There have also been rare cases of fat transfer where related fat necrosis causes significant facial dysmorphia (deformity or change of shape of the body part) and psychological distress.
MAJOR COMPLICATIONS. Inadvertent intravascular injection of harvested fat can lead to substantial complications resulting from fat embolism. Fat embolism can lead to soft tissue necrosis, as well as more serious complications including vision loss and/or stroke.
Potential risks vary depending on the specific filler used and the relative permanence of the filler substance and may include: Acne-like skin eruptions. Asymmetry and bruising. Bleeding from the injection site, or possible infection.
In a review of 22 articles including 3565 patients, Groen and colleagues7 identified that the most common complications of autologous fat grafting in cosmetic breast augmentation included induration, persistent pain, and hematoma occurring at 33%, 25%, and 16%, respectively.
Inconsistent Fat Survival
After a fat transfer, the body tends to absorb between 30-50% of the fat in its new location, meaning a large portion of the immediate volume doesn't last. Your plastic surgeon will account for this loss and inject an excess to meet your ideal size and shape.
Fat transfer to the face typically has a higher survival rate, especially in areas that don't move. The aging process continues after the procedure, but patients enjoy a more youthful appearance for many years. Touch-up procedures can extend the results.
Your body can't reject the transferred fat since it's your own tissue.
Following most facial fat grafting treatments, fat graft survival rate is 60%. This surviving fat is permanent, and as such, it responds just like any other bodily fat. If you experience weight fluctuations, you will notice changes in your fat grafting results.
Acute rejection is the most common cause of graft failure based on the primary biopsy diagnosis.
Conclusions. Severe complications such as blindness, stroke, and death can occur due to AE after facial fat grafting.
Fat Transfer Face Contouring
Most commonly, face contouring benefits people who are 30 years of age or older. The face, at this age, begins to lose “baby fat,” and as a result, fullness begins to fade.
Microfat transfer offers long-lasting results and a more natural appearance compared to synthetic fillers, as the transferred fat integrates seamlessly with existing tissue.
Blood Clots Blood clots (deep vein thrombosis; DVT) in the veins of the arms, legs, or pelvis may result from fat transfer if it is done as a surgical procedure. These clots may cause problems with the veins or may break off and flow to the lungs (pulmonary embolus; PE) where they may cause serious breathing problems.
It could theoretically be reversed by liposuction or direct excision of the fat from the face. But the need for this is uncommon in expert hands. Most surgeons would rather underfill slightly than overfill, as there is always the option for a touch-up procedure.
Ho offers several solutions to this challenge: Evaluating multiple donor sites: Fat can be harvested from various areas of your body, including the abdomen, thighs, and back. Combining donor fat: If necessary, fat from multiple sites can be combined to accumulate enough for the transfer.
While not as prevalent, nerve injuries have been reported following liposuction and/or fat grafting procedures [5, 6]. These injuries are the result of direct trauma, compression, or traction.
Swelling
Gum inflammation is one of the most common symptoms of a failed bone graft. The tissue at that area may mirror gingivitis or periodontitis symptoms, with red, puffy, or bleeding gums. Some minor inflammation is normal for the first few days.
Allografts are almost always rejected unless the immune system of the recipient is defective or the donor and recipient are highly inbred and closely related. Grafts between individuals of different species are called xenografts. Xenografts are always rejected unless the recipient of the graft is immuno-incompetent.
Posttransplant acute tubular necrosis is the most common cause of DGF. The two terms are often used interchangeably, although not all cases of DGF are caused by ATN. The incidence of ATN varies widely among centers and has been reported to occur in 20% to 25% of patients (range 2% to 60%).
Fat transfer surgery is safe. It's important to work with a plastic surgeon who has extensive experience performing fat transfer because it requires a high degree of skill.
The fatty cells introduced to the facial area during facial fat grafting are subject to the same biological processes as all fat cells, so they will disappear with significant weight loss.
How long does a facial fat transfer last? Unlike dermal fillers, which typically need to be re-injected every 12 – 18 months, a facial fat transfer can provide results that last years, decades, or even longer.
The total cost of facial fat grafting, including both the liposuction and fat transfer components of the procedure, typically falls in the $3,000 to $7,500 range at our practice.
In the first week, there is always swelling and sometimes bruising to the grafted areas of the face. Pain is generally minimal. In the second week the bruising settles. Less visible swelling gradually reduces day by day.
There are limits to how much fat can be grafted at one time so multiple procedures are usually needed – two on average -- to get the results you seek. It can take up to six months or more to achieve your final shape.