Six of the most common areas that plastic surgeons do fat transfers
From head to toe, these spots are the most-requested areas to plump
Fat grafting is known by many names, most often referred to as fat transfer, it is also analogous to fat injections, and the technology behind this procedure has accelerated at a whiplash pace. Fat transfer continues to shed its formerly infamous reputation as it becomes more popular among patients. The procedure that was once used in more minimal ways is now commonly used among surgeons as a longer-lasting alternative to fillers and, in some instances, breast implants or sculpting a patient's musculature.
"I think fat transfer is poorly understood," says Phildelphia-based plastic surgeon Dr. Christian Subbio. "It has a very specific set of advantages, but more importantly, a very specific set of limitations."
Fat grafting is a two-step "surgical procedure in which liposuction is gently performed to harvest viable fat cells," explains Denver plastic surgeon Dr. Manish Shah. "These cells are then reinjected into various areas of the body to restore lost volume to those areas."
One of the most significant limitations of fat grafting is the unpredictability of the final result. Fat cells are living organisms, and exactly how many of the fat cells will survive the delicate fat transfer process and take hold in their new home on the body is hotly debated, although Dr. Shah puts the survivability percentage in the 50- to 90-percent range, depending on surgeon technique and patient aftercare.
"The science of fat transfer is continuing to advance," says Dr. Shah. "We are learning how to optimize fat grafting surgery to improve procedural safety and overall results."
We tapped four members of the American Society of Plastic Surgeons (which requires its members to be board-certified) to learn which areas of the body patients most want their fat to be transferred and what results they can expect.
"Fat transfer to the breast has become increasingly popular – and it's understandable why," says Dr. Subbio, who adds that it's an especially attractive option for patients who are uncomfortable with implants or going under anesthesia. "The idea that one can achieve breast augmentation without the need of an implant, a foreign body, while using one's own natural tissue, taking it from one spot to another, has a lot of appeal."
Beverly Hills-based plastic surgeon Dr. Sheila Nazarian says patients who are most interested in fat transfer are usually women who "want small breasts" but they've "lost volume at the top of their breast or definition of their cleavage."
Dr. Nazarian says that these patients aren't looking for an implant, but rather "just a little boost, a little more lifted" look. Fortuitously, this is the profile of an ideal patient for a fat transfer procedure because the amount of fat that can be injected depends on the area of fat that already exists. "So if a patient has an A cup, they can't get to a C cup with one procedure," she says. "Maybe they could get to an A-and-a-half. If they do a repeat fat transfer, they could get to a B-and-a-half," she explains, because there are more live cells present at the second re-injection.
This is the most popular spot where women want to get a fat transfer, according to Drs. Shah and Rowe. For patients seeking a fat transfer to this anatomically tricky area (there are many blood vessels in the buttocks), it is paramount that the patient engages a plastic surgeon certified by the American Board of Plastic Surgery who has fat grafting experience.
"Fat can be placed essentially anywhere for volume enhancement and restoration," says Dr. Shah, and a fat transfer to your glutes provides an immediate and dramatic appearance of more rounded, chiseled buttocks.
"Men typically ask for grafting to the abs," says Dr. Shah, to create the visual of a sculpted, highly coveted "six-pack." During this procedure, also called abdominal etching, surgeons start by liposuctioning the abdomen in a specific way to define and highlight the muscle, and then place the liposuctioned fat back into the abdomen to further accentuate the muscle lines by plumping the edges, giving the appearance of super-ripped abs.
A crucial aspect of this procedure specifically, says Dr. Subbio, is for the surgeon to "really work with the patient's underlying musculature so you're sculpting the appropriate areas."
"This area is popular largely because the injected fat generally last longer than other currently available fillers," says New York City-based plastic surgeon Dr. Norman Rowe. "It's a great adjunct or even primary method to perform both cosmetic and reconstructive procedures."
Patients seeking a permanently enhanced cheekbone or jawline are now opting for a fat transfer over filler injections, which need to be refreshed every 6 to 12 months, whereas fat injections may last several years before needing to be restored.
Another area that is often requested by men are the arms. Augmenting the triceps and biceps via fat grafting helps shape and bulk the area, resulting in a more muscular, cut appearance that patients have not been able to achieve through diet and exercise alone.
"I believe that patients like the idea of recycling their own tissues to reshape their bodies," explains Dr. Shah, of the rising number of men seeking plastic surgery and fat transfers.
The skin on our hands reveals just as much about our age as the skin on our faces – if not more. Fat transfer to the top of the hands adds volume to restore a youthful, plumper contour to thinning or wrinkled skin. Fat can also be injected into the hands to improve veiny skin and make protruding veins less noticeable.
To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.