Posted on June 13, 2021
By: Dr. Asaf Yalif
When suburban Atlanta women come to our offices in Atlanta or Alpharetta for body contouring consultations, we always discuss what to do with the fat that we remove. Whether as part of mommy makeover or as a primary procedure like a Brazilian Butt Lift (BBL) fat grafting has become a really useful tool. Today we discuss who is a reasonable candidate for fat transfer and if it may be right for you.
We all have deposits of fat throughout our body that can be harvested. This can be done by direct excision, or more commonly with liposuction. As soon as they are removed from the body they begin to die, but if we put them back into the body, in a new location, they may survive, similar to how a skin graft survives. First the surrounding area will give some nutrients to the fat, and over time the fat will “take” and reestablish its blood supply and become permanent. Now this is not a guaranteed phenomenon, but it is the science behind the BBL. That means that if we inject fat throughout an area that has reasonable blood flow and is healthy a good amount of the fat injected can be expected to survive.
It depends on what you are trying to achieve and on your size and shape. Traditionally we say – If we are trying to do a BBL, we need a lot of fat to really change the contour. That is not as true as you would think if the goal is to create curves and shape, not just bulk. Not everyone needs a ginormous BBL!
If you are petite, sometimes the combination of the liposuction to the lower back and belly in addition to a more modest fat transfer can really change your curves. Remember, as we remove fat from one area, that area will tighten up and become smaller, creating a counterbalance to the buttock, making it appear even more dramatic.
What this means is that you do NOT need to gain or lose weight for a BBL. What you need to do is be weight stable. If you are weight stable then whatever we take out will hopefully be enough to create the curves you want without you having to alter your whole life for months gaining/losing to have enough fat to transfer. Think about it, if you are weight stable and we take 500 cc out of your belly and move it to your bottom then your body still has the correct proportion of fat, so the areas lipo’ed will not gain more fat to compensate. Or imagine if you gained 10 lb.’s to have enough fat to transfer, had the procedure, and then lost 10 lb.’s to get back to your normal weight. The fat that you just grew and transferred will shrink too!
So please, don’t go eating extra extra to make a better booty, just get to a weight where you are happy and then we can see if that weight is amenable to a look you want. If not, then we can have a reasonable discussion about if fat transfer may not be the best option for you or how to get the desired contour.
There are many different types of fat, and there is also fat that is we can’t get to. This means that while you may have deposits of fat in places you don’t like, we may not be able to utilize them for grafting purposes. I.e. – there is fat below the skin that is easily accessible but then there is also fat around your organs, which we can’t harvest!
100% of the transferred fat will not survive. Anywhere from 50-70% is expected to survive. That means that some of the fat will go away. We may need to address that with another round of fat grafting to achieve the desired contour.
No board certified plastic surgeon should inject fat into the buttock muscles anymore, as the risk of significant injury from fat embolism can’t be ignored (where fat gets into a blood vessel and clogs an artery or vein). We now inject only in the subcutaneous plane to mitigate that risk.
Other risks that are far more common include contour irregularities where the fat doesn’t survive and desire for more fullness, meaning that we may have to perform the procedure more than once to achieve the look you want.
Recovery from fat grafting requires wearing a compression garment for the area where we harvested the fat from while at the same time allowing the area where we put the fat into to swell. Initially there will be bruising and swelling and the transferred fat may feel very firm. Over a few weeks as the fat “takes” and establishes new blood flow the swelling and firmness will resolve and the area will soften considerably. While the transferred fat is still firm we recommend no pressure be placed on the area, i.e. if you have fat transferred to your butt do not sit on your butt until the fat softens! If you sit on it early some of the fat may not survive.
Most patients are back to normal within 3-4 weeks depending on the volume of fat transferred and the amount of liposuction performed.
As a Triple Board Certified Plastic Surgeon I make sure to spend significant time with you to help you realize your goals. With my years of experience and technical expertise, I know that I am more than capable of providing you with a result that exceeds your expectations.
Renew your look with expert, personalized treatment from Dr. Y. Begin the planning process with a one-on-one plastic surgery consultation in Alpharetta or Atlanta, Georgia. We are excited to welcome you to Y Plastic Surgery!