AUTOLOGOUS FAT INJECTIONS
or LIPO-FILLING or LIPOSTRUCTURE
DEFINITION, AIMS AND PRINCIPLES
The principle is an autograft of fat cells from fat harvested
from the patient.
Lipostructure can be used for many depressions (troughs)
which can be natural or post-traumatic.
The aims and indications of this procedure can be summed up
- Aesthetic indications
Indications concerning restorative or reconstructive surgery :
- The filling and smoothing of certain wrinkles,
especially of the face.
- Restoration of the ‘fullness’ of a gaunt face or
one showing the first signs of aging.
- Restoration of volume and shape to the face :
especially in the case of a face emaciated by
- In complement to certain neck- and face-lifts to
give a more balanced result.
- As an additional procedure after a previous facelift,
to improve the shape of the mid-section of
the face without resorting to another face-lift.
- Filling of a depressed zone resulting from injury
- Correction of irregularities following an
unsatisfactory liposuction procedure.
- Correction of wasting after triple therapy for
HIV + patients.
BEFORE THE PROCEDURE
Prior to the operation a thorough clinical and photographic
examination will have been carried out in order to determine
the corrections required.
HOSPITAL STAY AND TYPE OF ANESTHESIA
Type of anesthesia
Local anesthesia with sedation given by intravenous drip
(‘twilight’ anesthesia) is the usual choice for lipostructure.
One can also use local anesthesia alone, or general anesthesia.
The type of anesthesia will be chosen after discussion
between yourself, the surgeon and the anesthesiologist
The procedure may be carried out on an outpatient basis, in
an ambulatory facility, the patient arrives and leaves on the
same day. Admission is one hour before surgery, with no
food or drink taken for 6 hours before arrival. The patient is
discharged three to five hours after the procedure.
The harvesting of fat is carried out
atraumatically through a tiny
incision hidden in the natural skin
creases, using a small canula.
After harvesting, centrifugation
will be carried out for a few minutes, in order to separate the
intact fat cells, which will form the graft, from elements
which cannot be used.
Re-injection is carried out through 1mm incisions using
Tiny particles of fat are re-injected at different levels and in
multiple divergent directions. This increases the surface area
in contact with the implanted cells and receptor tissue and
ensures the survival of the grafted fat cells.
Since there is true bonding of living cells, when the technique
is correct and the graft takes, these grafted cells will become a
living part of the body. This means that lipostructure is a
permanent technique since the grafted fat cells will live for as
long as the surrounding tissues.
The length of the procedure varies according to the amount of
fat to be re-injected and the number of treated sites. It can vary from 30 minutes to 2 hours for lipostructure alone.
AFTER THE OPERATION
After the operation pain is usually mild.
Swelling appears during the 48 hours following the
procedure; this usually takes 5 to 15 days to disappear
Bruising appears after a few hours on the injection sites: it
disappears 10 to 20 days after the procedure.
Although recovery is in general rapid because of the nature of
the procedure, you will have to take into account the swelling
and bruising, and organize your social and professional life in
Exposure to sunlight or UV rays must be avoided for the
areas concerned for at least 4 weeks otherwise permanent
pigmentation can occur.
Once the swelling and bruising have settled the final result
will begin to be visible 2 to 3 weeks after the procedure.
The final aspect will not be visible before 3 to 6 months.
This is usually satisfactory, whenever the indication and the
technique have been correct: the depressions have been filled
and volume restored.
If the graft has taken correctly, we have already seen that the
cells remain alive for as long as the surrounding tissues.
Nevertheless the result will deteriorate little by little as these
We have seen already that lipostructure, when correctly
indicated and carried out, can be beneficial to patients, giving
a satisfactory result corresponding to what was expected.
In some cases localized imperfections can be observed
(without being true complications): hypo-correction of some
areas, slight asymmetry, irregularities.
They can usually be corrected by ‘touchup’ lipostructure
under local anesthetic 6 months after the initial procedure,
you will have been informed about this possibility.
Fortunately, real complications are rare following
lipostructure which has been carried out correctly. Rounded
canulas do not harm the skin, the blood vessels and the nerves
In fact practically all the operations go well and patients are
completely satisfied with the result.
Infection is normally prevented by prescription of antibiotics
before and after the procedure.
The most frequent complication of lipostructure is hypercorrection,
this is caused by re-injection of an excessive
quantity of fat giving an unsightly result.
This hypercorrection rapidly becomes permanent and cannot
be treated by simple lipoaspiration: it can only be remedied
by a true surgical operation to remove the excess fat.