The rise of the ‘natural look’

Why more subtle cosmetic procedures are in high demand

Expert Consultant Plastic Surgeon Professor Marcos Sforza, MyAesthetics explains how the demand for more natural looking results has led to a rise in lipomodelling over traditional cosmetic procedures.

What is fat transfer?

Lipomodelling (or fat transfer as it is more commonly known) takes fat from elsewhere in the body (usually the abdomen and thighs) via liposuction. This is then inserted into another area of the body to enhance its appearance. It’s best for breast and buttock augmentation and can be used in some facial procedures too.

How does it work?

You and your surgeon will select from where you want fat to be removed before a local anaesthetic is injected into the area. Your surgeon will create a small incision and using a sterile technique, carefully insert a cannula connected to a syringe to extract the fat by liposuction.

Liposuction is when fat is suctioned out through tubes as the doctor moves them around under the skin to target specific fat deposits.

After removing the fat, the surgeon purifies it by removing debris, red blood cells, stem cells and oil. Only mature fat cells are injected back into the body. Fat is injected in a thin line of droplets so the new fat cells can feed off neighbouring cells until the blood supply develops to support them.

Using their own fat cells rather than synthetic fillers means patients are less likely to experience allergies, infections, or a high rejection rate.

During the procedure, roughly 70 percent of the cells successfully become part of the new area. Due to this, surgeons must be careful not to “over-correct,” and insert more fat cells than needed, as this may cause residual lumps.

The length of time for a procedure will depend on the area being treated. For fat transfer to the face this could be around one and a half hours and to the breasts or buttocks it could take up to three hours.

Why has it become more popular?

There’s been a growing shift towards subtler and more natural looking results, especially in the case of breast augmentation, increasing the popularity of fat transfer breast augmentation procedures. Many women now only want up to one cup size bigger or simply wish to rejuvenate their breasts and give them a fuller, more youthful appearance.

Another benefit to fat transfer is that only a very fine cannula is needed to perform the treatment, so the incisions are incredibly small and usually very well hidden. Ultimately, this means anybody who is concerned about scarring will usually have better results with this technique.

Fat transfer doesn’t involve any artificial materials and many prefer the idea of using their own fat rather than a silicone implant or synthetic fillers. It is considered to have a more natural feel than silicone and saline solutions which are used to fill breast implants.

Who is a suitable candidate?

Although most patients are suitable for this technique, careful assessment is essential.

Ideal candidates for fat transfer procedures to the breasts, buttocks or face are patients who are a dress size 10 or above and desire a modest increase in size. Any smaller in dress size and there probably won’t be enough fat to harvest to make a considerable difference.

A patient’s health and relative weight are also important factors. Healthy patients simply heal better than those who are non-compliant with their nutritional intake or who are smokers.

Fat transfer is a suitable technique to resolve breast asymmetry and for medical purposes such as the correction of congenital breast abnormalities like Poland’s syndrome and tuberous breasts. Also, in many cases, it allows us to give patients a desired larger breast with smaller implants plus fat. The surgeon can sculpt the breast and also use smaller volumes of silicone what leads to less complications.

It can be used to correct minor implant issues like camouflaging ‘rippling’, which occasionally occurs after prosthetic breast augmentation.

How long does it usually last?

After about six months, the fat cells remaining should be permanently established and last a lifetime. It is important to maintain a stable weight, as fat will change naturally as your body ages.

There is the possibility that some of the fat grafted may disappear over time and the procedure may need to be repeated. There is also a chance with breast augmentation procedures, you may not get to the exact size or shape you would like using this technique, as it is difficult to predict exact sizes or measurements.

What are the potential risks or implications?

After fat transfer has taken place, bruising and swelling is usual in the area where the fat was removed. The treated areas can remain numb for several weeks – this is normal and sensation will return. You are advised to bring supportive underwear into hospital to help reduce swelling and bruising and they should be worn until the bruising settles.

Fat necrosis may occur in the breast area. This is a benign breast condition that consists of fatty tissue that has been bruised or injured and turns into a lump. Fat necrosis does not lead to the development of breast cancer, but it may sometimes cause breast pain.

One of the ways surgeons are trying to prevent this is by injecting fat in smaller aliquots. This allows a surgeon to meticulously place fat in a three-dimensional manner, so they can shape the breast rather than simply just enlarge it. This method also reduces the likelihood of other problems associated with the procedure, such as fibrosis, cyst and nodule formation.

What aftercare should be followed?

After surgery, patients may experience some discomfort for a few days. Downtime is usually minimal following either fat transfer to the body or face, however, you may notice some swelling and bruising which can take up to 1-2 weeks to subside.

A dull ache may persist in the areas that have been treated for up to 4 weeks but this can be managed easily with pain killers either your surgeon or aftercare team can provide.

Following fat transfer to the breasts, your consultant will advise wearing a support bra a few days per week after surgery and for buttocks, you will have a dressing in place for around ten days.

Where liposuction has been performed, you will most likely be required to wear a compression garment for around a month and to avoid exercise for up to two weeks following treatment.

Early wound inspection is essential to exclude post-op complications such as infection, necrosis and haematoma. A three-month assessment should be made to examine all recipients and to plan further staged procedures if necessary.