Fat Transfer

The technique involves aspirating and collecting fat through a small diameter cannula. The harvest technique is the same as for liposuction. You can select the donor site, but it is best taken from an area of diet resistant fat such as the abdomen, hips or thighs. In BBL the liposuction is part of the shaping technique to improve the appearance of the buttocks and give a more aesthetically pleasing shape in addition to the fat grafting.

The fat aspirate is processed in a specialised collector to remove blood, oil and excess water. This leaves concentrated fat cells, which are then gently re-injected into the targeted area to increase volume and correct contour abnormalities or irregularities.

The procedure takes approximately one hour to perform, under a general anaesthetic (you will be fully unconscious). This is normally carried out as a day case, so you do not need to stay overnight in the hospital. However, if you have the fat grafting as part of another surgery you may be required to stay in hospital a little longer.

Having cosmetic surgery should be a very positive experience. Complications are infrequent and usually minor. However, all surgery is not without risk, and it is important that you are aware of possible complications. All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss them. Decisions about this surgery should never be rushed.

These risks can be divided into the those specific to the surgery and those that relate to the anaesthesia.

General Anaesthetic risks: An anaesthetic is very safe, however, should a complication arise, the relevant medical expertise is immediately available to deal with this.The risks increase if you have certain medical problems, which will be discussed at length during the consultation. The risks include:

• Unintended intraoperative awareness, which is very rare.
• Dizziness and nausea.
• Sore throat.
• Damage to teeth or mouth.
• Nerve injury due to body positioning.
• Allergic reaction or anaphylaxis.
• Malignant hyperthermia, which is a rare life-threatening condition.

The anaesthetist will go through these risks, and others, in more detail prior to your surgery.

Scars: Apart from a needle mark, like having blood taken, there will not be any scars. The scars at the donor site are approximately 3 mm in size. These are hidden in the skin crease and should be barely perceptible. However, some patients heal with noticeably thickened, thin or stretched scars.

Bruising and swelling: This is very common on both the recipient and donor sites and the bruising may take a couple of weeks to settle.

Infection: This is rare, but I prescribe a course of antibiotics after surgery to reduce the risk of any infection.

Contour irregularities: It is possible to have indentations or laxity of the skin following this procedure. Massaging the area(s) should resolve this but occasional further surgery may be required.

Fat necrosis: If some of the fat does not receive a blood supply it will die and gradually be re-absorbed. This can sometimes leave a lump that cannot be seen but can be felt. Massaging should resolve this but occasionally a procedure to remove the lump may be required.

Fat loss: Of the fat that is injected, 40% to 70% of this should ‘take’ and become permanent. The remaining fat will simply melt away (re-absorb) over the next few weeks. If at this stage, you would like more volume, this can be performed approximately 12 or more weeks later.

Fat cysts: After fat transfer, these can sometimes occur. Most cysts can be aspirated with a needle if they are problematic.

Fat embolus: This is the obstruction of blood vessels by fat droplets. Although this is rare in other locations, it has been reported around the eye or in the buttocks. The highest risk occurs in fat grafting to the buttocks, and it is specifically linked with deep fat grafting into the muscle around the large pelvic veins, which are easily torn or injured. Sadly, there are multiple reports of BBL fatalities from round the world, where it has been performed with unsafe practices and without the addition of intraoperative ultrasound to confirm the correct placement of the fat. Fat embolus is extremely uncommon if performed with safe techniques and by a surgeon who is adequately experienced. To reduce any risk, I only perform fat grating superficially and under ultrasound guidance to ensure I am not fat grafting into the muscle.

Further fat transfer procedures: These are sometimes required to give the desired result as only a certain amount of fat can be injected during one operation. If you would like more volume, this can be performed any time after 12 weeks post-surgery.

Further liposuction: This may be necessary to give the desired result. Only a certain amount of fat is removed at one operation (1 litre). However, if you wish additional liposuction, then this can be performed at the same time.

Damage to internal structures: Liposuction is performed in the superficial layer of fat underneath the skin. As the cannulas are blunt, they are very unlikely to damage any important structures. However, if there is a hernia or weakness of the abdomen, then damage may be possible; this is very unlikely.

Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE): Following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and travel to your lungs. If the blood clot is large enough, it could prove fatal.

The overall risk for cosmetic surgery is less than 1%, but to reduce any risks of a DVT/PE, you will be provided with special stockings to wear in bed together with a blood thinning injection, if you are not mobile or have previously had a DVT or PE.

All the risks outlined above will be discussed in detail at your consultation with me. However, if you have further questions or concerns, please do not hesitate to ask.

Decisions about cosmetic surgery should never be rushed.

Your incisions used for fat harvest are closed with dissolvable sutures, which do not require removal.

I use a waterproof dressing, which will be removed after one week when everything should have healed.

You can shower as soon as you like after surgery, and you will be given spare dressings in case they become wet and need changing. I do not recommend bathing or swimming for 1 week after surgery.

Usually only simple analgesia such as Tylenol and Ibuprofen are needed in the initial post-operative period.

Initially, the area injected may seem larger than you expected. This is normal and it is partly due to swelling. It takes time for everything to settle down. The volume is likely to reduce as the swelling and bruising resolves and some of the fat absorbs.

It takes approximately 12 weeks to assess the result of your surgery. If at that stage you would like more volume, this can be performed approximately 12 or more weeks later.

Before you are discharged from Hospital you will be given a follow up appointment to see the nurse after one week post-operatively.

You will not be able to drive yourself home from hospital and, ideally, you should have someone to stay with you for a few days to assist you. If you have any concerns during this period, do contact the clinic for advice.

Scar Advice
Once the dressings are removed, I recommend that you massage the incisions using small circular motions at least twice a day for 5 minutes. You can use any moisturising cream of your choice and apply firm pressure until it blanches.

The scars would also benefit from Silicone scar gel (ScarAway® or Kelo-Cote®) twice a day, which will soften and fade the scars as well as applying sunblock for 12 months to provide sun protection.

The ScarAway® can be purchased from Healthcare Pharmacy at Governors Square in Grand Cayman.

You should take things easy for the first week and most patients return to work by 1 week. You can drive from as soon as you are comfortable, which is normally between 1 to 2 weeks. Most patients return to the gym at 2 weeks, and I recommend you wear your support bra for 4 weeks.

For self-funding patients, surgical fees are a combination of the hospital costs, the surgeon and anaesthetic fees and any consumables. I do not charge an additional fee for post-op appointments. The fee is based on the surgical time rather than procedure. This means that the costs are calculated fairly, and complex patients may have higher costs than routine patients. You will be given a quotation for surgery within 48 hours of your consultation.

Fat Transfer To Body - Nicotine and Surgery

Fat Transfer To Body - Pre-Op Instructions

Fat Transfer To Body - Post-Op Instructions