Fat Is The Original Filler

During the course of any day, Dr. Lavinia K. Chong is asked why fat isn’t the “same” throughout the body. Fat has been grossly underappreciated and in fact deplored, connotating a fundamental misunderstanding of the multiple roles fat plays. Structure and protection are critical reasons why fat surrounds critical structures: the kidneys, the extraocular muscles, even the heart. However, as America struggles with obesity, global fat expansion threatens not only our aesthetic sense of self but also our health by causing fatty degeneration of the liver, atherosclerotic coronary artery disease, peripheral vascular disease, and stroke.

Here is a Plastic Surgeon’s perspective on fat.

Like any organ, fat is genetically programmed to develop, expand, atrophy and die; the extent to which any anatomical zone follows its ontogenetic potential can also be modified by environmental factors, such as overeating, trauma, illness. Consider the contours of a baby’s face and body: everything is round, soft and smooth. Fat aging has a bimodal pattern: expansion or wasting but it also has a more diabolical variant, cellulite.

Facial lipoatrophy has been well studied by Rohrich and Pessa in postmortem dissection specimens. Loss of facial volume due to fat loss is fairly consistent and this serves as the “map” for repletion by fillers. By contrast, fatty degeneration or accumulation in the neck can be addressed by surgical excision, submental liposuction, and Kybella. After fat reduction, the next priority is ensuring satisfactory skin retraction or drape and this may require additional skin tightening modalities such as Cutera Secret RF.

Breast and body fat is definitely influenced by hormonal fluctuation, as evidenced by the sequela of pregnancy and lactation. Many women despair the expansion of compartments of fat in the armpit and bra “boobs”, belly and “FUPA” (Fat Upper Pelvic Area). The firm, high and tight structure of the young female breast sags shapelessly after breast feeding and seemingly expands upon menopause. Lacking any methods of “rejuvenating” these structural compartments, we can only resort to reducing the thickness, hopefully maintaining an attractive shape, hence the Mommy Makeover (a suite of procedures which may include breast reductions, mastopexy, abdominoplasty, and brachioplasty arm lifts) have become accepted and continually refined.

Conversely, unwanted fat has now become a virtual “goldmine” for regenerative medicine owing to the actual but limited availability of stem cells in mature adipose. Does it mean that we can now offer “stem cell” facelifts or breast augmentations? At this time, the physiology and growth requirements are still under definition. The American Society of Plastic Surgery (ASPS) has created a registry, GRAFTS, in which fat grafting cases may be analyzed in order to systematize methods, ensure safety and make patient results more consistent. 

Where is the most ideal fat found?

Belly fat is our preferred fat harvest area. Whether fat grafting to the face to replenish volume due to structural changes following dental surgery and the natural course of aging, or grafting to the breast to add volume to a deflated or depressed area, belly fat is the most common fat donor site.

Current accepted indications include fat grafting and fat transfer for:

• Facial Rejuvenation (either as a standalone procedure or in conjunction with a Facelift);
• Surgery for Congenital Breast Asymmetry & Breast Variations;
• Breast Surgery to attain symmetry during revisional breast cases, and;
• Replenishment of volume following the removal of breast implants (often performed as a staged procedure).

Where is this procedure performed, and how do I request a consultation?

Fat grafting and fat transfers to the breast and face, are procedures offered at our AAAASF-accredited Orange County Surgical Suite in Newport Beach. For the convenience of our patients, complimentary virtual consultations are available. All subsequent appointments (in-office consultation, pre-operative appointments, elective plastic surgery operations, post-operative appointments, and follow-ups) occur in one convenient location.

To find out if you are a candidate for fat graft/transfer to restore volume in your face due to aging, or as an alternative to restoring breast volume following your breast implant explant, schedule your in-office or virtual consultation with female plastic surgeon Dr. Lavinia K. Chong. Connect with our office via phone, text, or email our Patient Care Coordinator Nancy Muller today!