Fat grafting is a wonderful new procedure that has become a standard addition to plastic surgeons armamentarium in recent years. Every month we are discovering new uses and new understanding into how it works. Full potentials of fat grafting will no doubt be more realized in future as research improves understanding of several aspects of this new graft. Fat tissue seems to be rich in stem cells and other cells which, when taken together have a lot of restorative, augmentative and regenerative properties. Fat tissue can thus be harvested easily and grafted to areas where there is a need for this.
Dr. Mohan Rangaswamy inducted fat grafting into his practice in 2002. His first case was a man who had very atrophic and skeletonized hand following a nerve problem. His hand was so bony that he used to hide it and was averse to shaking hands. Dr. Mohan performed multi-planar micro-fat grafting on this gentleman with spectacular results. The results are still stable 7 years later. Encouraged by this success and with the unfolding of new knowledge, fat grafting became an increasingly important part of his practice.
Benefits of Fat grafts:
- Brings fresh new tissue to the area both for volume improvement and rejuvenation
- Simple method
- Natural and permanent filler with no adverse side effects
- Applicable to most parts of the body
- Can be repeated
- Can be used in creative and imaginative ways to solve several problems
Why do some doctors say fat does not stay? This often heard statement is born out of ignorance or out of seeing results of bad technique. Fat must be harvested, handled and transplanted very gently and using precise technique and precautions. It must be grafted as micro grafts or droplets such that each droplet is surrounded by living vascular tissue to nourish the fat. To put it in another way, for a good crop one must have good seed, sow it properly in good soil, with the seeds properly spaced and water and nourish them well to encourage good growth. Done properly, fat grafts stay well and lasts long.
Who is a candidate? Which areas can be improved?
Following are only some of the indications. This list is not exhaustive:
Face: for filling out sunken cheeks, highlighting cheek bones, to get well defined chin, jaw-lines, correct minor issues with the nose, plump up and define lips, create chiselled lip contours, improve frown lines between brows and deep furrows beside the nose etc. Also useful to correct changes brought about by severe acne.
Neck: to improve deep creases in the neck
Breast: To add volume to normal breasts [no implant], to give more natural look to breasts with implants and for breast reconstruction following mastectomy
Buttocks: To enhance volume and give lift effect – the so called “Brazilian Butt”
Calf: Enhance volume and contour
Genitals: Enhance female genitalia and as part of male genital enhancement in selected cases
Hands: To improve ‘bony’ hands, to give the appearance of youth to aged hands.
Reconstructive: Depressed scars, burnt areas, non-healing ulcers and more
Refinements: Fat with PRP
PRP is Platelet Rich Plasma. This is an extract of blood that can be prepared from the patient’s own blood. This is rich in platelets which in turn contain growth factors. We mix PRP with fat grafts to enhance their survival and to encourage greater rejuvenations. PRP can also be injected without the fat and has also been used to heal difficult wounds.