaline to help with pain relief and reduce bleeding. The fat is then harvested or removed from the donor sites. The donor sites are typically from the flanks, thighs and abdomen. This aspirate contains fat, fluid and oil. It is then processed using a centrifuge, which separates the components of the aspirate. The fat cells are then separated for use and injection into the areas that need it. Small incisions are made at the recipient sites and the fat is injected using cannulas. All the incisions are closed and dressed.
What happens after fat transfer?
Lipomodelling is usually performed as a day case procedure and so you normally go home the same day. You can expect some bruising in the areas where the fat has been removed and injected. It is recommended that you wear compression garments for the areas where the fat has been harvested. The areas that have been injected may swell more in the first few days and this usually settles. It is important that you understand this initial swelling will go down and so the final result will always be less than what you see immediately after the operation.
What are the potential risks or complications of lipomodelling?
Fat transfer like all operations may have potential complications. Fortunately, complications are not common following lipomodelling but can include:
Bruising is normal following this procedure but in some cases it may take a longer time to resolve.
A haematoma is a collection of blood that forms under the skin where there has been bleeding. Small haematomas usually resolve with time.
Some patients may notice some lumpiness or irregularities after the procedure in both the areas where fat has been removed and injected. These often settle with time.
Fat Absorption or Loss
It is generally expected that a proportion of fat will not survive and get absorbed. The percentage of fat that is absorbed is reported to be about 30-40% in the literature. This is why we may put more fat initially since we know some will get absorbed.
Sometimes the fat may not survive and die resulting in fat necrosis. Fat necrosis can present as firm lumps under the skin, which can sometimes be distressing to patients. Small areas of fat necrosis will often settle with time and eventually be absorbed.
Oil Cysts and Calcifications
There are some changes following fat transfer that can be detected on mammograms and other imaging studies such as ultrasounds or MRIs. Experienced radiologists are usually able to distinguish changes following fat transfer from other more serious changes.
There are some reports of fat cells being injected into the blood stream resulting in serious consequences such as blindness. This complication is very rare and it is important to make sure your surgeon is a fully trained and registered plastic surgeon.
The scars from this procedure are normally very small and usually settle well. In some patients with a tendency to develop abnormal scarring, the scars can become raised or lumpy, also known as keloid or hypertrophic scars.
There will normally be numbness immediately after the procedure since we use local anaesthetic. Some patients may experience numbness for a prolonged period after the operation. This may be as a result of swelling or bruising around small nerves in the treated areas. This is usually only a temporary problem.
Changes with time
It is important to understand that injected fat is living tissue and can change with time. This can be an issue if your weight changes and patients that have fat injected to the cheeks may notice more fullness in this area if they gain weight.