Loss of volume in parts of the body may be caused by your genes, aging or disease. Common problem areas are sunken cheeks, hollow eye sockets, flatter buttocks and drooping or asymmetric breasts. Lipofilling provides a remedy for this loss of volume. It is a unique way of improving the contours of your body using fat from your own body. Because lipofilling uses your body’s own fat, it is a really safe technique and presents no risk of rejection.

Stem cells may also be harvested from liposuction (the removal of fat cells) in addition to the fat cells. As a result, lipofilling (the injection of fat cells) enriches the tissue, for example with respect to scars, trauma and burns or after radiation.

Lipofilling of the buttocks

Your buttocks may start to sag or lose volume as a result of weight loss, pregnancy or less elasticity in the skin. A buttock augmentation by means of lipofilling can provide a remedy for this. Your buttocks will be augmented and made firmer using your body’s own fat tissue. You must have sufficient body fat for this procedure to be carried out.

Lipofilling of the breasts

People are increasingly opting to have a breast augmentation using their body’s own fat tissue. Liposuction is carried out elsewhere in the body to remove fat. The fat cells are then injected into the breasts using thin cannulas. Apart from augmenting the size of the breasts, lipofilling has the advantage of not leaving behind any large scars. Because the procedure uses material from your own body, the risk of complications is minimal. Rejection or capsular formation does not happen with lipofilling.

Lipofilling offers a number of benefits, specifically for women who have undergone a lumpectomy or breast reconstruction surgery in the past followed by radiotherapy:

Missing breast volume is filled up and the breasts feel softer

The appearance of misshapen and/or asymmetric breasts will be greatly improved.

However, there are also disadvantages of breast augmentation by means of a lipofilling procedure. The volume that can be transplanted is often limited and after the procedure a percentage of the injected fat will disappear again. If you want your breasts to look visibly bigger, a breast augmentation with implants is often a common solution. The advantage is that our plastic surgeons carry out the two procedures on a regular basis, so they can advise you on what the best solution is for you in your specific case.

Lipofilling of the face

Lipofilling is a good alternative to synthetic fillers.
Your face may lose volume and develop wrinkles and other irregularities as a result of aging, genes or disease. Lipofilling is a relatively long-lasting and safe way of remedying these complaints. Because the procedure uses fat from your own body, the risk of complications is minimal. For the first few months after the lipofilling procedure, the injected volume may reduce slightly. Approximately 60% to 80% of the injected fat delivers a lasting result. We cannot stop your natural aging process, so you may wish to repeat the procedure in the future.

Plastic surgeon

The consultation is always held with the plastic surgeon who will be carrying out your procedure.
This consultation will determine whether a lipofilling procedure can remedy your complaints and achieve what you are looking for. The plastic surgeon will ask you a number of questions, such as your medical history, what medication you are taking and whether you have any allergies.

They will check where to remove fat from your body and the quality of your skin. Older people often have lower skin elasticity, so the removal of fat may have less effect. If necessary, the plastic surgeon can advise a treatment that would also tighten the skin. This will have to be checked each time.

The pros and cons, possible complications and any risks of the lipofilling procedure will be discussed with you. The plastic surgeon will then show you before and after photos of lipofilling procedures that they have previously carried out and you will have an opportunity to ask any questions you have.

We know from experience that people’s expectations of a lipofilling treatment are sometimes too high. Lipofilling often improves the contours of the body. However, lipofilling is a difficult-to-predict procedure, and irregularities may appear in the surface of the skin after treatment. Our plastic surgeons are highly skilled in performing lipofilling treatments, but they cannot always predict how the treated area will recover. It is therefore important that you take sufficient time in your consultation to discuss what you are expecting from the results of a lipofilling treatment.

Consultants

Following on from your first consultation with your plastic surgeon, you will have an appointment with your consultant. The aim of this appointment is to tell you about the general aspects to be arranged with respect to your procedure. 

You are expected to arrive at the Boerhaave clinic half an hour before your procedure. 

Depending on the extent of the lipofilling procedure, it is carried out under local sedation or general anaesthetic. A minor lipofilling procedure for example in the face can be carried out under local sedation, but a more extensive treatment is performed under general anaesthetic. The duration of a lipofilling procedure depends on the desired volumes to be injected and the chosen locations for removing and injecting the fat cells.

In consultation with you, the plastic surgeon will determine beforehand where the fat is to be removed from. This is often the abdomen or thighs. These areas are marked out Small incisions approximately half a centimetre long are made in the skin, where possible in the natural skin creases, so that they can barely be seen afterwards.

The plastic surgeon then inserts a small needle through these incisions to inject fluid into the body to separate the fat cells, reduce blood loss and numb the tissue under the skin. It takes about twenty minutes for this fluid to take effect. After twenty minutes, the plastic surgeon inserts a fine suction needle just under the skin via the incisions. Fat is removed by moving this suction needle back and forth. Once the correction has been carried out to the satisfaction of the plastic surgeon, the incisions are closed using small absorbable stitches.

The fat harvested from the liposuction is then immediately centrifuged, which separates the loose fat and fluid from the living fat cells. These living fat cells are then carefully transferred into syringes and inserted via cannulas into the pre-marked areas. This thickens the layer of fat under the skin. Because some of the fat cells will soon dissolve, a slightly greater volume of fat cells is injected than is needed.

For lipofilling, it is important that the injected fat cells receive oxygen and nutrients. These are supplied by the nearby blood vessels. Not all the injected cells will receive sufficient oxygen, so they will be removed by the body. The duration of a lipofilling procedure depends on the scope of lipofilling. A more extensive lipofilling procedure will obviously take longer.

If your lipofilling treatment is carried out under local sedation, you will be free to go home half an hour after the procedure. If the lipofilling treatment is performed under general anaesthetic, you will usually be kept at the clinic for a further 3 to 4 hours after the procedure. After the operation, you will be taken to the recovery room, where your blood pressure, heart rate and other vital signs will be monitored. You will stay there for about half an hour, after which you will rest in a bed in the day care department for a further 3 to 4 hours. You will only be free to go home once the nursing staff and anaesthetist give their approval for you to leave. After a procedure carried out under general anaesthetic, you may eat and drink easily digestible food, such as water, tea and rusks once you are home. This also helps prevent nausea and vomiting, which in turn reduces the chance of post-operative bleeding and/or pressure on the wound. It is therefore important to keep your fluid intake up.

There may be a small amount of bleeding or seepage from the wound holes in the first 24 hours. You shouldn’t worry about this. It will soon stop.

Post-procedure pain

After the treatment, the treated area will be painful and you may feel pressure on the treated area. Painful bruising, swollen skin and soreness are normal symptoms. You may experience a build-up of fluid in some places. This often subsides after approximately 2 to 6 weeks. You may also feel pain in your muscles, as if you have been doing strenuous exercise. When you walk, you may feel a painful burning sensation around the treated area. The areas from which fat was removed will be more painful than the areas into which fat was injected.

Recovery

As with every surgical procedure, the body takes time to recover. The treated area will initially be very swollen. The scars may also be red and raised immediately after the procedure. You shouldn’t worry about this, as it is your body’s natural reaction.
The skin around the treated area may turn from blue to yellow. You may also have decreased sensitivity of the skin.

Scar cream

At your first check-up, you will be given a scar care cream to take home with you. Once the wound has closed and the scabs have disappeared, you can start applying the scar cream. If you apply this cream to the closed wound twice a day, you increase the chance of the wound healing nicely.

A lipofilling procedure can deliver impressive results. The final results of the lipofilling will not be clear to see straight away. The skin is swollen and raised, and the volume of injected fat cells will go down. Approximately 60% to 80% of the injected volume will remain, as dead cells and fluid will be removed by the body.

After a couple of weeks, the swelling will have subsided and any fluid will have disappeared. It will take about 3 months to see whether or not the lipofilling procedure was a success. The end results will not be visible until 1 year after the procedure. Only then will the body have fully recovered from the operation.

The effect of a lipofilling treatment is often lasting. Once the injected fatty tissue adopts its final shape, it will no longer disappear. However, it is not possible to stop the natural aging process, so you may wish to undergo a further treatment over the course of time.

Scars

The scars after a lipofilling treatment are not large. A lipofilling scar is half a centimetre long on average. The plastic surgeon will do everything they can to ensure that the scars are virtually invisible. The scars will initially be red and swollen, but this will start to fade after a couple of weeks. The scars will then be barely visible. It is useful to know that a scar takes 1 to 1½ years to completely calm down. So remember to apply the scar cream to your scars and stay out of the sun. After the first year, always use factor 30 or higher when you are in the sun, to protect your skin.

It is important you are aware that every surgical intervention can entail risks and complications. Plastic surgery procedures are in principle carried out on healthy people, so the risks and chances of complications are low. We make sure any risks are reduced to an absolute minimum, by providing plenty of information, taking a thorough medical history (noting your case history, including medication, any problems experienced in previous operations, allergies, etc.) and applying our professional procedures.

Lipofilling is successfully performed each week at the Boerhaave Medical Centre. The chances of any complications arising are luckily rare. You can help reduce certain risks by carefully reading through the instructions you are given prior to your lipofilling treatment.

Possible complications of a surgical procedure may be:

• Haematoma (blood clot under the skin which has to be removed)
• Adverse reaction to the sedation
• Haemorrhaging
• Infection
• Change in sensitivity
• Permanently visible scars
• Damage to underlying structures
• Unsatisfactory aesthetic result.

Smoking

Patients who smoke or use tobacco or nicotine products (such as nicotine patches and chewing gum) at the time of their surgery have a greater risk of complications, such as skin loss and impaired wound healing. People who are exposed to passive smoking may also have an increased risk of complications such as these. What’s more, smoking may have a negative effect on the anaesthesia, which may in turn lead to an increased risk of bleeding. People who are not exposed to tobacco smoke or nicotine-containing products have a significantly lower risk of such complications. It is important not to smoke for at least 2 weeks prior to the operation and to keep this up for the entire recovery process.