Cosmetic plastic surgery utilizes a wide range of operations, both for the face and the body, that aim to improve our image and reconstruct a youthful look. In most cases, the plastic surgeon is called to deal with two “problems”: laxity and fat. Let’s forget the former for a while and discuss the latter.

Fat: a mythical word that scares every person who desires a nice silhouette. A constant struggle to keep our body fat below a certain percentage. A fight that seems one-sided against all those delicacies that chefs have come up with.

To be honest, our body fat percentage constantly rises as one grows older, even for people that eat properly, exercise regularly and keep their body weight stable. After the age of 30, body fat increases, while muscle mass decreases. It is caused by what is called ageing.

Even though our body fat increases over time, this is not the case for our facial fat: It actually decreases. In combination with tissue laxity, they make the face look “empty”, and saggy. That loss of volume (caused by the decrease in facial fat) can be restored by inserting a substance that will restore – fill volume and rejuvenate its look.

Several injectable fillers are readily available for this purpose. Permanent fillers (e.g. silicone) are not used any longer, since their complications can be rather severe. Absorbable fillers (like hyaluronic acid, collagen, polylactic acid, hydroxyapatite) that comply with the strictest safety regulations are available that can “fill” your face easily and quickly are available. The result is temporary (it can last from several months to a year and a half), but if one feels it is satisfactory, one can repeat the process and sustain the result for as long one wants. Absorbable fillers are very useful when you want to fill a single “line” (like the nasolabial folds), but when you want to volumise a larger area (the entire cheek for example) then the amount needed is quite significant and the cost of the procedure can rise considerably.

In such a case, we can use fat as a filler. Fat that we can harvest from the same individual. As fascinating as it might sound, using fat from a different person is not an option, because those fat cells would not survive. The most common areas from which we harvest fat cells are the abdomen, the buttocks and the thighs, even though any area that has fat to spare is a potential donor site.

Essentially, a small liposuction is performed at the donor site, but the fat removed is not discarded. The fat aspiration is performed with specially designed very thin cannulas, so that it will make it easier for the small particles of fat aspirated to survive in the recipient area. A slight centrifugation of the aspirated fat is sometimes recommended in order to separate fat from blood that has also been aspirated in the process. Other physicians advocate against centrifugation for it might disrupt the fat cells. The collected fat is then injected in the area that we want to “fill”.

A fraction of the injected fat cells do not survive and is absorbed by our body in a few weeks time. That is the reason why we usually inject a bit more fat than needed (doing initially what is called an “overcorrection”) in order for the final result to be the desired one. The outcome of lipotransfer lasts for a very long time, since fat cells that survive in the new injected site, continue to live and prosper. In any case, one can repeat the procedure after a few months if such a thing is deemed necessary.

During lipotransfer, the volume of an area is restored and in the meantime new cells are being transferred under the skin of an area of the face, a fact that makes the skin look fresher and rejuvenated. Not only can therefore the face look “fuller” but the skin can look sturdier and more youthful as well.

Lipotransfer is a procedure that is considerably lengthier compared to the injection of a ready-made absorbable filler (like hyaluronic acid), but it can be used to fill a defect as small as a tiny wrinkle to a very large post-traumatic tissue defect. In the meanwhile it can also make the skin look more rejuvenated.

Modern techniques for lipotransfer are very advanced, making it a reliable and safe procedure for the rejuvenation of the face, or any other bodily area as a matter of fact.