Facial Fat Transfer

Micro-fat and nano-fat fat transfer

Fat injections have increased rapidly in recent years among cosmetic surgery applications. This is due to the ease of application and the success of long-term results.

Why Fat injection;

1) To increase the volume,
2) to reduce hardness in the areas that fat extraction was previously done.
3) to improve skin quality in areas with reduced skin quality
it is a method of injecting fats extracted from the body to another area.
Fat injections can be targeted anywhere in the body. it can be injected into post-accident or congenitally deficient areas, areas that have collapsed after doing liposuction, and also to increase the volume of the breast and / or hips. Fat injection is also used to provide volume and rejuvenation on the back of the hands, where aging and subcutaneous fat deficiency are very prominent.

However, the face is often the target area of fat injections. It can be used for Thickening of the lips on the face, reduction of nasolabial lines, fullness of cheekbones, formation of forehead bomber, filling under-eye area or contouring the jaw tip.

Generally, when the excess fat is extracted (by 3D laser lipolysis), the fat is taken to the areas where volume is lost or more volume is desired. After the application, the body contour becomes smoother and more prominent.

The areas where fat is taken for fat transfer are usually abdominal, waist or thighs or knees

The amount of fat to be taken for fat injections can be quite variable. Up to 1000 cc fat can be used to enlarge the hip, while 500 cc may be sufficient for breast augmentation. fat injections to the face can require between 5 to 60 cc depending on the application.

Depending on the amount of fat to be used, local or general anesthesia might be required. If a small amount of fat is to be used, the application can be done with local anesthesia in 30 minutes. However, if the amount of fat to be used is can take longer than 1-2 hours then the application should be done with general anesthesia.

Like all plastic surgeons, I also have some considerations to improve the success of the fat transfer. While extracting, I use atraumatic cannulas that do not damage the fat and tissues. Also, take maximum precaution as fat shouldn’t contact with the air and dry out. a system that extracts the fat cells with low pressure is used and the fat is accumulated in special collector containers.
There are 3 types of fat transfer according to the size of fat grafts: 1) Macro-fat 2) Micro-fat 3) Nano-fat fat graft. The first two are used to provide volume, while the last is used to improve skin quality, not volume.

Recently, the trend of “Brazilian Hip” (BBL-Brazilian Butt-Lift) is done with fat injection. In BBL, the excess fat in the abdomen, waist, and back is removed and the waist is thinned and contoured, but the hips are plumped to become tighter and more distinct. In breast augmentation, the upper part of the breast is plumped so that the décolleté area has more volume and more beautiful. In this type of fat transfers, it is not necessary to dilute the fat and Macro-fat graft is mainly the applied.

In the fat transfers to the face and hand, first the micro-fat and then the nano-fat graft was identified. The use of macro-fat grafts was particularly problematic in areas with thin skin such as the face, as it caused stiffness and agglomeration. Therefore, the application to these areas was problematic.

The problems associated with the use of macro-fat grafts have led to the development of micro-fat grafts application. In this application, fat is separated from connective tissues with special filters and the size is reduced. After the process, the fat cells can pass through the 1.2 mm cannulas without clogging or applying more pressure. Micro-fat grafts can be Used in areas where volume needs to be given, such as the back of the hand, nasolabial folds, forehead, chin and cheek region. Micro-fat graft injections create a volumetric lift effect when applied to a face that had volume loss. Harmony is obtained with fullness and contour transitions, and the skin becomes more vibrant and more beautiful.

In the early 2000s, fat cells were identified as an important stem cell source, such as bone marrow and thrombocytes. After this development, began the change to the fat transfer. And Nano-fat transfers was developed after micro-fat transfers. While obtaining stem cells from the bone marrow is difficult and traumatic process, stem cells from the fat were obtained and used as the stem cells were very easy to obtain thus the number of applications increased rapidly.

According to the studies, stem cells count is stated to be more in the lower abdomen, around the belly, thighs and knee fat. Nano-fat grafts are the emulsification in which there is no living fat cell in the fat taken from these regions and thinned enough to pass through 0.7 mm cannulas with special filters. This emulsification contains plenty of substances called Cytokines, this substance allows the growth factor to be released, which stimulates the healing cells to attack the repaired area and repair the damaged tissues. The aim is not to provide volume but to improve the quality of the skin, reduce stains, lighten the skin, and to rejuvenate and tighten the skin in total. With the application of nano-fat, cells were injected into the regions and skin layers that could not be injected before. In the injection of nano-fat grafts, the emulsified material is introduced through very fine cannulas just below the dermis. and it is especially applied to thin skin areas such as eyelid circumference and neck. It can be applied to any area of the skin that appears stained, wrinkled, thin, poor quality or damaged. It can also provide good results in reducing acne pits and under-eye bruises. The effects of the application begin to be seen between 1-3 months. The skin quality improves significantly over a 6-month period.

Micro-fat and nano-fat grafts can be used at the same time if the area have volume loss in addition to bad skin quality. Nano-fat grafts can be combined with all kinds of facial aesthetics, such as skin peeling applications, device skin rejuvenation applications, fillers and Botox applications. As it Improves the results of all applications.

The most important factor for the fat cells to survive and provide the desired volume in fat transfers is the good blood supply of the injected area. If the area has previously been traumatized in any way (liposuction, injuries, etc.) or if the person smokes, the amount of blood supply and oxygen content in the blood will be reduced, thus impairing the outcome of fat transfer.