Liposculpture

Lipofiling — also referred to as free fat transfer or fat grafting — is a procedure to fill up areas with your own body fat instead of using a chemical filling or an implant. This is a highly efficient procedure as it is not very invasive and produces natural results. About 60% of the fat stays forever. With fat transfer through extensive liposuction of the abdomen and the flanks, and lipofilling of the gluteal area and the hips, a curvy female body contour can be accentuated.

If the body fat constitution allows for it, lipofilling is the preferred technique for body contouring. Dr. Doornaert has performed extensive research on the topic of lipofilling at the university in Ghent, Belgium for the PhD he obtained.

Contras of fat transfer

• No fat—Since the fat comes from the patient’s own body, fat transfer is not ideal for patients with very little body fat.
• Limited volume—The downside to this type of hip augmentation is that the transferred fat cells must get a healthy supply of blood to remain alive. Since pressure is detrimental for the surviving fat cells, there are limits to the amount of fat that can be injected in one procedure. This procedure also takes longer, since fat must be harvested from another area of the body. Additionally, it’s important to note that liposuction removes extra-abdominal fat only, so if you carry a lot of intra-abdominal weight, liposuction may not be able to produce the results you desire.
• Absorption—Whenever a lipofilling is done, a portion of the fat (about 40% on average) is absorbed by the body while the remainder stays in place for the long term. It is for this reason that most patients require a substantial amount of their own fat in order to create the desired long-term result. 

Pros of fat transfer

• A benefit to this type of procedure, along with enhanced areas, is a trimmer midsection (or whichever area of the body from which the surgeon decides to transfer fat).

What regions can be sculpted?

• Fat transfer to the breast region—Fat tissue can be harvested from regions of the body where depots exist, such as the thighs, the belly, and the hips, in a real liposculpture procedure. After processing the fat, it can be used for lipofilling. This is performed by placing tiny deposits of healthy fat throughout the tissues that need to be augmented. In certain cases, a natural lifelong augmentation without scars can be performed. In other cases, lipofilling can be used as an adjunct to the placement of a smaller implant to obtain a more natural and long-lasting result. Again, the best solution for you will be discussed with the doctor.
• Fat transfer to the buttock region—If the body fat constitution allows for it, liposculpture is the preferred technique. The popular name for this fat transfer is a Brazilian butt lift. The results are stable, the complications minimal, and no long-term problems are to be expected. Dr. Doornaert has performed extensive research on the topic of lipofilling for the PhD he obtained. While there are a few different procedures that can give transgender patients a fuller, more feminine backside, the most successful procedure to date is the Brazilian butt lift. The Brazilian butt lift differs from traditional buttock implants because it uses fat from selected areas of your body (rather than artificial implants) to enhance your backside. The Brazilian butt lift is ideal for transgender women because it not only increases fullness and projection, it can also be used to eliminate or re-contour fat from more masculine regions of the body such as the abdomen or the flanks. The fat transfer procedure (including Brazilian Butt Lift) is less invasive than implant augmentation, and the required liposculpture helps contour the gluteal area. A disadvantage is that the amount of volume that remains after a year varies from person to person.
• Fat transfer to the hip region—The most common medically-accepted approach to augmentation of the hip region is to transfer the patient’s own fat to this area. More information on hip augmentation via liposculpture.

Procedure

The fat used for fat transfer can be extracted from any part of your body like the abdomen or thighs by liposuction, and it will be injected where needed.

Fat grafting of the body is usually performed under local anesthesia with sedation. If it is combined with other procedures it will mostly be done under general anesthesia. The method used by Dr Doornaert is called the Coleman method.

• Liposuction—The fat used to re-inject in the body can be taken through means of liposuction from any part of the body having a sufficient amount of fat, in most cases from the abdomen or the upper legs or the thigh. After injecting local anesthesia, which minimizes bleeding in this particular area, a very small incision is made and fat is aspirated using a blunt needle with multiple perforations and a special aspirator. The small incision is closed with one stitch.
• Filtration—This fat is filtered to separate blood, oil and local anesthetic from the fat cells.
• Fat injection—The place where we want more volume is injected with a minimal amount of local anesthesia after which fat cells are injected with cannulas.
  • The trick of fat transfer is to inject only a very small amount of fat with each pass of the cannula. This way the grafted fat will be in direct contact with the surrounding tissue and will make it possible for the fat to grow in the vessels really fast. Thus the fat can survive.
  • About 60% of the fat stays forever, the other 40% is absorbed by the body. Therefore a little overcorrection is done during the operation.
• Repetition—After 6 months, if necessary, another fat graft may be performed until the desired effect has been obtained. Repetition is needed for about 50% of our patients.

Recovery

• After the procedure, it is necessary to avoid pressure on the lipofilled areas to allow for maximum fat survival.
• Conversely, a pressure garment is indicated for the compression of liposuction areas. Around the flanks, the bandage should be worn for 2-3 weeks. If liposuction is performed from the legs, liposculpture pants are worn for 6 weeks.
• No wound care is necessary.
• No sports for 3 weeks.

Complications

• Compliance is VERY important after these procedures. You will receive specific guidelines on where to avoid pressure, and what not to do. No matter how perfect the surgery, complications will arise if the post-operative guidelines are not met.
• Less volume than hoped—A second session may be scheduled to top up any shortfall in volume. There are many factors that determine how long fat grafting lasts. Your body naturally absorbs fat, so the surgeon must over-inject initially, and success rates can vary considerably. Some fat is reabsorbed by the body and sometimes only a certain percentage is permanent although newer techniques are showing increased longevity.
• If you gain weight in the future—If you gain a considerable amount of weight after fat grafting, it may show up in the area that was treated.

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