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Fat transfer for treatment of wrincles in the face

© Peter Atkins -

Although the popularity of fat transplantation is a relatively recent development in plastic surgery, the concept of fat transfer is not new. As early as 1893, free fat autografts were used to fill a soft tissue defect. The use of autogenous abdominal fat to correct deficits in the malar area and chin was reported in 1909. Throughout the early part of the 20th century, attempts were made to correct hemifacial atrophy and breasts defects but grafting did not develop until the 1980s with the popularity of liposuction.

An ideal substance should be readily available, inexpensive, long lasting, natural feeling, and would not cause adverse immunologic reactions. Autologous tissue meets these requirements. Fat can be harvested through inconspicuous stab incisions. The harvesting does not leave a defect, and the removal of fat is often desirable. Fat tissue is soft and feels natural. It can be introduced to correct a variety of deficiencies, it is not immunogenic, and it is readily available and inexpensive. Autologous fat transfer has been used for correction of facial scarring, including acne scars. Enhancement of facial volume also can be achieved for disease processes such as hemifacial atrophy and for patients with aesthetic concerns. Signs of facial aging also can be improved. This procedure can be performed on an outpatient basis with local anesthesia.

Aging and scarring result in loss of subcutaneous tissue. Indications for fat grafting include correction of atrophy due to aging or scarring and enhancement of facial elements and the filling of defects for exemple after a local trauma. The most important principle in the surgical management is the atraumatic transfer of fat. Trauma to fat  in the process of harvesting or placing fat affects the survival of the graft. Fat transfer should occur at the time of harvest. Although fat cells are cultured experimentally, viability decreases over time. This will adversely affect the survival of fat, thus the volumetric result.

The major complications of fat grafting can be undercorrection and overcorrection. Undercorrection  can be result of the placement of less than the required amount of fat or from the resorption of some of the graft. Although placing too little fat obviously fails to correct the defect, increasing the amount of injected fat does not always prevent problems. Placing too much fat in a particular area can contribute to failure of revascularization of the graft. Edema usually can be evident for 1 week after the procedure.

Bleeding complications usually are rare. Althrough rare, infections can occur wherever the skin envelope is violated.

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Be careful

Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion or motion during the time of healing. Dr. Michel will give you specific instructions on how to care for yourself. Additionally it is of major importance to comply with the rules of the follow up intervals.

Costs of your operation

As aesthetic and reconstructive surgery is always a very individual procedure the costs can vary widely according to the extent of the operation. A concrete price note can be given with the first appointment.


If financing is desired the best is to contact your bank. German institutions financing beauty procedures might be available too.