Lipofilling: correcting volume loss with body fat

As we age, we lose volume in our face. The cheeks and cheekbones become less prominent, the temple area deepens, the corners of the mouth start to sag, and several other characteristics appear due to volume loss. There are different ways to restore this volume. The most well-known method is filling these areas with a hyaluronic acid-based filler. Another option is to use body fat to address the volume loss. This involves removing fat from one area (usually the abdomen, hips, or buttocks) and injecting it elsewhere.

For which areas?

The treatment is suitable for restoring volume in the face, as well as the labia majora and the backs of the hands. In the face, the temples, cheeks, and the region around the mouth can be effectively treated with lipofilling.

Lipofilling treatment: how does it work?

We need fat! During an informational consultation, the ‘donor area’ is determined; this is the place where the fat can be harvested from. I personally prefer to use fat from the “love handles.” Large amounts are not needed, as most people have a bit of fat that can be used. During the treatment, the donor area is locally anesthetized with tumescent fluid (a large amount of fluid with a little anesthetic), which needs to work for about 45 minutes. Afterward, the fat to be transplanted is removed with a thin tube. After harvesting the fat, it is processed in a special way to retain as many viable fat cells as possible. There are various methods to process and purify the harvested fat. We use the Puregraft system, a method that advancedly filters the harvested fat from unnecessary material, leaving behind the usable fat cells.

Now we can use the harvested and processed fat. The fat cells are injected where more volume is needed, which is discussed beforehand. We aim to apply the new fat tissue as evenly as possible. This ensures a beautiful end result and a higher survival rate of the fat cells. The fat cells need blood circulation, and when too much is injected in the same area at once, fewer fat cells will survive the transplant. Additionally, there is an increased chance of developing fat cysts. Therefore, only a limited amount of fat cells can be injected at one time. The treatment takes about 2 and a half hours.

After the lipofilling treatment

After the treatment, the small holes made to harvest the fat are covered with bandages. It is useful to bring tight leggings, cycling shorts, or tights to keep the bandages in place and apply pressure to the donor site.

Recovery

In the first few days after the treatment, anesthetic fluid will seep from the holes made to remove the fat. You may feel a bit tired, and possibly a bit chilly. You might also experience a bruised feeling and a sort of muscle ache in both the area where the fat was removed and the area where the fat was injected. Swelling and bruising are expected and will significantly reduce after a week. It may take some time for the bruises to disappear completely. After the treatment, it is wise to take it easy and avoid sports or heavy labor for a week. Showering is allowed, but visiting a sauna or swimming pool is not.

The result

You should see it as a filler treatment. Since we have a fair amount of material, we can treat several areas of the face at once. You will then have some bruising and swelling in the first few days. Also, some of the fat cells will not survive, so the volume decreases in the weeks to months after the treatment. The final result can be assessed after about 3 months. Because we can immediately introduce a significant amount of material, there will be a noticeable result right away. When using fillers, you often use no more than 3 ml due to the price, but now we have many more ml available. Some of this will die off, but the fat that survives will remain longer. Of course, the aging process continues, and volume will diminish again as it would otherwise. As with fillers, the best result with lipofilling is achieved with maintenance.

Depending on the degree of volume loss and the result of the treatment, multiple treatments may be chosen. We advise maintaining a period of approximately 3 months between each treatment.

Risks and complications

Lipofilling is a safe procedure. As with any procedure involving injections, there is a risk of infection. Sometimes small lumps can be felt, which generally disappear on their own. Specific risks in areas treated symmetrically include slight asymmetry. It is otherwise a comparably safe procedure to filling with fillers such as hyaluronic acid. However, there is no risk of rejection, as it is your own fat.

When to choose lipofilling over hyaluronic acid

More and more people are critical of the use of non-body-own products, yet still wish to undergo a cosmetic treatment to address volume loss. In that case, lipofilling is particularly suitable. Additionally, a common complaint about regular fillers is that the result is not permanent. With lipofilling, you have a more sustainable solution than with hyaluronic acid-based fillers. On the other hand, this latter can be seen as an advantage; if you do not find the result ideal, it is only temporary and can be removed with an “antidote.” Finally, lipofilling is very suitable for people with significant volume loss, where the use of regular fillers would be too costly.