Fat grafting (also known as fat transfer or fat injection), has broad applications in aesthetic plastic surgery. Fat can be injected to enhance volume in tissues where fat has diminished. Fat grafting involves harvesting fat from one part of the body, washing and purifying it, and then carefully re-injecting it into the areas requiring augmentation. For example, many patients choose to do what is commonly called a Brazilian Butt Lift, getting liposuction with fat transfer to their buttocks. The procedure may need to be repeated several times to achieve the desired result but can produce long-lasting and natural-appearing results.

Good candidates for this procedure:

  • Patients who desire more volume in specific areas of their body (most commonly the buttocks)

brazilian butt lift

What to expect: Consultation

All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for fat grafting.

During the consultation, Dr. Hsu will first ask about your goals, and specifically what areas of the body you would like to remove the fat from, and what areas you would like to put it into. He will also ask about medical history, including existing medical conditions, past surgeries, tobacco usage, daily medications, supplements, and allergies. If he determines that you are a good candidate, Dr. Hsu will explain the next steps in going forth with the procedure. In order to reach your aesthetic goal, both you and Dr. Hsu will work together to decide all the necessary details that will ultimately give you the best results. 

Surgery Details:

fat grafting

On the day of surgery, come in early to fill out paperwork, meet the anesthesiologist, and the staff will prep you for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last questions you may have. 

After liposuction is performed to remove fat (please see our Liposuction page for more details if desired), the fat is purified and then washed with an antibiotic rinse, placed in sterile syringes, and then injected in small doses to the buttocks. Dr. Hsu's technique is to carefully inject various areas in very small deposits which ensures that the fat cells receive enough blood supply to live and heal properly. Some fat cells will be eventually re-absorbed by the body, so often, Dr. Hsu will inject a little bit more fat than necessary to compensate for this re-absorption. 

One limitation of the fat transfer is how much fat Dr. Hsu can use from liposuction. The volume of the fat transfer depends highly on the amount of available fat after liposuction. 

Recovery & Post-operative Instructions:

Following the surgery, you will wear a compression garment that encompasses the liposuction areas and buttocks for a couple weeks to ensure the fat remains where it was injected. You will sleep on your belly for the following two weeks. During those two weeks minimize sitting and when doing so, use a large pillow to minimize pressure on fat cells. 

Most importantly, you should keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe around the surgical areas. Dr. Hsu will usually remove stitches during the first week follow-up appointment. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to return to most types of exercise and activity. 

During the recovery period, we recommend walking within the house several times per day to speed healing and minimize the possibility of developing blood clots. If you have any inquiries after surgery, Dr. Hsu is available 24 hours to address any immediate concerns. For an extended period of time after surgery, Dr. Hsu will maintain regular contact with you to make sure you are pleased and healing well. Most follow up appointments are scheduled immediately after surgery and for up to a year afterward. 

Dr. Hsu's view on Fat Grafting.

Fat grafting has gotten more popular over the past ten years as there has been more recognition among plastic surgeons that there are changes in fatty tissue volume as the body changes.  Central among these has been a rise in popularity of fat grafting to the buttocks, also termed a “Brazilian lift.”  In reality, the skin is not being lifted, but the increase in volume from fat grafting gives an appearance of a lift to the area, and hence the name.

As with liposuction, this works well for patients who have specific areas that they would like improved.  There is a limit on the amount of fat that can be transferred safely, so it is best used when the fat can be directed to specific areas in the buttocks.  A large number of my patients for fat grafting to the buttocks mention specific hollows in the outer areas of the buttocks, particularly that they have noticed over time.  In these patients, directed fat grafting to these areas can be very successful.

Fat transfer does require patience for the areas to soften. The increase in volume can be seen right away, and patients can usually get around without difficulty by two weeks after surgery. It can take some time for small areas of firmness to be softened up with the use of massage, so I always advise patience when it comes to this.