Table of contents:
Lipofilling — 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 for ever. Lipofilling often gives the final touch in your facial feminization surgery.
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. This cosmetic procedure can be used to rejuvenate the face, augment the cheeks or lips, or correct problems such as hollowness around the eyes or scars.
Fat grafting is usually performed under local anesthesia. If it is combined with other procedures, it will mostly be done under general anesthesia. The method used by Dr Bart van de Ven is called the Coleman method.
- Liposuction—The fat used to re-inject in the face can be taken through means of liposuction from any part of the body where there is a sufficient amount of fat. In most cases, this will be taken from the abdomen or the upper legs. 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 more volume is wanted is injected with a minimal amount of local anesthesia after which the fat cells are injected with very fine cannulas.
- The trick with a 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 tissues and will make it possible for the fat to grow in the vessels really fast. Hence, the fat can survive.
- About 50% of the fat stays forever. Therefore the surgeon takes measures to compensate for the loss of volume by over-injecting.
- This is an example of what fat injection looks like in the lips:
- After six months we can speak of a final result because after that we do not see much change anymore. How the transplanted fat will behave over the following years/ decades is still unknown. However, it is likely that the normal aging process will continue and that the fat slowly goes away. On the other hand, we also expect that the difference made by the transplantation will last very long.
- Repeating—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.
- Swelling—Immediately after the surgery, the cheek will be quite swollen and bruised. In about 3 weeks time approximately 80% of the bruising and swelling will have disappeared. After 4 months you can get a good impression of what the final result (after 6 months) will be. About a week to ten days after surgery you will feel confident about going out and resuming your social life. If any bruises have developed, they might remain visible for a little longer but you can hide them reasonably well with a good concealer in case you'd like to.
- Exaggeration—In the beginning, the correction may still look rather exaggerated. We usually over-correct, which means injecting more fat than is actually needed. We do that because about 40% of the transplanted fat cells do not survive. The final result is assessed after 6 months.
- Correction—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. However, 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.
Frequently asked questions
What does this procedure cost?
There are 3 options to receive a financial and operative proposal. You can either send us pictures and receive a quote and an FFS simulation, or you can book a Skype or a live consultation with Dr Bart van de Ven during which you will also receive a quote and FFS simulation. Click here if you want to get a general idea of FFS prices.
What happens if there are complications after the procedure and is this covered?
We will correct the complication if surgically possible, without charging any surgical fees. Hospital, material and traveling costs are for the expense of the patient.
Can I get this surgery if I’m a cis woman?
Yes, of course. We perform Facial Feminization Surgery on all women. Every woman is welcome at our clinic!
How long does it take for the final result to be visible and the bruises to disappear completely?
Recovery looks different for every patient, but bruising usually disappears after two to four weeks. The final result can be visible after a few months, but it may also take longer than a year. All information on recovering from FFS can be found on our recovery page.
Will I regain fat again in the donor area after lipofilling?Yes, if you gain a lot of weight. A few fat cells will always remain in the donor area. The latter is a prerequisite for surgery since otherwise, your skin would stick directly to your muscles in the treated area.
How long does the fat stay?
In general, 60% of the fat stays forever. Therefore a little overcorrection is done during the operation. Repetition is needed for about 50% of our patients. There are many factors that determine how long fat grafting lasts. Some fat is always reabsorbed by the body, the amount can vary considerably from body to body. The fat that stays after 6 months, stays forever. After 6 months, if necessary, another fat graft may be performed until the desired effect has been obtained.
Is it possible to inject a few ml of fat in the face while getting lipofilling of the breast, hip or butt area?
Yes, this is possible.
We are doing our very best to keep this information up-to-date. In case you see anything that no longer seems accurate, or in case you have a question, please fill out the form below!