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These techniques help restore lost volume or lift depressed scars using your own tissue.

Fat grafting is used for broad areas (such as your cheeks), while dermal grafts are best for localized defects, such as your lipstick line or forehead frown lines.

Both treatments require only a local anesthetic.

Technique: Fat Graft

Although fat for grafting can be collected from almost any body area, your abdomen, flanks, and hips are common donor sites.

Fat collection is liposuction.  A mixture of IV fluids and local anesthetic is injected into your donor site. Fat is then removed and processed (to remove damaged fat cells and fluids.)

Using specialized blunt needles, your processed fat is placed into the recipient site(s) through small puncture incisions.  These incisions only rarely need a suture.

Fat is placed in multiple thin strands, taking a new blood supply from the surrounding tissue.

Dermal grafting uses a segment of your own skin as a "filler."  The graft surface is treated with a  CO₂ laser, removing the layer of cells that creates calluses.  After removing the graft, your donor site is repaired with sutures. Using small incisions, the graft is placed under your defect.

When treating depressed scars, the scar itself is used as the filler graft.  The scar is treated with the laser, and the adjacent normal tissue is sutured closed over the scar. 

Which Graft?

Since they are complementary, both techniques can be used simultaneously. 

Dermal grafts give a more localized correction, such as the border of the lip, depressed scars, or the deep hollow beneath your eyes. 

Fat grafting can be tailored over a larger area, restoring a more natural contour over the cheekbone area than can be accomplished with cheek implants. Fat grafts help to restore normal proportions to your lips, both in the red and white portions of your lips.

Both techniques cause swelling, though fat injection usually swells more than dermal grafts. The greatest swelling develops during the first 24 hours, and may continue to increase up to 72 hours. 

Cool compresses help limit swelling & bruising. The majority of swelling improves over the first 7-10 days

While it takes 1 year to see the final results, there is usually only minimal changes after 3-6 months.

Risks are the same as any other surgery. These include bleeding, infection, scarring, altered sensation, and possible need for more surgery. Antibiotics are used around the time of surgery to limit the risk of infection.

Copyright © 2002 Denis F. Branson, M.D.  All rights reserved.
Revised: 10/28/02.