Articles by Dr. Little

Fat Grafting – Part 1

Fat grafting has become an integral treatment in aesthetic and reconstructive procedures. Fat grafting has been performed for many years. It is not until recently that we understand how fat grafting works and the potential benefits. Fat grafts were initially used in the late 1800’s. However, it was not until the 1980’s that the widespread use of liposuction allowed for easier harvesting of fat grafts. Since that time, there has been a revolution in the research related to the optimal techniques required and possible benefits. Fat grafting is now used for a variety of aesthetic uses as both a filling agent and therapy for damaged tissue. In the face, it can be used to increase volume throughout. It can be used as a stand-alone therapy or as an adjunct to other procedures such as a facelift or blepharoplasty. Fat-grafting has been utilized in breast augmentation and is commonly used as an adjunctive procedure in breast reconstruction after treatment of breast cancer. There is a considerable buzz around fat grafting for gluteal augmentation, often termed “Brazilian Butt-Lift”. In addition to adding volume, fat grafts have been shown to regenerate and improve the surrounding tissue. The science is complex and the exact mechanisms are not yet fully understood. This series of articles will review many of these issues surrounding fat grafting.

Fat Grafting – Part 2 – Science of Fat Grafting

The transfer of fat to other regions of the body was initially performed in the 1800’s. Surgical techniques limited their use until the early 1980’s. At that time, suction-assisted lipectomy (liposuction) became widely accepted. The fat removed could then be transferred to other regions. Early results were disappointing. This was attributed to volumes transferred and techniques used. Since that time, there had been a tremendous amount of scientific data studying the molecular dynamics, benefits, and optimal techniques required.

The transfer of fat has demonstrated many claimed and validated benefits. It does not cure cancer. However, it does act to increase volume and improve the quality of the tissue in the areas treated. Many studies have documented long-term fat retention (maintenance of volume) and improvement of the overlying skin. These improvements are seen as increased skin thickness, decreased pore size, decreased wrinkling, and other microscopic variables associated with the improvement of skin quality.

Current research is focusing on the techniques to optimize grafting, the molecular dynamics of these grafts, and the modalities utilized to evaluate long-term results. As with many new aesthetic options, there will be many “snake-oil” claims. This series of articles aims to present the current scientific data and dispel some of the myths that make it to the mainstream media.