​Understanding Your Fat

When fat is taken from one part of the body and injected into
another part (a procedure known as fat grafting or fat transfer), the
body goes through a series of reactions to accept and sustain the
injected fat. The success of the procedure depends on various factors,
such as how the fat is harvested, prepared, and reinjected, as well as
how well the body can establish blood supply to the transplanted fat
cells. Here's an overview of how the body reacts and sustains fat after
a fat transfer procedure:

1. Fat Harvesting
The fat is typically harvested from areas where there is excess fat
(such as the abdomen, thighs, or flanks) using liposuction. The fat
cells are carefully removed to ensure they remain intact for
reinjection.

Liposuction Process: Cannulas (small, hollow tubes) are used to
gently suction the fat from the donor area.

Purification: The harvested fat is then processed and purified to
remove any blood, fluid, or damaged fat cells, ensuring that only
healthy fat cells are injected.

2. Injection of Fat into the New Area
Once the fat is prepared, it is injected into the desired area, such as
the buttocks (as in a Brazilian Butt Lift or BBL), breasts, or face, to add
volume and contour.

Small Injections: Surgeons inject small amounts of fat into
different layers of tissue, often using multiple passes, to ensure
better distribution and integration of the fat cells with the
recipient tissue.

3. Initial Reaction: Inflammation and Immune Response
When fat cells are injected into the new area, the body initially
responds with inflammation, which is a natural part of the healing
process. This occurs because the body treats the fat transfer like an
injury, triggering an immune response.

Inflammation: The body sends white blood cells to the area to
begin the healing process, which may cause mild swelling or
redness. This is a normal part of tissue integration.

Immune Cells: While some immune cells help with healing,
others (such as macrophages) may clear away any damaged or
dead fat cells.

4. Fat Cell Survival: Blood Supply and Oxygenation
For the fat cells to survive, they must establish a blood supply in the
new area. This is one of the most critical factors in determining how
much of the transferred fat will survive long-term.

Vascularization (Blood Supply Formation): The body needs to
quickly form new blood vessels around the injected fat to provide
it with oxygen and nutrients. Fat cells that receive sufficient blood
supply are more likely to survive.

Oxygen and Nutrients: The fat cells rely on nearby blood vessels
to provide them with oxygen and nutrients. If the fat cells don't
receive adequate blood supply, they can die off (known as fat
necrosis).

5. Fat Cell Survival Rate
Not all of the injected fat will survive. Typically, 50-70% of the fat cells
survive, while the remaining cells are gradually absorbed and
eliminated by the body. Surgeons often account for this by over-
injecting fat, knowing that some of it will naturally be absorbed.

Early Fat Loss: Within the first 3-4 weeks after the procedure,
some fat cells will die due to insufficient blood supply. This fat will
be reabsorbed by the body.

Permanent Fat Cells: The fat cells that successfully integrate and
establish blood supply will become a permanent part of the tissue
in the new area.

6. Remodeling Phase
Over the next few months, the body continues to heal and remodel
the injected fat. The cells that survive this process become part of the
local tissue and will function like any other fat cells in the body.

Fat Cell Integration: Once integrated, the fat cells will behave like
native fat cells. They will respond to changes in weight, meaning
they can increase or decrease in size based on overall body fat
changes.

Body Acceptance: The body does not recognize the transplanted
fat as foreign because it comes from the same person (autologous
tissue transfer). This minimizes the risk of rejection, a problem
commonly seen in foreign tissue transplants.

7. Long-Term Maintenance
The fat that survives after several months is considered permanent.
However, the volume may still fluctuate over time based on factors
such as weight changes, aging, and hormonal shifts.

Weight Changes: The transferred fat will behave like regular fat
cells in the body, meaning they can expand or shrink depending
on overall body weight gain or loss.

Touch-Up Procedures: In some cases, patients may require
touch-up procedures to maintain or enhance the results if too
much fat is reabsorbed by the body.

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