Q. Where do you get the fat from?
- The donor site is usually the abdomen, but the thighs work well too. Sometimes patients ask if the fat pad under the chin can be used. Usually this site is not used because it's hard to get enough fat from this small area. In very thin patients, I tend to use the outer thighs. There is almost always extra fat in these areas.
Q. How long does it last?
- Plastic surgeons do not have a good answer for that question. We know that the injected fat can develop a new blood supply and survive in its new
"home." The percentage of take is variable. At least some of the fat is absorbed. This typically happens within the first month after surgery. Plastic surgeons compensate for this absorption by over-injecting slightly, because we are counting on losing some fat to absorption by the body. Some patients seem to keep virtually all their fat (see K.M.) and some do seem to lose almost all the fat that is injected. The majority of patients fall in between. They will lose some of the fat but keep some too. This is the big advantage over temporary fillers which will completely dissolve within a year.
Q. Will I bruise?
- Yes, you will likely have bruising.
Q. Do you inject it with a needle, like JuvédermTM?
- No, it's actually a small "cannula," like a mini-liposuction cannula. If a needle is used, there may be more trauma to the fat cells. That is why we use cannulas. A small incision is made at each of the injection sites. The incisions are closed with a single, small suture.
Q. After injection, can the fat move around?
- No. When the fat is injected in little tunnels under the skin, it really cannot move around. Little clumps of fat form and are held in these compartments. Accordingly, the surgeon is careful to place the fat just where it is needed. Although some operators make numerous passes with the cannula, I try to limit them so that the fat does not have other paths to follow. I think limiting passes also helps reduce swelling because there is less tissue trauma.
Q. When will I be comfortable in public? I don't want to look like Goldie Hawn did in the movie
"First Wives Club."
- The answer depends on the amount of swelling and bruising, how much fat is injected, and your comfort level about looking a little swollen. Most patients are pretty self-conscious about their appearance the week after the injection. It is helpful for prospective patients to look at photographs of other patients at various times after surgery and decide for themselves when they think the appearance is acceptable, keeping in mind that you may swell and bruise differently.
Q. I'm nervous about having my lips enlarged. How can I be sure they are not too big afterward?
- Patients don't want to look ridiculous afterward. A good understanding with the surgeon is the key. Before surgery, many patients worry that their lips will be too big. After the fat injection, patients are worried that the fullness will go away! Lip augmentation does not have to be
"all or none." The surgeon may inject a small volume of fat in the patient who wants to be conservative and more in the patient who desires more volume.
Q. Do you do fat injection in men's lips?
- Yes. Men do not need to have thin, old-looking lips either. Frequently when I perform other facial cosmetic procedures in men (see patient D.C.), I will inject a small amount of
fat in the lips simultaneously.