Fat Grafting or fat transfer is by its name is a very artistic and result oriented procedure in the field of both Re constructive and Cosmetic Surgery. Indication for this procedure is vast from Hemi facial atrophy of the face mean congenital depression of cheek fat till the cosmetic Breast and Gluteal augmentations.
Basically this procedure is done for filling of fat where it is need and for given detailing to a depress site in the body. The common causes for this procedure are the depression of one side of the face depression or defect on the forehead. Other common causes are nasolabial fold filling augmentation of cheek bones, breast and gluteal or the hip augmentation.
The procedure is simple but time consuming and can be done under local and general anaesthesia, I prefer doing under local for small areas and for big fat transfer as for breast or hip area; I usually do this procedure under general anaesthesia.
Procedure for Hemi facial atrophy or Depression of one side of face:
Hemi facial Atrophy or the depression of one side of the face is a condition in which a person has wasting of fat and the atrophy of musculature on the cheek area, which gives very unpleasant appearance on the face.
After examining and counselling procedure date is given to the patient. The procedure has it three major parts:
The first step of the fat grafting procedure is to harvest the fat from the body. Good site for that are inner thighs, lateral thighs or flanks areas. Area for harvesting is marked and a local anaesthesia called tumescent solution is injected. Make sure that the area is cleaned properly. I usually use a spinal needle or a cannula 18 G for injecting anaesthesia As the procedure is under local anaesthesia so some oral sedative can be given to a patient to decrease his or her anxious level. After injecting the solution we should wait for 7 mins for the drug to response. After this step we make tiny stab incision and insert the tulip small cannula attached with is a 50 cc syringe to collect the fat in a sterile manner. To and fro motion is done to harvest the fat same as in liposuction, the fat start to collect in the syringe.
When enough fat is collect in the syringe than other syringe is attached to fill. The collected fat is than centrifuge for mints at 3000 rpm in an electronic centrifuge. It will separate the saline and the blood from the fat and we can have pure fat to transfer.
Injecting and Fat Transfer:
This is very technical and hard part and requires an expert hand. The depress area has been marked before injecting the fat. A tulip cannula is than attached to the syringe containing fat, I prefer to make a plane in the affected area before injecting the fat so the fat should release easily and without any effort. I slightly over correct the area with the fat because some degree of fat may have the chance to absorb. After transferring the fat to the effected field I place cotton with tincture benzoic solution at the injected site, this will help prevent the leak of the fat. I usually do not prefer any dressing but ask the patient to not give pressure for 2 or 3 days at the injected site. Some antibiotic and the pain killer should advise for one week.
Autologous graft is much safer easier way to reshape your defects which can bring back your aesthetic appearance and fat grating is the natural way to do that.