What is fat transfer and what does it involve?
Fat transfer, also known as lipofilling or autologous fat transfer, is a surgical procedure that involves extracting fat from one area of the patient’s own body, processing it and subsequently transferring it to another area to add volume, modify contours or improve certain facial or body proportions.
It is therefore an autologous transplant of living adipose tissue: the fat comes from the patient’s own body and, once transferred, some of the fat cells or adipocytes can integrate into the tissues of the recipient area.
- The procedure begins by extracting fat through liposuction from a donor area.
- The adipose tissue is then processed so that it can be reinjected in a controlled manner into the area to be treated.
One of the important factors in promoting the viability of the transferred tissue is reducing the amount of time between the extraction and reinjection of the fat. Other relevant factors include:
- the extraction technique
- the handling of the tissue
- and its processing using systems that maintain suitable conditions throughout the procedure.
The latest research has identified ideal donor areas for different recipient areas, making appropriate selection important.
At Clínica Planas, processing can be carried out using a closed system, followed by filtration or decantation of the adipose tissue before it is transferred. The aim is to preserve the viability of the fat as much as possible to promote its vascularisation and integration into the recipient area.
Fat transfer has a dual benefit within body contouring surgery: it makes it possible to reduce volume in certain areas through liposuction and use some of that same fat to add volume and reshape other areas.
For this reason, it can be used both to enhance certain areas — such as the buttocks, breasts or cheekbones — and in body and muscle definition procedures.
Areas where fat transfer is most commonly performed
Fat transfer can be performed in different areas of the face and body. The amount of fat transferred, the depth at which it is placed and the technique used depend on the anatomy of the recipient area and the surgical objective.
Buttocks
Fat transfer to the buttocks or buttock augmentation using the patient’s own fat is one of the best-known applications of body lipofilling and can be performed in both women and men.
The objective does not necessarily have to be simply to increase volume. Fat transfer makes it possible to work on the shape, projection and proportion of the buttocks in relation to the waist, hips and overall body contour.
Aesthetic goals may vary depending on each patient’s anatomy and preferences. Some women may seek a rounder shape, while certain men may prioritise greater projection while maintaining a narrower contour.
Safety is a fundamental consideration in gluteal fat transfer. The fat must be placed within the anatomical planes established for this procedure, and the injection can be performed under ultrasound guidance, allowing the position of the cannula to be visualised in real time during the transfer. The fat is deposited above the gluteus maximus muscle, within the subcutaneous adipose tissue.
The amount transferred must be individualised. The clinical reference document describes volumes commonly requested in Europe of approximately 200 to 500 cm³ per side, although the appropriate amount depends on the patient’s anatomy, available tissue and individual goals.
Breasts
Breast fat transfer or breast augmentation using the patient’s own fat uses the patient’s own adipose tissue to add volume and modify certain characteristics of the breast contour.
It can be performed as a breast augmentation using fat alone or as part of a hybrid breast augmentation, combining breast implants with lipofilling.
Fat transfer makes it possible to work selectively on different areas of the breast, which can be useful for refining the contour and achieving smoother transitions.
It can also be considered following breast implant removal. After implants are removed, fat transfer can be used, when sufficient donor tissue is available and it is clinically indicated, to restore some of the lost volume and reshape the breast.
The amount of fat that can be transferred depends on multiple factors, including:
- the patient’s anatomy
- the availability of adipose tissue
- the characteristics of the breast
- and the capacity of the recipient tissues.
As a reference based on the protocol described, approximately 50–150 cm³ per breast may be transferred during a hybrid augmentation, while certain breast augmentations performed exclusively with fat may involve approximately 200–300 cm³ per side. These figures are approximate and must be individualised.
Following fat transfer, not all of the transferred fat necessarily survives. Some may be reabsorbed during the first few weeks and months, meaning that the initial volume should not be interpreted as the final result.
At Clínica Planas, hyperbaric oxygen therapy may be considered as part of the medical and postoperative protocol for certain patients. Its indication must be determined individually by the medical team.
Cheekbones
Facial fat transfer to the cheekbones makes it possible to use the patient’s own fat to add volume to the midface and modify its contour.
One of its characteristics is the use of the patient’s own tissue, allowing the volume to be distributed in a personalised way according to the facial anatomy.
The fat can be obtained during liposuction performed on another area of the body, processed and subsequently used for facial lipofilling.
As with any fat transfer, some of the injected volume may be reabsorbed. Fat graft survival can vary between patients and anatomical areas, meaning that a second session may need to be considered in certain cases.
Pectoral Area
Pectoral fat transfer makes it possible to use the patient’s own fat to add volume and modify the contour of the pectoral region.
In men, it can be used as part of certain body definition procedures to emphasise the pectoral contour and achieve greater harmony between the chest, shoulders, waist and abdomen.
According to the procedure described in the original document, the transfer is performed under ultrasound guidance and can target specific planes within the pectoral region. The main plane, however, is the superficial layer of the pectoralis major muscle.
Pectoral lipofilling can also form part of comprehensive gynaecomastia surgery, depending on the patient’s anatomical characteristics and reshaping goals.
In women, the pectoral region can also form part of the different planes in which fat is distributed during certain breast augmentation procedures using the patient’s own adipose tissue.
Deltoids
The deltoid is one of the muscles that determines the shape and visual width of the shoulder and can be particularly relevant in certain male high-definition liposculpture procedures.
A body reshaping strategy may combine the reduction of adipose tissue through liposuction of the abdomen, flanks and back with a selective increase in volume in specific muscular regions.
In this context, deltoid fat transfer can be used to enhance the width of the upper third of the body and contribute to a more pronounced V-shaped silhouette.
The deltoid has three main portions:
- anterior
- middle
- posterior.
Fat distribution must be planned according to the patient’s anatomy and the desired result. At Clínica Planas, we have established a new protocol involving additional injection into the posterior head of the deltoid.
In women, when indicated, the transfer can be performed more selectively, prioritising specific areas to maintain the desired body proportions.
Six-Pack and Rectus Abdominis Muscles
High-definition liposuction aims to highlight specific anatomical and muscular features of the abdomen by selectively working on different layers of adipose tissue.
So-called ultra-high definition can also incorporate fat transfer in relation to the abdominal muscles to increase specific volumes and enhance the appearance of muscular definition.
In the case of the rectus abdominis muscles or six-pack, planning may include an ultrasound examination beforehand to assess the thickness and characteristics of the muscles.
According to the protocol described, when the rectus muscles are less than one centimetre thick, ultrasound-guided fat transfer may be considered to increase their projection.
The indication must be individualised and form part of an overall plan for the abdomen, as the perception of definition depends both on muscle volume and on the distribution of the adipose tissue covering it.
Obliques
Fat transfer involving the oblique muscles, also referred to as the Spartan technique, aims to enhance definition along the sides of the abdomen.
This is an advanced body contouring procedure that can be combined with liposuction to work on both the depressions and prominences that visually define abdominal anatomy.
The transfer is performed under ultrasound guidance, usually in relation to the internal oblique muscle.
Paraspinal Muscles of the Back
Fat transfer in the paraspinal muscle region, known as the Xpine technique, can be used as part of back and body definition procedures.
After the adipose tissue has been treated through liposuction, selective fat transfer can be used to modify specific volumes in the lumbar region.
The aim is to emphasise the anatomical features of the central and lower back and refine its transition towards the buttocks, integrating it into the overall body contour design.
Trapezius
The trapezius plays an important role in the contour of the base of the neck and upper back.
In certain patients, particularly those with developed musculature who wish to enhance the volume of the upper third of the body, fat transfer to this region may be considered.
The indication and volume must be adapted to the patient’s proportions and, when fat is transferred in relation to muscular structures, the technique requires precise anatomical planning.
Latissimus Dorsi
The latissimus dorsi is one of the main muscles of the back and contributes significantly to the shape of the torso.
In certain body definition procedures, autologous fat can be used to modify the volume of areas associated with this muscle and visually emphasise its lateral border. The transfer is performed under ultrasound guidance.
At Clínica Planas, the use of hyperbaric oxygen therapy may also be considered before or after certain fat transfer procedures, always according to the patient’s individual medical indication.
Biceps and Triceps
Fat transfer to the arms can be used to modify the volume and definition of specific muscle groups, particularly as part of male body contouring procedures.
- In the biceps, fat distribution is planned taking into account the different muscle heads and the individual anatomy of the arm.
- In the triceps, the procedure described in the original protocol primarily targets specific muscle portions with the aim of adding volume and definition.
The aim is not to indiscriminately increase the size of the arm, but rather to achieve a proportionate relationship with the shoulders, pectorals and torso.
Quadriceps
Fat transfer involving the quadriceps can be used to enhance specific anatomical features of the front of the thigh.
In the procedure described, particular emphasis is placed on the lateral region of the quadriceps.
The amount of fat transferred must be determined individually according to the patient’s build, existing muscle development and leg proportions.
Back of the Thigh
Fat transfer to the back of the thigh can form part of a reshaping strategy involving the thighs and buttocks as a whole.
Selective modification of specific volumes makes it possible to enhance the definition of the upper and posterior thigh and its transition towards the buttock.
In this way, planning is not limited to increasing the volume of one specific area, but instead seeks to modify the proportions and transitions between different regions of the body contour.
This technique requires surgical expertise to augment, using fat and under ultrasound guidance, the proximal regions of the biceps femoris, semimembranosus and semitendinosus muscles.
Calves
Calf fat transfer can be used to modify the volume and contour of the leg using the patient’s own adipose tissue.
The procedure is performed in relation to the gastrocnemius or calf muscle, which has a medial and a lateral head.
The distribution of fat depends on the patient’s anatomy and the desired result. In certain men, both regions may be treated, while in women a more selective distribution may be considered to maintain the desired proportions. For example, in women, the medial region alone tends to be augmented to maintain a feminine contour.
After fat transfer involving muscular structures, the return to exercise should be gradual and follow the surgeon’s instructions.
Final Results of Fat Transfer
The results of fat transfer evolve during the months following surgery. Although an increase in volume may initially be visible, factors such as swelling and the reabsorption of some of the transferred fat occur during the first few weeks.
For this reason, the volume immediately after the procedure should not be considered the final result.
The integration of the fat depends on its ability to establish a blood supply within the recipient area. Some of the transferred adipocytes will survive and integrate into the tissues, while others may be reabsorbed.
The survival rate is not the same in every patient or anatomical area and may depend on factors including:
- the technique used
- the vascularisation of the recipient tissue
- the volume transferred
- and individual patient characteristics.
When are the results visible?
The first changes can be seen immediately, but the results of fat transfer continue to evolve during the months following the procedure.
- During the first few weeks, swelling gradually decreases and some of the transferred adipose tissue either integrates or is reabsorbed.
- By around the first three weeks, the fat that has survived is considered to have made significant progress in its integration process. However, the contour and volume continue to evolve afterwards.
For this reason, the final result of a fat transfer is assessed at approximately six months.
In transfers involving muscle tissue, a significant proportion of the initially transferred volume may be reabsorbed. The reference document places this loss at approximately 30% to 50% in certain intramuscular procedures, although fat graft survival can vary from one patient to another.
Are the results permanent?
Fat that successfully establishes a blood supply and integrates into the recipient area can remain there long term as living tissue.
However, this does not mean that the volume and shape will remain completely unchanged throughout life. The transferred adipocytes can increase or decrease in size if significant changes in weight occur, while body contours can also change as a result of ageing and other physiological changes.
For this reason, maintaining a relatively stable weight and healthy habits can help preserve the results.
In procedures designed to enhance muscle definition, the final appearance is also related to maintaining muscle mass. Exercise and an appropriate body composition can influence how this definition is perceived over the long term.
Advantages Compared with Traditional Implants
Fat transfer and implants are different techniques and are not necessarily equivalent alternatives for every patient. The choice depends on:
- the area being treated
- the volume the patient wishes to achieve
- the availability of donor fat
- the patient’s anatomy
- and individual preferences.
One of the main characteristics of fat transfer compared with implants is that it uses the patient’s own tissue.
As no prosthesis is introduced to create the additional volume, implant-specific complications do not occur, such as implant rupture or capsular contracture.
In addition, fat allows for highly personalised volume distribution and makes it possible to selectively work on different anatomical regions and transitions.
In breast surgery, for example, the patient’s own fat can be used exclusively when the anatomy and desired increase in volume allow it, or fat and an implant can be combined through a hybrid breast augmentation.
Fat transfer can also be particularly useful for patients undergoing explantation who wish to consider using their own tissue to restore some of the breast volume.
However, the increase in volume that can be achieved with fat is limited by the amount of adipose tissue available and the capacity of the recipient area. In addition, some of the initially transferred fat may be reabsorbed, meaning that more than one session may be necessary in certain cases.
For this reason, the decision between fat transfer, implants or a hybrid technique should be made after assessing each patient’s anatomy and goals.
Frequently Asked Questions About Fat Transfer
What is the difference between fat transfer, lipofilling and autologous fat transfer?
The terms fat transfer, lipofilling and autologous fat transfer are used to describe procedures based on the same principle: extracting adipose tissue from the patient’s own body, processing it and transferring it to another area of the body.
The specific technique, amount of fat and plane in which it is deposited vary depending on the area being treated and the surgical objective.
Where is the fat for a fat transfer obtained from?
The fat is obtained through liposuction from an area of the patient’s own body that has sufficient adipose tissue.
The choice of donor areas depends on the patient’s anatomy and the surgical plan. In body contouring procedures, extraction and transfer can be planned together to reduce volume in certain areas and use that tissue to reshape others.
What percentage of fat survives after a fat transfer?
There is no single percentage that applies to every patient. Some of the transferred fat may be reabsorbed during the first few weeks and months, while the remainder establishes a blood supply and integrates into the recipient tissue.
Survival depends on numerous factors, including the extraction and processing technique, the vascularisation of the recipient area, the volume transferred and the patient’s individual characteristics.
How long does it take for the fat to settle after a fat transfer?
The first few weeks are particularly important for the integration of the transferred adipose tissue. According to the protocol described by Clínica Planas, by around three weeks, the surviving fat has made significant progress in its integration process.
However, this does not mean that the aesthetic result is final at this point. The volume and contour continue to evolve over the following months, and the final result is usually assessed at approximately six months.
How long do fat transfer results last?
The fat that survives the initial process and successfully integrates can remain in the recipient area over the long term.
As it is living tissue, the transferred adipocytes respond to changes in the body. Significant weight gain or loss can alter their volume, while ageing can also cause changes in the tissues.
Can buttock fat transfer be performed using your own fat?
Yes. Buttock fat transfer uses fat obtained from the patient’s own body to modify the volume, projection and contour of the buttocks.
The procedure must be planned individually, and the safety of both the technique and the injection plane is particularly important in this area. According to the protocol described by Clínica Planas, the fat is placed above the muscle under ultrasound guidance.
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