Fat grafting is proving to be a novel procedure for sculpting previously neglected areas of the body — shoulders, pectorals, legs and stomachs — to create definition.
That was one of the topics of a panel discussion presented at The Aesthetic Meeting, the annual conference of the American Society for Aesthetic Plastic Surgery (ASAPS), held May 14 to 19, 2015, in Montreal. Panel members offered their views on the fast-evolving practice of fat grafting and how surgeons are discovering best practices to produce the most natural-looking results.
“Fat grafting is a relatively new way to literally sculpt the body, and it is revolutionizing plastic surgery,” panelist Constantino Mendieta, M.D., says. “A patient’s own body tissue is used, so there is no chance of rejection. Further, there is a lot of flexibility with using fat to contour the overall body shape because fat takes on the physiologic component of whatever it is adjacent to. If you inject fat near bone, it takes on the characteristics of bone, and the same applies to muscle.”
That’s according to an ASAPS news release that followed the meeting.
According to the release, the panel discussed how fat grafting and implantation, usually thought of as separate procedures — the former for contouring and reshaping, the latter for augmentation — can work together well, especially when a patient seeks a dramatic augmentation that neither procedure can effectively create alone.
“The fat can help to create a natural look around the edges of the implants or when replacing larger implants with smaller ones and the pocket size inevitably changes,” panelist Ashkan Ghavami, M.D., explains. “It is a solid option for smoothing out and contouring the breast with implants, and should be tailored to the individual patient. It can also accompany a breast lift.”
Dr. Mendieta says he recommends a 10- to 15-pound weight gain for patients who don’t have enough extractable body fat for grafting. Patients who can’t gain weight should be limited to implants, he adds.
There are other limiting factors, according to Dr. Ghavami, including bone structure, the quality of the skin itself and the extent to which a patient’s tissue can be stretched. “Additionally, too much fat in a particular area can cause it to rupture and explode the surrounding ligament borders, so there is no need for excessive large volume of body fat transfers in everyone. As with breast implants, volume has to match each patient’s tissues.”
The panel also stressed that patients must have realistic expectations of what can be achieved using these procedures.