Montreal Fat injections & Fat transfer (fat graft) – Objective

Fat injections & Fat transfer

Women and men who lack fullness or volume in one part of the body but have other parts of the body with excess fat (that they cannot get rid of through diet and exercise) are excellent candidates for fat transfer or fat grafting. While liposuction is 100% reliable in removing fat, it is important to understand that as much as 50% of the transferred fat can be resorbed (disappear) over time when larger volumes of fat are transferred. In such a case, further fat injections may be required in order to achieve the desired results.

Dr. Nicolaidis stopped posing breast implants in May 2021, when he became uncertain about the safety of breast implants for ALL women (more in the section Breast Augmentation with Fat Transfer). He does not perform large-volume fat transfer to the breast for his patients because of the increased risk of cyst formation or micro calcifications, which can be misinterpreted later as possible breast cancer on mammograms and therefore require work-up to rule out breast cancer. However, he will perform small to medium-volume fat tranfer to the breasts (as well as other areas). Performing fat injection to the breast in smaller volumes keeps the risk of cyst formation or microcalcifications to a minimum.

Buttock and calf implants have very high complication and revision rates. Therefore, Dr. Nicolaidis has become a big proponent of fat injection to these areas rather than implants. The Brazilian butt lift is an example of fat transfer from areas of excess fat to the buttock. The combination of liposuction from the abdomen and sides and fat injection to the buttock then becomes a very powerful tool for sculpting the body, allowing for radical improvements in shape.

Montreal Fat injections & Fat transfer (fat graft) – History

As we have said, Dr. Nicolaidis performs only tried and true techniques that have stood the test of time and get consistent long lasting results. Fat transfer is a relatively newer technique with fewer long-term results known. Therefore, a brief history of fat transfer will be given.

Fat transfer was popularized by Dr. Sidney Coleman in New York in the 1990s, during which time Dr. Nicolaidis was working at the Albert Einstein School of Medicine (New York). Dr. Coleman changed the way Plastic Surgeons approached the face, advocating the injection of small quantities of fat to the face in order to decrease lines and improve volume, rather then pulling skin as in facelifts. Plastic Surgeons gradually tried injecting larger and larger quantities of fat in the rest of the body in order to increase volume and improve contour ; this “large-volume” fat transfer has become increasingly popular over the last several years.

Cautious Plastic Surgeons have hesitated to do fat injection to the breast for two reasons. First of all, large volume fat transfer to the breast can lead to cyst formation or microcalcifications, which can then be confused for possible breast cancers on mammograms. Secondly, breast implants have had a long-standing history of reliability (although their safety is being increasingly questioned). Finally, there was a theoretical concern of inducing breast cancer by injecting fat into the breasts; however, no studies or investigations have shown or suggested this to be the case in the 20 years since its use.

On the other hand, buttock and calf implants have much higher complication and revision rates. And the incidence of cancer in these sites is very low compared to the breast. Therefore, Dr. Nicolaidis has become a huge fan of fat injection to these areas rather than implants.

Montreal Fat injections & Fat transfer (fat graft) – Anesthesia

Most cases require general anesthesia for maximum patient safety and comfort as well as more aggressive fat removal. Only the most minimal cases of fat transfer can be done well under local anesthesia.

Montreal Fat injections & Fat transfer (fat graft) – Surgical techniques

Fat is removed from unwanted areas using simple liposuction techniques. However, rather than throw out this fat, the fat is concentrated through numerous means and reinjected in areas lacking fullness. Care must be taken in order to avoid excessive injections in any given areas in order to avoid fat cell necrosis (or death), leading to more fat resorption, or cyst formation.

Montreal Fat injections & Fat transfer (fat graft) – Recovery

Patients are generally asked to wear a compression garment for the first several days to one month after surgery in the liposuctioned areas. On the other hand, we try to avoid pressure on the regions receiving the fat. Therefore, Dr. Nicolaidis will ask patients to avoid/minimize sitting for 3-4 weeks following a Brazilian Butt Lift

Montreal Fat injections & Fat transfer (fat graft) – Return to work

Patients can usually return to work in just a few days, though swelling and bruising usually take several weeks to subside. Following fat transfer to the buttock (Brazilian Butt Lift), patients cannot sit for a period of 3 weeks after surgery.

Montreal Fat injections & Fat transfer (fat graft) – Possible complications

The most common problem after liposuction involves irregularities of the skin surface, including depression or wrinkling. As already mentioned, up to 50% of the transferred fat can be resorbed (or disappear). Fat transfer risks include cyst formation, infection, microcalcification and death of the fat cells, leading to resorption.

Montreal Fat injections & Fat transfer (fat graft) – Post op Instructions

In the first week after fat injection, be sure to :

  • Keep your dressings dry and clean ;
  • Wash with a sponge unless Dr. Nicolaidis says otherwise ;
  • Avoid pressure over the area of fat injection ;
  • Wear your compressive garments (if provided) at all times for the areas liposuctioned ;
  • Walk at least 5 minutes every hour during the day (do NOT simply stay in bed constantly).

Your first post-operative appointment for fat injection with Dr. Nicolaidis is very important, even if you feel very well. Call us as soon as possible if you do not have an appointment already scheduled (the first visit is normally scheduled before surgery).

After the first week of fat injection :

  • Patients may shower;
  • Continue to avoid pressure over the area of fat injection for at least 2 more weeks ;
  • Protect your new scars from sun exposure for a total of 6 months ;
  • Continue wearing compressive garments (if provided) until Dr. Nicolaidis says otherwise ;
  • In order to avoid blood clot complications, keep moving (walk regularly during the day).

Please note :

  •  It is normal to have some bruising in the area of fat injection in the first weeks after surgery.
  •  For your comfort, be sure to take your pain medication as prescribed.

For further information about fat transfer & fat injections (Fat Graft), please click here : American Society of Plastic Surgeons