Fat Injection
Q:
Is it possible to get fat injections to the lower half of the legs? I look like I have chicken legs - my thighs have all of the meat and the lower half of my legs are boney. It is very embarrassing and I hate wearing anything that exposes my legs. Please advise.
A:
Autologous fat transposition to the legs and ankles is a useful procedure. On average you can get 1 inch of circumferential increase and additional amounts can be injected later. Although only a fraction of the injected fat survives, it is for life and it does not have any untowards effect on the body. It can grow when people put on weight, and it shrinks when people lose weight just as any other fatty layer. The author has not witnessed any circulation difficulties.
Q:
I am 48 yrs old, very thin and petite weighing only 118 pounds. I have very thin legs and no buttocks. I am looking into fat injections or something other than implants to give me a more feminine rear. What are my options?
A:
The procedure of fat injections from another area of the body into the buttocks is producing acceptable results, although to a limited extent. You should schedule a consultation with a plastic surgeon that will examine you and assess your actual situation.
Q:
I would like to have larger breasts but do not want breast implants. Is it possible to take fat from another place in your body (such as the buttocks) and place these fat cells in the breasts to increase the breast size?
A:
Breast enlargement with fat injections is definitely not recommended. Fat injections into the breast will lead to some fat necrosis. The fat necrosis in turn will lead to microcalcifications. These microcalcifications can appear similar, on a mammogram, to the signs of breast cancer, necessitating a biopsy procedure to rule out the possibility of cancer.
There is another way to enlarge the breasts called the BRAVA method. In this method you wear a suction apparatus that looks like a bra. If you wear this for several months, it may increase the size of your breast by one size. However, not all patients have had success with this device.
Q:
Is there anything that can be done, cosmetically, for the deep grooves in my shoulders from the weight of a bra supporting large breasts? I do not want to undergo breast reduction.
A:
Grooves on the shoulders can be helped with fat injections if the patient does not want breast reduction.
Q:
I have a heart-shaped face and have a nice, delicate chin but I would like to have a slightly fuller look to my chin to achieve a more oval shaped face -- without surgery. Would Restylane injections help me achieve this look and how long would the results last?
A:
In my practice, I have used Restylane only for the treatment of fine lines and wrinkles, not for facial augmentation. It sounds like a chin implant combined with fat injections may serve you best. Results of a chin implant are, of course, permanent as long as the chin implant is in place; the longevity of fat injections depends on how quickly the body reabsorbs the fat -- I would predict 3 months to a year.
Q:
Can the fat injection procedure be used to enlarge the buttocks? If not, are there any procedures available for this?
A:
Fat injection to enlarge the buttocks, in my opinion, is not a reliable procedure. The fat may dissolve in a relatively short period of time. I believe that there is the potential for lumps of scar tissue that could be removed only by a surgical procedure. Implants placed in the buttocks have a higher complication rate than many other cosmetic procedures, so I personally am not a proponent of this procedure.
Q:
I'm considering fat injections around my lips and have heard from various sources that a) the fat can be frozen after removal to be used for subsequent injections as needed over the following months, or b) the fat cannot be frozen and remain useful, and only fresh cells used immediately are worth injecting. There is a substantial difference in cost and discomfort between these two methods, but, most importantly, I would like to know which statement is, in fact, true. Are frozen fat cells useful or not? If they are, is there any benefit at all to repeating the procedure each time to withdraw fresh cells?
A:
To my knowledge, the scientific facts surrounding this question have not been definitively answered. Theoretically, it may be true that preserved fat cells remain viable; however, it is likely that time diminishes their efficacy. From a practical standpoint, I doubt that there is much
difference in the cost of the surgery using freshly harvested fat versus stored fat, because of the added cost of providing fat storage under temperature-controlled conditions. Most patients could not tolerate the procedure of replanting the fat cells into the face without some type of anesthetic, so the issue of discomfort is really moot.
Q:
I am unsatisfied with the shape of my face. I feel it is too thin. I was wondering if fat injections would give me a fuller look. Also, I have an under-bite and wanted that corrected. Would it be possible to do both of these procedures at the same time?
A:
Yes, fat injections can be used to plump up a thin face. There are also facial implants available for augmenting the cheeks, the chin, the area below the cheeks, the temple area, and the side of the jaw bone or mandible. A qualified plastic surgeon can examine your face and determine which would be best for you. Your under-bite may be corrected at the same time but the type of correction also depends on the extent of your "under-bite." Again I suggest that you consult with a board-certified plastic surgeon.
Q:
I am 32, 5'8" and 130 pounds. I am thin, but my face still makes me look overweight. My weight can fluctuate up to 145 pounds in the morning, all of which appears to gather in my face and neck. I do not have any medical problems (and have had tests to determine this). I am considering having the fat from my cheeks and neck removed because no matter how much weight I lose my face appears "heavy" and "round," a problem I only began to notice over the past 4 years. Does removing fat from the face and neck stop weight from re-depositing in these areas and does it usually result in a more contoured and thinner appearance that is permanent? Is there a better procedure for this type of problem?
A:
Your weight fluctuation sounds a bit unusual and may be related to medications you took or are taking. I recently did a facelift and sculpting on a patient who was on steroids for many years with very good results. Liposuction of the neck and jaw line may also help but liposuction in the
face is not something I would do.
Q:
I am 29 years old and am considering fat injections for my face. I have high cheekbones and began to notice that my face is not as full-looking as it used to be. I tried gaining weight but my face is still sunken in. My question is, will fat injections help my sunken-in face?
A:
Loss of facial volume or sagging of the face is common with aging. Treatment options to restore the face include fat injections, cheek implants, or a facelift. At the age of 29, it is doubtful a facelift would be indicated for you, but cheek implants may improve the fullness of your face. The risks of cheek implants include the possibility that the implants could become infected or could move out of position. However, the disadvantage of fat injections is that the fat has a tendency to be dissolved by the body over time, thereby losing the desired volume change. The success of fat injections is very dependent on the techniques used to take the fat from another area of the body and then to inject it. I would suggest you consult with a member of the American Society for Aesthetic Plastic Surgery to see if you are candidate for any of these procedures.
Q:
I am wondering why one's own body fat can't be used for breast enlargement?
A:
Many people ask if plastic surgeons can use the fat obtained from liposuction to enlarge or fill other areas of the body. We often use this fat in the face, but usually in relatively small amounts. Occasionally, fat is injected into areas of contour irregularity in other parts of the body. Again, however, the volume used is relatively small. The problem with using the fat in the breast is that it would require a large volume. This makes it difficult for the fat to get a blood supply from the surrounding tissue and actually "live." The fat may then fibrose, or turn into scar tissue, which can form lumps and sometimes calcify. This makes the examination of the breasts for malignant tumors difficult. So, interference with the detection of possible breast tumors is a major deterrent from using suctioned fat in the breast area. Living fat, based on some sort of blood supply or piece of living tissue or muscle, is often used, however, for breast reconstruction after mastectomy or other reconstructive surgery. These are called flap reconstructions, involve major surgery , and are not usually used for breast augmentation alone.
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