Lipofilling

WHAT IS LIPOFILLING?

Lipofilling is a surgical procedure consisting of two stages: the first involves the removal of adipose tissue (fat) from areas of the body where it is most prevalent, and the second involves its transfer, after appropriate treatment, to other regions of the body where it is in short supply, most often to the face but also to other body sites.
Adipose tissue (fat) is sucked from the areas of the body where it is naturally present in greater quantities, such as the abdomen, hips, thighs, knees. Then, using small cannulas attached to syringes, it is injected into the area that is to be filled This is in effect a tissue graft.

Since in grafts the transferred tissue does not retain any vascular connection with the donor site, survival of the transferred tissue can only occur if the target area has good vascularisation. Direct contact with the tissues of the recipient site will allow nourishment of the transferred tissue first by imbibition and then by the formation of new vessels (neoangiogenesis).

BODY LIPOFILLING

As far as the body is concerned, lipofilling is suitable for correcting volume asymmetries, shaping body lines and improving body contours.
Lipofilling lends itself very well to redefining the buttocks area, in the case of asymmetry, or the legs, in the case of excessively thin calves, or to give the hands or the male and female genital region a youthful appearance again.

The lipofilling technique is widely used in the breast as a supplement to cosmetic or reconstructive surgery after breast cancer. In this area, lipofilling is used to: supplement and complete both breast reconstruction surgery with implants and breast reconstruction surgery with autologous tissue; in the treatment of tissue damage following radiotherapy cycles; in the integration of missing volumes following quadrantectomies; in cases of reduction of capsular contracture; and in the correction of asymmetries.

In general, lipofilling is most commonly used in minor corrections and remodelling, performed by infiltrating fat cells into hypotrophic tissues provided they are well vascularised. This procedure is not suitable for treating large areas or for grafting large quantities of fat cells, as in these cases there is a risk that the injected cells will not be nourished by the tissues into which they are transferred, leading to necrosis and infection.

FACE LIPOFILLING

As the years pass, the tissues of the face and neck are subject to natural ageing. The wrinkles and furrows of an ageing face are caused by thinning of the skin, dislocation of muscle masses, atrophy of fat cells and a natural reduction in skin elasticity.

These imperfections are usually concentrated in the periocular area and are often associated with hollow eyelids, depressions in the cheek area, deeper nasolabial grooves and loss of facial contour definition.
Facial lipofilling can correct these imperfections by reshaping facial volumes and smoothing out furrows and wrinkles, giving patients a rejuvenated appearance with a natural effect.

WHAT TO DO BEFORE LIPOFILLING SURGERY?

Before lipofilling surgery, the plastic surgeon will have to take an accurate anamnesis of the patient, evaluating a number of factors that are fundamental to the success of the operation. In addition to a clinical examination of the patient and thus the identification of the areas to be operated on, their extent and the amount of fat cells to be transferred, the examination also includes an assessment of the patient's lifestyle and any current pathological conditions.

The planning of the operation also includes a detailed pre-operative plan, which is also drawn up on the basis of certain assessments made by the surgeon together with the patient and concerning the areas from which the fat cells are to be taken.
The patient has to follow the instructions given by the surgeon concerning the diet to be followed before and after the operation and the intake of cigarettes, alcohol and drugs.

LIPOFILLING SURGERY

The procedure can be performed either under local anaesthesia with sedation, in which the patient remains awake but feels no pain, or under general anaesthesia. The choice of the type of anaesthesia also depends on the duration of the operation, and this factor also determines the possible hospitalisation. For smaller operations, an outpatient procedure can be opted for; in the case of larger operations, it may be necessary for the patient to stay overnight in the clinic.
The lipofilling procedure always consists of two phases, regardless of the areas to be treated. The first phase consists of harvesting the adipose tissue through micro-cannulas and syringes that aspirate the cells at low pressure. It is necessary that the harvested material is properly filtered, as only intact and viable cells are suitable to be re-injected into the target area. Once filtered, the material will be cleansed of damaged cells and unsuitable by-products and can be infiltrated in small quantities, always in contact with adequately vascularised tissue.

The procedure lasts between 30 minutes and two hours, depending on the areas treated and their extent.

LIPOFILLING: THE POST SURGERY

At the end of the operation, an elasto-compression bandage is applied to reduce any oedema or haematoma and is maintained for about three to four weeks. The patient may experience soreness in the treated areas, which can be easily controlled with common painkillers; generally speaking, the operation is not very painful.
One can return to daily activities gradually over the course of a few weeks, and the result begins to be noticeable after the first three weeks, reaching its final outcome about six months after the operation.
Thanks to the stem cells naturally present in the adipose tissue, the lipofilling technique gives the treated area an overall aesthetic improvement.

The results obtained with lipofilling are generally long-lasting and satisfactory for the patient. The only limitation of this procedure is the partial reabsorption of the transferred adipose tissue. It remains, however, the only valid technique for certain areas of the body that cannot be treated with alternative methods.

FAQ

Who can undergo body and/or face lipofilling surgery?

Lipofilling surgery is suitable for all patients (women and men) who have volume deficits in certain areas of the body, as the natural convexity can be harmoniously restored by means of this technique.
Lipofilling of the face is intended for men and women who want to correct typical imperfections due to ageing facial tissue, such as furrows and wrinkles in the periorbital area and cheeks, together with volume deficits or a reduced definition of the mandibular profile and mental region. The same technique can be used on the lips and zygomatic region and gives the patient an increase in volume with more stable and natural results, offering itself as a valid alternative to the use of fillers with resorbable materials.

Is there an ideal age to undergo body and/or face lipofilling?

No, there is no age limit for undergoing body lipofilling surgery. As with most cosmetic surgery procedures, it is advisable to wait until the age of majority or at least the full development of the body, in order to better target the areas to be treated and to have better and longer-lasting results.
Most lipofilling operations are performed on patients between 20 and 60 years of age, but it is also possible to treat patients between 60 and 80 years of age with this technique and achieve good results. Depending on their age, patients have different needs and requirements, which the surgeon will understand and discuss with him/her. Usually, younger patients require volume increases in certain areas of the face, especially the lips and zygomatic region. Lipofilling in patients over the age of 40 usually has different objectives: to harmoniously restore the fullness of facial volumes and to improve skin quality (effect related to the presence of stem cells in the reimplanted adipose tissue).

Can body and/or face lipofilling be combined with other cosmetic surgery procedures?

Yes, body lipofilling can be combined with other aesthetic or reconstructive surgeries in the same body area. It is frequently combined with gluteoplasty or liposuction.
To achieve overall facial rejuvenation, facial lipofilling can be combined with a facelift operation. In this way, the filling of volumes through the infiltration of fat cells is enhanced by lifting the deep tissues of the face. Operations that are frequently associated with facial lipofilling include blepharoplasty (eyelid reconstruction or correction), mentoplasty and malaroplasty (cheekbone augmentation).

What are the risks and/or complications of body and/or face lipofilling surgery?

Lipofilling is a relatively simple, non-invasive operation that can be repeated over time if the implanted fat tissue is partially reabsorbed by the body. Since it is, in any case, a surgical procedure that involves anaesthesia and a post-operative course, it is essential to turn to plastic surgery specialists operating in appropriately equipped facilities. Only in this way can any rare complications (infections or bleeding) that may arise after surgery be controlled and resolved. The risks can be further reduced by meticulously following the instructions given by the doctor.

In addition, numerous studies published in the world's most prestigious Plastic Surgery journals have definitively overcome misgivings that breast lipofilling was responsible for a possible diagnostic delay in breast cancer.