Fat grafting or fat transfer has become popular in the last decade but was first described more than a 100 years ago. It is now well established both in science and clinical practice. Still some doctors consider it unreliable, the fact is that fat grafting is a gentle technique and may fail if due attention is not paid to all the steps.
What is Fat grafting?
Basically, fat grafting is a technique of collecting living fat cell clusters in small particulate form using gentle aspiration and re-injecting this fat in the form of linear threads or mesh-work into the receiving tissue. It is not oil that is injected. The fat clusters must be in contact with well-vascularized living tissue so that they can get nourished; initially by a process of diffusion and later by in-growth of new blood vessels. This principle is similar to skin grafting or other tissue grafting. If these principles are respected, fat grafting becomes safe and reliable.
What are the known benefits of fat grafting?
Fat graft does much more than fillers. In addition to giving volume to the area, fat grafts bring with them special cells called adipose derived stem cells (ADSC). These cells get activated on transfer to a new area by as yet ill understood mechanisms (injury and relative lack of oxygen in the beginning may be the triggers) and start to multiply as well as release certain chemicals called growth factors. There may also be cell to cell signaling involved. The result is formation of healthy new blood vessels, new collagen, reduction of abnormal scars and improvement in the overall health of the area.
Which areas can benefit from fat grafting?
Commonly we do fat grafting to face, breasts, hands, buttocks and to other parts of the body if contour enhancement is needed. We also use fat grafts to improve old scars, deep scarring, painful nerve entrapments and in selected cases of joint arthritis. Fat grafting for genital area is a special application in both men and women.
What can be done to improve the results of fat grafting?
This is an area of intense research. According to available evidence, platelet rich plasma and patients own previously isolated stem cells can boost the survival of fat (see under Stem cells for more information)