Fat Transfer

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About Fat Transfer

Fat transfer to the breasts, face, and buttocks is a plastic surgical technique where fat is harvested from one place in the body and re-injected into another place in the body to increase volume or alter shape. When the face is the recipient site, very small instruments are used and small amounts of fat are used and often times, this procedure can be done entirely in the office under local anesthetic. When the fat is injected into the breasts or buttocks, more volumes are needed; therefore, it becomes more of an involved procedure. In all of these cases, very small, hollow cannulas are used to harvest fat, most often from the saddlebags, sometimes from the buttocks, thighs, and occasionally from the abdomen. The fat is harvested in a similar fashion as liposuction, but the tools are smaller and the suction weaker because the harvested fat is smaller in size. The fat is then separated from blood and other bodily fluids and then re-injected with small cannulas, multiple passes into multiple layers. For the face, this is done on a small scale; usually no more than 50 cc’s is transferred. For the buttocks, it is done on a larger scale; up to 900 cc’s can sometimes be transferred into each buttock depending on the patient’s size. With the breasts, it is usually anywhere from 100 up to 400 or 500 cc’s depending on the patient’s size. For the breasts and the buttocks, general anesthesia is usually needed. The patient is on their stomach, the fat is harvest from the backside, and re-injected into the buttocks. If the patient is having their breasts augmented, the patient’s body has to be turned and then the breasts are treated. When the breasts are augmented with fat, the result is an increase in size, usually no more than one to two cups. This is a technique that can also alter the shape of the breast or help with some breast implant complications. When there has been radiated tissue, fat transfer has also been shown to improve the texture and the look of the radiation area over time.

About Stem Cell Transfer

The term Stem Cell Transfer has now been associated with Fat Transfer. Stem cells are found in fat. They always get transferred with the fat. The stem cells help the fat grow in its new environment and survive for the long term. This is true for the face, the buttocks, and the breasts. It is important to remember in all cases; more than one treatment may be needed. This is true especially in radiated tissue. Up to five (5) treatments may be needed three (3) months apart, all depending on the deformity, the size of the patient, and the area to be treated. Prior to surgery, the patient should be in good health and able to tolerate anesthesia.

Risks, Complications and Drawbacks of Fat Transfer

Any patient undergoing this surgery has to accept the following possibilities:

  • Resorption. All patients have to accept that some of the fat to resorb. It is inevitable. 100% take is rarely achievable.
  • Limited results. If a patient wants an ‘implant look’, they should use an implant. Only as much fat that is available in a certain patient is what can be transferred. Some patients have body types that just do not have enough fat to get a certain type of result.
  • More than one treatment may be necessary if the treated area has a lot of movement or if it is an area with previous radiation.
  • Scars. These are very rare since the only incisions that are used are made with a needle; however, sometimes the puncture sites can produce a red mark which is visible and this is most frequently seen near the breast bone area.
  • Skin irregularities. These may occur from the donor site harvest. They may require additional treatment if they are obvious or aesthetically unacceptable.
  • Infection. This is possible with any surgery and may require the use of prolonged antibiotics.
  • Bleeding. All patients should expect some bruising. Collections of blood are very unusual with this type of surgery.
  • Skin blisters and Irritation.
  • Complications from anesthesia. These can occur with any surgery. This is why it is important for the patient to be healthy to be able to undergo anesthesia.
  • Puncture of body organs. The small cannulas, if they are placed in a plane that is too deep could puncture a lung or underlying organ. Should this extremely unusual complication occur, hospitalization may be necessary.
  • Fat necrosis, calcification of fat or fatty oil cysts. These can occur anywhere fat is transferred, especially in areas of higher volume such as the buttocks or the breasts. If they are small, sometimes they are never noticed and have no clinical consequence. They can sometimes be palpable and may need to be aspirated or removed. In the breast, if a calcification occurs, it usually has a different appearance than the calcifications of normal breast tissue. However, sometimes the two can look very confusing and this is why follow-up with mammograms and a radiologist skilled at reading mammograms is very important. Further treatment may be necessary if there is an area of question and biopsy may need to be done.
  • Loss and gain of transferred fat. As a patient loses or gains weight, the results may change as well.
  • Fat embolism. This is when a small little particle of fat gets into a blood vessel. Usually these are of no consequence, but if they are large, then a patient may become symptomatic and supportive care could be necessary, possibly hospital based.
  • Asymmetry. Asymmetry can occur anywhere there is a right and a left side. The “take” of transferred fat may not be exactly the same on the right vs. the left or vice versa. It is out of the control of the surgeon to be able to control how the body accepts the transferred fat on one side vs. the other. This is why sometimes additional touch-ups might be necessary to get as symmetric results possible.
  • Numbness. This is usually an issue at the donor sites from the liposuction. Most of this is temporary in nature and rarely does it become a permanent problem.
  • Surgically wetting solution. There is a possibility that large volumes of fluid containing dilute local anesthetic drugs and epinephrine that are injected into fatty deposits for harvesting fat may contribute to fluid overload or systemic reaction to these medications. Additional treatment including hospitalization may be necessary.

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"Dr. Pautler is an amazing person. I wanted to have a breast augmentation but was nervous. She took the time to fully explain everything to me. I never felt as if a question was stupid or not worth her time. I quickly realized that I had found the right doctor. My surgery went very well, thanks to the expert hands of Dr. Pautler. The first few days of my recovery were as expected. Then I noticed that my incisions were becoming increasingly itchy. On a Saturday morning, I called the number Dr. Pautler had given me. A little while later, she met me in her office. I was having a rare allergic reaction to the adhesive. She was able to treat me and told me to come into the office on Monday. I was very grateful for this weekend visit with her. Much to my surprise, I got a phone call the next day, from Dr. Pautler. It was a Sunday! She was calling to see how I was feeling. I would definitely recommend her to anyone. I wish more doctors were as caring and as compassionate as her.”

"I recently went to Dr. Pautler to have my first breast augmentation back in May 2017. Dr. Pautler is such an amazing women and surgeon. From the moment I walked into her office for my consultation to my last follow up appointment, every one in her office was so welcoming, professional, and made my experience so much better. She took a lot of time with me during our initial consultation to discuss all of my options. She was so honest with me from the get go and I instantly felt comfortable putting my personal appearance into her hands. I never once felt that she tried to pressure me into doing anything that I was not comfortable with. Her bedside manner is absolutely amazing...and I am a nurse who works on a post surgical unit and frequently see how surgeons do not always have the best bedside manner. The staff in her office are so friendly and remember you when you come in for all of your appointments...and that meant a lot to me that I was not just another patient. During my pre-op and post op stages at the hospital, all of the staff had great things to say about her. They often refer to her as "amazing", which made me feel so good! I am now completely healed from the surgery, and I could not be happier with my results. She made me feel so much better about my physical appearance and I have so much more confidence now thanks to her!”

"Worth the long drive. The local surgeons close to me have 2 hour long office waits, incompetent staff, change pricing and hospital locations at zero hour, and don't explain everything well. Dr. Pautler came recommended to me and I'm glad she was.”

"Wonderful doctor who is so caring! Having her perform my mommy makeover was the best decision of my life!! My body looks amazing thanks to her!”

"A lifetime of being thin and in shape and still... fat arms. At age 44 I was approaching 1,000 barre classes (yay!) and I told myself, if I still hate my arms after 1,000 barre classes, I will get the arm lipo. I had received quotes for the procedure twice before but chickened out - also my husband and even plastic surgeon has said 'you're thin and in great shape. You don't need it'”

"I was on the fence with going through a Breast Augmentation for a few years. There were obvious reasons on why I wanted one, but I knew that going through with this surgery would need to be done at the best time with the best doctor. After visiting a few doctors that I was uncomfortable with, someone I knew personally suggested trying her doctor, Dr. Pautler. I immediately called the office...”

"I recently went to Dr. Pautler to have my first breast augmentation back in May 2017. Dr. Pautler is such an amazing women and surgeon. From the moment I walked into her office for my consultation to my last follow up appointment, every one in her office was so welcoming, professional, and made my experience so much better. She took a lot of time with me during our initial consultation to...”


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