The initial goal of fat grafting, also known as lipofilling, is to treat volume losses created by disease, trauma, or aging. Fat grafting or fat injection is an outpatient procedure frequently performed to add volume and create fullness in some regions of the body and especially on the face such as cheeks, forehead, lip line, lips, jaw line, chin and periorbital region. Besides, fat injection is used to correct facial asymetries, depressed scars and surgical scars results from disease, trauma and surgical procedures. Recently fat injection is used for periorbital rejevunation and nose.
Fat graft were are harvested from patient’s own body. When determining the body part for fat graft harvested especially, waist, tummy, tights and buttocks (especially buttocks in women) ,which are the natural fat deposit area in the body, are are prefered for fat injection.
Fat injection is performed alone or combined with another surgical procedures such as liposuction, abdominoplasty or nose surgery . A fat injection procedure is performed under local anesthesia and sedation or alone local anesthesia. Fat injection is a procedure that does not require hospitalization. Several hours after the surgery patient can go home.
Fat injections or fat grafting involve harvesting fat from one part of body with special canulas and then injecting them into another part of your body with fine canulas after several steps like washing , extracting and concentrating to a certain level, Also, it is a procedure without scar because incisions are very small. Following the procedures a light dressing was applied to prevent swelling. It is removed in 2 days.
Recently, for delcate areas such as eyelids, periorbital areas and lips, smaller injection cannulas is used. Fat injection with cannulas as small as 0.7 mm in diamater is known as microfat grafting. For these indication, fat is harvested with small-hole cannulas to obtain a lipoaspirate with smaller fat particules. This fat graft were injected very superficial level of skin ( deep dermal layer) with fine needle. It is called microfat grating and is used for treatment of fine rhytides in face.
Nanofat grating is more refined technique for treatment of fine rhytides. In nanofat grafting, to work even more superficially with still finer sharp needles , the harvested fat was mechanically emulsified and filtered until liquid suspension was obtained. With nanofat grafting sun damaged skin at decolletage with fan-shaped rhytides , lower eyelid blepharochalasis and dark coloration of the lower eyelids skin and perioral upper lid rhytides were treated.We use nanofat gratfing for these purposes.
Immediately after fat injection cold compress is suggested to reduce swelling. Cold compress can be applied by cold packs or ice bags every hour for 15 minutes . Cold pack carefully wrapped in a towel or a fabric can be placed directly on the skin otherwise skin irritation may occur.
Typically, the very first days swelling may cause little discomfort after fat injectetion. This will dissipate gradually. Fat grafting gives minimal discomfort that can be controlled with medication. Patient should have a rest to manage potential swelling and bruising in some areas. Little bands or strips placed on the injection sites are removed the following day . As a precaution antibiotics is prescribed just for 5 days.
You will see the result immidiately after lipofilling, however, in the early stage, the area may look raised more than you expect, because in addition to the nature of fat injection eudema or swelling which is common, affects the post-operative look . But after several days swelling will gradually dissipates, decreases and ends. However, if fat grafting is made on the lips the swelling may prolong and sometimes overly swelling may be experienced.
The area can be washed the following day and moisturizer can be spreaded. To prevent swelling you should avoid extreme hot and steam exposure.
Lipofilling results are permanent. Certaian part of injected fat is absorbed. Absorbation ratio may range between 30-70%. Secondary injections may be necessary because some of the injected fat is absorbed in the body and then it is broken up. The absorbation ratio varies depending upon the region whether it is mobile or not. Fat lasts longer on the fixed areas like forehead, cheek or chin rather than mobile areas like lips or perioral area. Final result of fat injection can bee seen at the end of the 3 months. In other word if you need a second injection it is better to wait for 3 months between thw injections.
Prof. Dr. Muhitdin Eski
Face Surgery
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