– aesthetic and reconstructive.
The excess fat in the 
body is often viewed as unhealthy deposit that will distort the anatomy of the body making it disproportionate. In desperation the affected person would often seek medical solutions to get rid of these unsightly deposits so that a desirable body shape and contour can be achieved and maintained. Only recently, plastic surgeons have found a remarkable way to utilise the fat by transferring it to deficient parts of the body to augment any contour defects.
Now, in extensive use, reconstructive surgeries transfer the fat cells, which contains stem cells, to regenerate soft tissues and initiate new blood supplies. This will then improve the quality of the atrophic soft tissues and skin. Sagging skin and wrinkles distorting the facial features can be improved by plumbing up the depressed contours thus making the patient looking younger with smoother and taunt facial skin. In addition the stem cell transfer in this procedure will also improve the quality of the soft tissues and hopefully maintain the structures for a longer time. It has also been extensively used for aesthetic breast enhancement surgery where the patient’s own fat is used to build up the breasts. In reconstructive breast surgeries, the fat can be used to build up distorted breasts after lumpectomy, mastectomy or following post- mastectomy breast reconstructions. They will also improve the quality of skin and soft tissues after radiation.
Fat from where?
We have a lot of fat distributed all over the body but most commonly, they are located in the abdomen, waist, thighs, buttocks, arms and back.
Normally the fat is harvested from the abdomen, waist and thighs for the autologous fat transfer. For small areas like the face, the amount needed is small and a small cannula with a syringe can be used to remove the fat manually.
Breast. For the larger areas like the breasts, we normally use the Water Jet or Vaser Liposuction to remove the fat. After washing and filtering, we use the fat to transfer it into the large areas below and above the breast but not into the breast tissues. This will then pick up the blood supplies and survive to provide the bulk for enhancement.
For patients who want to increase the breast to larger sizes, a few sessions of fat transfers would be required. Some of the transferred fat would not survive but whatever that survived will be permanent. It must be stressed that the transferred fat will take a while to pick up the blood supply, survive and then bloom to provide the bulk. It may take a few months.
Buttock. The fat has also been extensively used for buttock enhancement where patients want to have their sagging buttocks filled and perked up. The results are encouraging. It has also been used to fill up the contour defects after extensive removal of the soft tissues in tumours or in areas injected with silicone by non-medical personnels in the past. This silicone granuloma if not removed will distort the body anatomy, cause inflammation and for some may result in soft tissue cancers.
Face. For the face, the fat graft will raise wrinkled and sunken areas of the face thus adding fullness to the naso-labial folds, sunken cheeks and lips. Excessive and aggressive grafting may lead to unwanted fullness and distorted contours.
Side effects
This procedure can be repeated as many times as possible. There are very few side effects like swelling, bruising and discomfort in the areas where the fat is harvested and also in the recipient site. A small puncture wound is required to remove the fat. There is a slim possibility of infections or allergic reactions. There is little downtime and patient’s satisfaction is high.
Overall benefits
Autologous fat grafting procedure is now increasingly used in aesthetic and reconstructive procedure to enhance the body contours and defects. It is using the body’s own tissue and there is no rejection of these tissues. This procedure can also be repeated. It is permanent and will be naturally incorporated into the body. As the transplanted fat graft also contains some stem cells, it will help to improve the circulation and quality of the recipient site. It has also been increasingly used by other surgical disciplines as its potential as a beneficial donor are being realised.
Dr Yeap Choong Lieng Plastic Surgeon Dr Yeap Choong Lieng is a graduate of the Medical College of the University of Singapore. He was Consultant Plastic Surgeon and Deputy Head of the Department of Plastic Surgery at the Singapore General Hospital , until he resigned to start his private practice at the Mount Elizabeth Medical Centre/ Hospital. Dr Yeap actively keeps pace with the latest developments in the field of Aesthetic Surgery and goes on yearly teaching trips to under-developed countries to educate surgeons on reconstructive surgeries. www.dryeapplasticsurgery.sg