We had an extensive discussion about fat injection, also called fat grafting or fat transfer. This technique removes fat from one area of your body using liposuction, processes it, and then injects it into another area to restore volume, improve contour, or fill a defect. Because this uses your own tissue, fat grafting is a natural option for volume restoration in several parts of the body.
How Fat Injection Works
Fat grafting is a three-step process:
- Harvesting: Fat is removed gently with liposuction from a donor area, commonly the abdomen, flanks, thighs, or buttocks.
- Processing: The harvested fat is purified to remove blood, oil, and damaged cells. The goal is to isolate healthy, viable fat cells for transfer.
- Injection: The purified fat is injected into the target area in small amounts and multiple layers. This technique maximizes blood supply access and improves long-term survival of the fat.
Fat Survival After Transfer
Not all transferred fat survives. Over the first two to three months, your body reabsorbs a portion of the injected fat. On average, about 50 to 70 percent of the transferred fat survives long term. The fat that survives becomes a permanent part of your body and behaves like normal fat.
Excellent Applications for Fat Grafting
Fat injection works very well in several areas:
Face
Fat grafting can restore volume to areas that lose fullness with age or weight loss, including cheeks, temples, nasolabial folds, under-eye hollows, lips, and general facial contouring. It provides softer, more natural volume than fillers when larger correction is needed, and once the fat survives, results are long lasting.
Hands
Fat grafting to the hands restores volume that is lost with aging. This can soften the appearance of prominent tendons and veins, creating a more youthful look with natural feel and durability.
Buttocks (Brazilian Butt Lift)
Fat grafting is commonly used to improve buttock shape and projection using your own tissue while simultaneously contouring the donor areas. This avoids implants and produces a natural look and feel.
Because the buttock region involves important safety considerations, this procedure must follow strict surgical protocols to reduce serious risk.
Body Contour Irregularities
Fat grafting can help correct depressions and contour irregularities from previous surgery, trauma, or congenital asymmetry. Transfer adds soft, natural volume in areas where implants or other approaches may not be appropriate.
Breast Reconstruction After Mastectomy
Fat grafting can play a valuable role in breast reconstruction patients, helping smooth defects, improve contour, and camouflage implant edges in women who have already lost breast tissue to cancer. In reconstruction, the benefits often outweigh the screening concerns discussed below.
Recovery and Results
Early Healing
- Expect swelling and bruising at both the donor and injection sites.
- The treated area may look slightly overfilled at first because of swelling and because some fat will be reabsorbed.
First 2 to 3 Months
This is when fat survival declares itself. The area gradually decreases in size as swelling resolves and a portion of fat is reabsorbed. The remaining fat becomes permanent.
Long-Term Behavior
Surviving fat behaves like normal body fat. If you gain weight, the area may enlarge. If you lose weight, it may shrink. Stable weight supports the best long-term result.
Multiple Sessions
Because fat survival is not 100 percent predictable, some patients require two to three sessions to reach their desired final volume.
General Risks and Considerations
Fat grafting is very safe when performed appropriately, but risks include:
- Partial fat reabsorption: expected, often 30 to 50 percent
- Fat necrosis: some fat may not survive and can form firm lumps
- Asymmetry: uneven survival may lead to mild differences
- Contour irregularities: small lumps or depressions can occur
- Infection, bleeding, hematoma, seroma: standard surgical risks
- Need for revision: additional sessions may be needed
- Unpredictable survival: exact long-term retention cannot be guaranteed
Important Note About Cosmetic Fat Injection to the Breast
We discussed a specific application that has become popular on social media: fat injection to the breast for cosmetic augmentation. I do not perform fat injection to the breast for cosmetic augmentation, and I do not agree that it is safer than implants.
Why the Breast Is Different
In areas like the face, hands, buttocks, and body contour correction, fat necrosis is generally not a serious long-term concern. The breast is different because of lifelong breast cancer screening needs.
When some transferred fat dies, it becomes scar tissue. Over years or decades, calcium deposits can form in that tissue. These calcifications are permanent and, on mammograms, can appear identical to calcifications associated with breast cancer.
Three Serious Consequences
- Cancer scares and anxiety: benign calcifications can trigger fear and repeat workups.
- Mandatory biopsies: radiologists cannot reliably distinguish benign from malignant calcifications on imaging alone, so biopsies become routine whenever findings are suspicious.
- Risk of masking true cancer: calcifications from fat grafting can obscure early cancer detection, which is the most important factor in breast cancer survival.
These calcifications often appear years later, precisely during the decades when breast cancer risk rises. We do not have long-term 20 to 30-year safety data for cosmetic fat grafting to the breast, yet it is being promoted heavily online.
Reconstruction vs Cosmetic Context
In reconstruction after mastectomy, fat grafting can be medically useful and the risk-benefit balance is different. For cosmetic augmentation in healthy breasts, fat grafting introduces lifelong screening complications for an elective goal, and that is not a trade-off I am willing to recommend.
Why Implants Are Different
Breast implants do not create calcifications that interfere with mammography or hide breast cancer. Radiologists can clearly see implants and image around them using established techniques, without causing false positives that require biopsy.
If you desire breast volume enhancement, breast implants remain the gold standard for cosmetic augmentation because they do not compromise future screening or early detection.
Making the Decision
For appropriate areas such as the face, hands, buttocks, and body contour correction, fat grafting is an excellent option that delivers natural, long-lasting results using your own tissue. For cosmetic breast augmentation in healthy breasts, I recommend traditional implants to avoid the long-term screening risks we reviewed. My priority is helping you look your best while protecting your long-term health.
Photos were obtained, a quote was given, and the patient will return in a week for further discussions if needed.
