Fat transfer, or fat grafting, involves moving fat from one part of the body to another. Fat is removed with liposuction and then injected into another part of the body. This adds volume and in many cases also improves the appearance of the overlying skin due to growth factors in the fat cells. Fat can be transferred in small quantities to the lips, cheeks, or areas of depression from scarring. It can also be transferred in larger quantities to increase the size of the breasts or buttocks.
How does it work?
When fat is removed from the body and re-implanted, it must grow new blood vessels in order to survive and become permanent. This takes a few weeks, and during that time, fat cells survive by oxygen and nutrients diffusing into the cell. This is why it’s important to be cautious about how fat is transferred and how the area is managed after the procedure. Transferring too much fat altogether or more than 1-2mL into the same exact spot might lead to death of the fat. Excess pressure on the area for more than 20 minutes after surgery can also lead to loss of fat. Usually, volume is just slowly lost. But sometimes, the fat can turn into oily cysts or hard lumps of scar tissue.
How does the fat behave over time?
By 6 months after the procedure, the fat that is present should permanently remain if there is no change in health or infection in the area. As a patient gains and loses weight, the new fat in the area will behave like the fat from the area where it was taken. So if you take fat from a “trouble spot” it will be less likely to be affected by weight loss, but it might be more affected than the surrounding area with weight gain. This is a careful consideration when deciding which areas to take and transfer fat.
Where can I transfer fat?
Fat can be transferred anywhere on the body. The most common areas our practice treats are the lips, breasts, and buttocks.
What are the risks?
There are multiple types of risks possible, and it depends on the amount and location of fat transfer. With small areas of fat transfer like the lips, the biggest risks are bruising, asymmetry, loss of fat, cyst or lump formation, and contour irregularities from liposuction in the “donor” area. Downtime can be less than a week depending on a person’s pain tolerance and activity level.
With larger amounts of fat transfer, the risk of fluid pockets (seromas) in the area of liposuction, loss of fat, cyst or lump formation, and risks of anesthesia apply. The downtime is extended to weeks instead of days, and compression garments and lymphatic massage treatments become essential to healthy recovery and good results.
Targeting Specific Areas
Face
Some patients prefer the more permanent effects of fat transfer compared to filler. Obviously there is appeal to lasting results and benefits to the quality of the skin where the fat is injected. But fat can be permanent and can change with weight gain or loss, so it should be done carefully to avoid problems in the future. The most common type of fat we use in the face is referred to as Nanofat. This is fat that has been passed through multiple filters to break up the cells and release the growth factors. This stimulates the area to thicken collagen and smooth the overlying skin. Rather than add volume, it helps improve skin texture and plumpness.
Microfat is another commonly used form of fat grafting that consists of slightly larger, more refined fat particles designed to provide subtle structural volume while still blending naturally into delicate facial tissues. Microfat can be used to soften contour depressions, restore volume loss under the eyes, improve hollowing in the cheeks or temples, and refine transitions throughout the face. Because the particles are smaller and more delicate than traditional fat grafts, Microfat allows for smoother integration and precise contouring in thinner-skinned areas. In many cases, Microfat and Nanofat are used together to simultaneously improve both volume and skin quality for a more comprehensive rejuvenation result.
Breasts
Many patients are interested in the idea of using their own fat to enhance the breasts rather than relying solely on implants. Fat transfer can be an excellent option for patients looking for subtle, natural-looking improvement in breast shape, contour, and fullness. However, it is important to understand that fat transfer alone typically provides a modest increase in breast size — often about one cup size per procedure — depending on the patient’s anatomy and available donor fat.
More commonly, fat grafting is used strategically to refine and enhance breast shape rather than dramatically increase volume. Fat can be placed in specific areas such as the upper pole, cleavage, areas of implant rippling, contour irregularities, or areas of volume deficiency following breast reduction, breast lift, augmentation, or revision surgery. Because the transferred fat is your own tissue, results often feel very soft and natural.
In addition to traditional fat grafting, newer regenerative options such as Renuva® and AlloClae™ are becoming increasingly popular for select patients. AlloClae is an off-the-shelf regenerative adipose matrix designed to mimic the structure and support of natural fat tissue. It can be used to improve contour irregularities, provide soft tissue support, and enhance shape in areas where additional volume or coverage may be beneficial. Unlike traditional fat transfer, AlloClae does not require liposuction harvesting, making it an attractive option for patients with limited donor fat or those looking for smaller contour refinements.
These advanced grafting techniques can be particularly helpful in revision breast surgery, breast reduction, implant camouflage, correction of rippling, or improving transitions between the chest and breast tissue. In some patients, grafting may also be combined with internal support techniques or “internal bra” reinforcement to optimize long-term shape and structural support.
As with any fat grafting procedure, not all transferred fat cells survive. Fat that does not successfully establish a blood supply may be reabsorbed by the body or occasionally form firm areas such as oil cysts, calcifications, scar tissue, or palpable lumps. Although current research does not show that fat grafting increases the risk of breast cancer, these changes can sometimes appear on mammograms or imaging studies and may require additional imaging or biopsy to fully evaluate. For this reason, it is important to continue routine breast cancer screening and inform your radiologist if you have had prior fat grafting to the breasts.
Buttocks
Known as the “Brazilian Butt Lift”, transferring fat to the buttocks is is the most common type of fat transfer done in our practice. It is more likely to add size and shape to the buttocks than to effectively “lift” them, especially over time and with weight gain or loss. The results depend on how much excess skin there is to fill out, how strong the connective tissue is, how much fat is available for transfer, and the patient’s pre operative shape. Suctioning of fat around the buttocks can also help improve the shape dramatically, even if fat is not injected. These areas include the love handles, upper back, inner and outer thighs, and waistline.
The most common complication of fat transfer is loss of volume over time, but there can be some serious risks. If too much fat is injected or if it is placed incorrectly, this procedure could cause fat to be injected into the blood vessels, which can be fatal. If proper guidelines are followed regarding the amount and location of injected fat, the risks are minimal. This is why it is important to ensure that your surgeon or surgery center follows current guidelines from the ASPS (American Society of Plastic Surgery) and the AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities).