Most of body sculpting consists of removing fat. But that’s just the half of it. Putting it back in the right places can add the final touch.

By: Andre Berger, M.D.

What is the essence of beauty in a woman’s face, hands, buttocks, or breasts? It’s volume! Natural, youthful volume that is—in the right proportion and shape. And the common denominator? Fat. Localized fat loss is associated with aging and always leads to deflation and the loss of youthful proportion and shape, thereby diminishing volume and the appearance of beauty.

What’s really exciting is that now, with the advancement of fat transfer techniques, technologies and enhancements, we have entered the era of volume restoration and regeneration directed at reversing and correcting volume loss using fat transfer. Today, rather than throwing out and basically wasting the fat removed with liposuction, patients are putting the fat to good use by transferring it to areas of fat deflation.

The most common donor sites are the abdomen, pubis, thighs, flanks, buttocks and knees; and less commonly, the calves, upper arms and sides of the chest. The primary sites for fat transfer are areas where fat is normally found, such as: facial and body depressions due to loss of fat deposits, upper and lower cheeks, the area between the eyebrows, the chin, the back of the hands, the buttocks and now even the breasts.

Fat transfer techniques have evolved enormously since the first reported transfer of fat obtained from liposuction in 1982. The basics, however, are unchanged. Fat is transplanted from one area of the body to another, and if injected in very small units, it will develop its own blood supply without rejection or allergic reaction. What has changed, and dramatically improved the results that can be achieved, are new fat transfer techniques, tools, technologies, and enhancements.

The newer fat transfer techniques also include more advanced and safer methods of quickly harvesting clean and pure fat tissue ready for immediate transfer injection. These new techniques use only local anesthesia, causing little to no bruising, swelling, or discomfort and requiring little to no significant recovery time. Procedures include the use of lower pressures when extracting the fat, the use of lasers and water to assist in the liposuction, and finally the use of improved cleaning procedures to wash or clean the extracted fat.

Once the physician has extracted fat that is clean and viable for face and body sculpting, there is a new array of techniques to make that part easier, too. More refined injection techniques include gentle pre-tunneling in the area to be injected, low pressure microdroplet injection techniques, and improved injection cannulas that are highly polished and have blunt tips. All have contributed to the significant improvements we are seeing in fat transfer results.

In the early days of fat transfer, retention of the fat in the new location was a problem. As much as half would be lost in the ensuing weeks and months. Today, if successful, 75 to 85 percent or more of the volume restored with transfer will be retained and preserved for an extended period of time, which may be for several years.

This higher retention rate is due to new techniques, including the injecting methods (in tiny amounts, rather than in a single, large injection). Other newer enhancement techniques include the use of tissue growth factors derived from platelet rich plasma (PRP) processed from the patient’s own blood. Experience has demonstrated that the use of PRP increases the long-term survival of the transferred fat cells.

The latest enhancement, holding tremendous promise for improving long-term survival of fat transfers, is the use of adult stem cells derived from the patient’s harvested fat tissue. For this procedure, the fat is processed to either increase the stem cell count or to extract the stem cells so that they may be cleaned, concentrated and then mixed back in with the fat that will be injected. This stem cell-enhanced, fat-transfer method has been reported to deliver significantly positive improvements in fat-transfer outcomes, with improvements in survival of the transplanted fat by an additional 10 percent to 25 percent—in other words, no loss of volume.

So now, thanks to the combination of new techniques and newer technologies, we have more effective, dependable and natural ways of reversing the volume loss associated with aging—or to enhance volume in certain key areas (breast, buttock, thighs, etc.) so as to better sculpt the body into the shape that patients desire, improving aesthetic contours and features. Indeed, fat transfer has come of age as a highly effective tool in the battle to reverse aging and enhance beauty.

Dr. Andre Berger is a member of the American Academy of Cosmetic Surgery and the American Academy of Anti-Aging Medicine. He practices cosmetic and anti-aging medicine in the heart of Beverly Hills, Calif.