I have heard that fat grafting is great but that in the areas where fat was removed, if you later gain weight, the fat is deposited very unnaturally.
Question: I have heard that fat grafting is great but that in the areas where fat was removed, if you later gain weight, the fat is deposited very unnaturally. Is this true and, if so, what can be done to reduce this undesirable side effect?
Answer: For the most part, when fat harvesting is performed for facial fat grafting, there is not enough fat removed to cause any contour irregularities in most patients. It is true that, if fat is harvested from a single location and then a patient gains weight, that there can be an undesirable irregularity to their volume in that area. I personally prevent this from happening by harvesting fat from a broad fanlike area, typically across the abdomen and, in very thin patients, I will occasionally harvest fat from the inner aspect of the knees. By harvesting fat in a fanlike or flat area, even if a patient later gains weight, the weight should be distributed across this area quite evenly, and it should not create any sort of visible abnormality.
As you may already know, fat cells do not divide but only get bigger, and we essentially have the same number of fat cells for all of our adult life. If we, therefore, remove fat cells from one area via liposuction, whether it be for body contouring or for harvesting for facial fat grafting, that area will never have as much fat as it would have had this fat not been previously removed. Therefore, if patients do gain weight in the future, they will tend to place less volume of fat in the area that had been harvested than they would have prior to the removal of that fat and they will, therefore, tend to place fat in areas that have not been treated.