Fat transfer—also referred to as fat injections, fat grafting, or lipofilling—is a very common procedure that has been around in plastic surgery for decades and has become one of the most important adjuncts to many face and body treatments performed today. With aging, we all develop tissue sagging and some “deflation” in our faces (especially in the central third of the face and around the mouth) or other delicate areas of the body due to losing fat, collagen, and even bone. Fat grafting involves taking fat from one part of the body, purifying it, and then reinjecting it into another targeted treatment area. The areas of the face that are most common for fat injections are the lips, nasolabial folds (smile lines), corners of the mouth, chin, vertical lip lines (also known as smoker’s lines), and under the eyes. In addition, fat grafting can be an excellent option for rejuvenating the backs of the hands and even the décolleté area of the upper chest and lower neck region.
Dr. James F. Boynton performs fat grafting in the office or in surgery, depending on the complexity, volumes, and areas being addressed. This state-of-the-art technique provides a means for restoring a youthful facial appearance that cannot be accomplished by way of traditional facial cosmetic surgery techniques, which have focused primarily on skin excision and tightening in the past. For this reason, Dr. Boynton frequently performs fat transfer in combination with other facial procedures, such as facelift and/or eyelid surgery.
To learn more about this innovative cosmetic treatment, please explore the detailed information provided throughout this page. If you have any questions, or if you are interested in scheduling a consultation to find out if fat transfer can help you achieve your aesthetic goals, please contact Boynton Plastic Surgery today.
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The Evolution of Fat Transfer
Fat transfer in general has been around for more than three decades. Plastic surgeons have known scientifically for many years that fat cells can be removed (by various liposuction-style techniques) and transferred to another part of the body where they then “take up” a blood supply and live in the new location without rejection from the body. Historically, conventional fat transfers to the face of the 1980s and even 1990s could lead to areas of “lumpiness” and “puffiness” because of overfilling of fat to areas (such as the cheeks) in combination with the larger particle size of the fat and larger cannulas/surgical instrumentation. Now, however, newer technologies, improved processing techniques, and finer cannulas and surgical instrumentation in the last few years has allowed for exciting breakthroughs with small-particle fat transfer—namely, microfat and nanofat injections.
Dr. Boynton believes the ability to obtain and inject microfat and nanofat has been a very important and exciting development for enhanced results and improved success with fat transfer to the face and hands, in particular. This has virtually eliminated concerns for lumpiness that was common with large-particle fat grafting (or “yesterday’s fat transfer to the face”). In fact, nanofat is broken down and emulsified to such a tiny particle that it really does not even impart any volume (no actual viable fat cells) to the area of transfer. Instead, it imparts stem cell and growth factors directly into the dermis of the skin, which Dr. Boynton believes imparts rejuvenation and skin improvements to the region for a more youthful appearance.
Types of Fat Used for Fat Injections
There are three “types” of fat used for fat grafting: macrofat, microfat, and nanofat. Historically, macrofat was utilized for virtually all fat grafting procedures. Now, however, the technology is available to stratify fat by “particle size.” As a result, macrofat is mainly employed for the augmentation and/or enhancement of regions like the buttocks, breasts, and other larger body areas. (For example, macrofat can be injected into the breasts to help disguise potential ripple lines from an implant for a patient who is quite thin.) Contrarily, microfat and nanofat consist of smaller fat particle sizes, enabling them to be injected into more delicate areas of the body—i.e. the face or hands—without concern for the “lumpiness” that may occur when larger fat particles are injected via bigger instruments. In fact, most of the facelift, neck lift, and/or hand rejuvenation procedures Dr. Boynton performs have some component of microfat or nanofat injections done concurrently to further improve results.
Obtaining Microfat and Nanofat for Fat Transfer
To obtain microfat and nanofat, a patient’s own fat tissue is first harvested from a donor area, such as the hips, abdomen, or back. Once collected, a special centrifuge is utilized to isolate a concentrated graft of healthy, usable fat cells—a process that Dr. Boynton believes helps significantly improve the survival rate of transferred fat. Next, the isolated fat is passed through a sequential series of three separate devices designed to break down the size of the fat particles until microfat or nanofat is achieved. (The difference between the two is that nanofat is filtered through an ultra-fine mesh.)
Once obtained, this all-natural microfat or nanofat is then reinjected into targeted treatment areas using very fine injection cannulas to rejuvenate, smooth, and/or volumize the skin with exceptionally natural-looking results.
Fat Grafting with Microfat
Due to its smaller particle size compared to conventional macrofat, microfat injections can be an excellent option for restoring lost volume and/or improving contour in areas that require absolute delicacy and precision, such as the:
- Hollows underneath the eyes
- Backside of the hands
As an added benefit for many patients, the volumizing effects of microfat transfer in these areas can often help improve the appearance of overlying skin.
Fat Grafting with Nanofat
Nanofat particles are too small to provide a notable “volumizing” effect, but studies suggest that the stem cells present in nanofat help to rebuild dermal support structures—such as collagen—and regenerate healthier, more youthful-appearing skin. As a result, some of the most common aesthetic skin concerns that can be improved with nanofat grafting include:
- Fine lines
- Texture irregularities
- Discoloration (under the eyes, for example)
- Sun damage
- Poor elasticity
- Superficial scarring
Currently, Dr. Boynton uses nanofat transfer in the face and backs of the hands, as these areas have responded particularly well to nanofat injections.
The Potential Stem Cell Effect of Nanofat
It is scientifically proven that stem cells reside in high concentrations in fat, and there is much anecdotal experience to suggest that these stem cells are what “helps” with skin quality enhancement and rejuvenation, scar improvements, resolution of dark under-eye circles, tissue healing, etc. To date, no scientist has demonstrated an objective, quantitative method for measuring any “stem cell effect” in facial rejuvenation surgery, if it is indeed present. However, based on his own experience—as well as that of nanofat technology pioneers Drs. Sydney Coleman, Steven Cohen, and Patrick Tonnard—Dr. Boynton believes that a positive stem cell effect truly exists, which potentially explains why an improvement is seen with nanofat even when the injections are not adding volume. A great deal of basic science research is currently being conducted, so a clearer understanding of the healing properties of fatty tissue and stem cells should evolve in the next few years.
Candidates for Fat Grafting
Ideal candidates for fat grafting procedures are typically individuals who are in reasonably good general health and are considering options that can effectively rejuvenate the skin with long-lasting results. Women and men who are interested in this treatment must also have enough excess fat cells in the donor area to allow Dr. Boynton to extract an adequate amount for transfer to the areas targeted for rejuvenation. In many cases, the hips, abdomen, or back offer good areas for liposuction of the fat cells; however, other areas may be considered as well. During your initial consultation, Dr. Boynton will evaluate your needs and talk with you about the best options for your goals. If fat grafting is a good option for you, Dr. Boynton can create a customized treatment plan designed to provide you with excellent results. If you are not a candidate for this procedure, Dr. Boynton will be happy to talk with you about alternative options that can help you achieve successful cosmetic enhancement.
Fat Transfer vs. Dermal Fillers
Both fat transfer procedures and injectable dermal fillers – such as JUVÉDERM®, Restylane®, and many others – offer effective methods of rejuvenating, smoothing, and volumizing the skin; however, there are some key differences in these two types of treatment options that can make one more beneficial than the other in certain cases. For example: the results from fat grafting treatment are known to last quite a bit longer than most dermal fillers can achieve, which reduces the need for periodic “touch-up” treatments over time in order to maintain the effects. Fat injections may also be a more ideal option for patients who have larger areas of volumization they would like to address. That said, fat grafting does involve a more invasive approach than dermal fillers. With fat grafting, liposuction must be performed on another area of the body to harvest the fat cells; with dermal fillers, no surgical step is required since the treatment only involves injections of the filler solution. Dermal filler treatments also typically do not necessitate a recovery process, whereas fat grafting procedures often require a brief recovery period for the regions where liposuction was performed.
The best treatment option for you will be determined at your initial consultation and based on your unique needs and expectations. Dr. Boynton will talk with you about all aspects of fat grafting and help you decide whether fat injections, dermal fillers, or another option may be the most ideal for your goals.
SNIF Technique for Lines Around the Mouth
SNIF (Sharp Needle Intradermal Fat grafting) is a technique pioneered by Dr. Patrick Tonnard that involves injecting microfat and nanofat directly into the fine creases around the mouth—in a similar way to conventional fillers. Dr. Boynton is very proud to have had the opportunity to learn this technique from Dr. Tonnard and work with him personally. This is particularly helpful for diminishing vertical lip lines (smoker’s lines), which have traditionally been some of the most difficult facial lines to treat.
Combining Facelift with Fat Transfer
With the growing understanding that specific “compartments” of the face lose fat with aging, adding fat back into certain areas via fat injections has become an important part of facial rejuvenation—particularly during facelift surgery. On its own, a facelift essentially lifts and “resuspends” tissues to correct drooping. Because fat grafting adds volume in places not “fixed” by the tissue lifting (as well as imparts some stem cell rejuvenative effects onto the skin that further heighten the results), it creates a synergistic result that exceeds what a facelift alone can ever achieve. In Dr. Boynton’s experience, fat transfer in conjunction with a facelift—whether done at the same time or sequentially—can absolutely improve and potentiate facelift outcomes.
Recovery After Fat Transfer
Immediately following fat transfer, there may be some degree of swelling, bruising, and/or soreness in both the donor and recipient treatment areas. These side effects are temporary and should diminish gradually as time passes until fully resolved. The majority of Dr. Boynton’s patients are able to return to non-strenuous daily routines like office jobs, school, and running errands within a few days (up to a week depending on the degree of swelling), though more physical actions and activities will need to be avoided for longer. This includes vigorous exercise, heavy lifting, and contact sports, all of which may have a negative effect on the final outcome if resumed before healing is complete.
Ultimately, the exact recovery timeline and details will depend on your individualized treatment plan and unique healing process. At the time of your consultation, Dr. Boynton can provide a more personalized idea of what to expect after fat transfer.
Results from Fat Transfer with Microfat and Nanofat
Generally speaking, women and men seeking cosmetic treatment want to look better and more youthful—not puffy and overly “full” in the face or hands. The latter appearance is a stigma of fat injections in the 1990s, when too much volume was often placed using less precise and fine instrumentation. This typically led to overfilling and lumpiness, which can be particularly difficult to eradicate (one of the main reasons Dr. Boynton always tells patients it is better to undertreat with fat than overtreat). Fortunately, the newer techniques of utilizing microfat and nanofat injections allow for incredibly natural-looking rejuvenation.
The rejuvenative results achieved with microfat and/or nanofat injections are generally very long-lasting. While about 30–40% of the harvested cells may be reabsorbed by the body when fat is reinjected, the remaining fat cells take root in their new location, obtain a blood supply, and become a permanent “filler” in that particular area. Due to this natural reabsorption, a second “session” of fat transfer may be necessary to achieve an ideal contour improvement—often with less fat than the first time. This is done at least six months after the initial treatment, and continual retreatment thereafter is typically not necessary for most patients.
Cost of Fat Transfer
When performed in-office, the average cost of fat transfer starts at approximately $5,950 and upwards for microfat and state-of-the-art nanofat injections to the face and about $3,500 and upwards for the hands. Exact pricing for fat injections varies from patient to patient based on several factors. Some of the most common elements that can influence the total cost of treatment include:
- The specific concerns you wish to address
- The quantity of fat needed for transfer
- How many treatments sessions are necessary
- Whether treatment is performed in-office or in a surgical setting
- Whether treatment is combined with another procedure
- The experience and skill of the plastic surgeon
Dr. Boynton can provide a personalized price quote for fat grafting after conducting a thorough physical examination and discussing your unique needs and goals at the time of the consultation. In the event you are interested in financing, a member of our team can also introduce you to several payment plan options available through CareCredit® that can help break the expense of treatment into more budget-friendly installments.
Schedule a Fat Grafting Consultation
Microfat injections, nanofat grafting, and the revolutionary SNIF technique all require specialized training and surgical instruments, as well as patience, finesse, and attention to detail on the part of the plastic surgeon. When these procedures are performed properly, lasting and natural-appearing improvements to the treatment area(s) are possible.
To learn more about fat transfer, or if you would like to schedule a consultation with Dr. Boynton, please contact our practice online or via phone today.