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Fat Transfer

(Lipo-Transplantation)

Dr. Zemplenyi offers augmentation of soft tissue of the face (cheeks, temples, around the eyes, nasolabial folds, etc) with patient's own fat, especially when such adipose tissue is available during liposuction. Fat augmentation may also be performed as a separate procedure, especially when a larger volumes of soft tissue augmentation and filling are needed. In many patients persistence of a portion of the transplanted fat may be achieved following several, sequential sessions of fat transfer.

Since the advent of liposuction in the early 1980's numerous physicians have been using harvested fat for augmentation of soft tissue defects and volumetric filling. Fat transfer is an appealing concept because patients tend to have a sufficient amount of their own fatty tissue in the donor sites (abdomen, hips, buttocks) to allow for transfer injection of larger volume. Thus it is possible to achieve three-dimensional volumetric filling and correction of gravity sagging and age-related volume loss in facial structures such as the cheeks. Persistence and duration of transferred volume of fat has been relative unpredictable. Only a portion of the transferred  fat cells  survive and continue to be viable in the new recipient site. Survival of transplanted fat cells depends on multiple factors such as the gentleness of harvesting at the donor site and the micro-injection technique used to build the volume in the recipient site. Survival of the fat is dependent on the volume of transplanted fat injected into each created small tunnel, purity of the fat with absence of free oil or blood, and depth of placement of the fat into the underlying muscle versus the normal fatty layer. Adjunctive substances such as platelet-rich plasma may be used in an attempt to enhance survival of the harvested fat. Currently Dr. Zemplenyi uses Selphyl (platelet-rich plasma matrix gel) to improve the results of fat transfer. Fat transfer augmentation may be performed as a separate procedure both under local anesthesia or with sedation "twilight sleep", especially in patients who require a large volume of filling as this technique bypasses the high cost and limited volume encountered when commercially available volumetric fillers such Radiesse or Sculptra are used.

Using techniques for optimization of fat transplant survival Dr. Zemplenyi has patients in whom the volume restored by the transplanted fat appears to very long lasting if not permanent. However, the  durability of transplanted fat cannot be fully predicted. Thus, in patients needing smaller volumes of correction, Dr. Zemplenyi recommends other fillers (please see the section on injectable fillers under the Non-surgical procedures).