Fat Injections (Fat grafting) in Turkey

Fat grafting, also known as fat transfer or fat injections, is a surgical procedure that involves transferring fat from one part of the body to another. The primary goal of this surgery is to enhance or augment the area where the fat is injected. The procedure consists of three main steps: extracting adipose fat through liposuction, processing and purifying the fat, and then reinjecting it into the desired area to achieve improvement.

Since the 1990s, fat grafting has been a reliable technique used by plastic surgeons to enhance the cosmetic appearance of various body parts, including the face, breasts, hands, feet, hips, and buttocks. More recently, its therapeutic benefits have also been recognized, particularly in healing wounds and scars, and in repairing breast tissue damage following radiation treatment.

A Brief History of Fat Grafting

The concept of fat grafting dates back to the late 19th century. The first documented procedure was performed in 1893 by German plastic surgeon Gustav Neuber (1850-1932), who transferred fat from the arm to the orbital region (around the eyes) to correct scarring caused by osteomyelitis, a bone infection.

Just two years later, in 1895, Dr. Viktor Czerny (1842-1916) successfully transferred a lipoma to the breast to restore symmetry after a partial mastectomy.

Despite these early successes, fat grafting struggled to gain widespread acceptance for the next century due to the complications that frequently accompanied the procedure. The lack of modern liposuction techniques and the inconsistent quality of the extracted fat often led to unsatisfactory results.

Who Performs Fat Grafting and Where?

Fat grafting is typically performed by plastic surgeons, given that liposuction is a critical component of the procedure. Plastic surgery residents receive extensive training in the standards of care for liposuction and are well-versed in managing potential complications.

This procedure should be carried out in an accredited outpatient surgery center or hospital. Facility accreditation is crucial as it ensures that the facility undergoes regular inspections to maintain patient safety and adhere to best practices.

The Fat Grafting Process – A Detailed Overview

Fat grafting involves a three-step process to transfer fat from one part of the body to another, with the goal of enhancing the targeted area. The steps are as follows:

1. Extraction of Fat from the Donor Area:
   Fat is harvested from a donor area using liposuction techniques. This step is most effectively carried out using manual methods with thin liposuction cannulas that have small holes. It’s important to note that laser or ultrasonic liposuction methods should be avoided during extraction, as they may damage the fat cells.
2. Processing the Fat:
   After extraction, the fat undergoes a process that includes decanting and centrifugation. This step is essential for separating viable adipose fat cells from debris, excess fluid, and dead cells. An alternative method involves washing the fat with a sterile saline solution. The discarded fat cells are those unlikely to survive the grafting process and could potentially cause issues for the healthy cells.
3. Reinjection of Purified Fat:
   The final step involves reinjecting the purified fat into the recipient area in small droplets throughout the subcutaneous tissue. This technique is crucial to ensure that each fat droplet receives adequate blood supply, which is necessary for the fat graft’s survival. The amount of fat injected varies based on the specific patient case and the body area being treated and is measured in cubic centimeters (cc).

Types of Anesthesia Used in Fat Grafting

The type of anesthesia used during fat grafting depends largely on the volume of fat being extracted.

• Local Anesthesia: Suitable for smaller volumes of fat extraction, local anesthesia is administered by the surgeon and allows the patient to remain awake during the procedure.
• IV Sedation or General Anesthesia: For larger volumes of fat (over 500cc), IV sedation or general anesthesia is typically required. This should be administered by a certified registered nurse anesthetist (CRNA) or, preferably, a board-certified anesthesiologist to ensure patient safety.

Common Areas for Fat Grafting

Fat grafting is a versatile procedure that can be applied to various areas of the body to enhance appearance and function. Below is a summary of common applications along with the typical volumes of fat injected:

• Face (10cc – 100cc total):
  • Adds volume to hollowed or wrinkled areas, such as under the eyes and along the nasolabial folds, restoring a more youthful appearance.
  • Helps in scar repair.
  • Enhances cheek volume to create the look of higher cheekbones.
  • Improves skin texture and overall appearance.
• Breasts (25cc – 400cc per breast):
  • Increases breast size by one or two cup sizes.
  • Corrects asymmetry between breasts.
  • Repairs damage to breast tissue from radiation and treats capsular contractures related to breast implants.
  • Assists in correcting scar deformities from lumpectomy or breast reconstruction.
• Hips (100cc – 300cc per side):
  • Adds volume to create a more feminine profile and improves the waist-hip ratio.
• Buttocks (200cc – 1300cc+ per cheek):
  • Enhances the size and perkiness of the buttocks (commonly known as the Brazilian butt lift).
• Hands and Feet (5-10cc per extremity):
  • Reduces wrinkles and rejuvenates appearance.
  • Provides additional padding for bony feet.

Fat Grafting and the Potential of Adipose Stem Cells

Fat grafting has gained significant attention from plastic surgeons not only for its aesthetic benefits but also for its remarkable regenerative properties. These regenerative capabilities are attributed to the high concentration of mesenchymal stem cells (MSCs) found in fat tissue.

In 2001, a groundbreaking study by a team of plastic surgeons and researchers from the University of Pittsburgh was published in Tissue Engineering. This study highlighted the potential of adipose tissue in cell-based regenerative therapies, marking a significant revelation for the scientific community. Until that point, adult MSCs were primarily associated with bone marrow. However, it was discovered that adipose tissue is a far more abundant source of MSCs—300 to 500 times more concentrated by volume compared to bone marrow. Moreover, the extraction of adipose tissue is considerably easier than that of bone marrow, opening up new possibilities in the field of regenerative medicine.

Since 2001, advancements have been made in harnessing the regenerative potential of adipose tissue. Clinically, fat grafts are now being used to rejuvenate the skin, reverse radiation-induced tissue damage, and treat autoimmune skin disorders. The potential applications of adipose-derived MSCs are vast and could extend to all areas of the body with further processing of the tissue. However, advanced processing techniques beyond basic fat grafting fall under the regulation of the Food and Drug Administration (FDA) and require an Investigational New Drug (IND) application.

Beyond Plastic Surgery

Expanding the Use of Adipose Tissue

Adipose tissue can be processed in various ways, with fat grafting being the most basic technique. This method allows some of the regenerative properties of MSCs to be applied to injured tissues. However, not all injuries are suitable for a fat graft. In such cases, isolating MSCs from adipose tissue through collagenase digestion offers even greater potential. These isolated cells can then be delivered intravenously or intra-arterially to areas where fat grafts are not viable. Additionally, MSCs can be cultured ex-vivo in a laboratory setting to significantly expand the population of these regenerative cells.

There are numerous ongoing clinical trials (Phases I, II, and III) utilizing adipose-derived MSCs to treat a wide range of conditions, including COPD, pulmonary fibrosis, congestive heart failure, osteoarthritis, Parkinson’s disease, diabetes, autism, Crohn’s disease, multiple sclerosis, macular degeneration, urinary incontinence, neurological disorders, and many others. Current information on these trials can be found on the clinicaltrials.gov website, with retrospective summaries available in various publications.

Fat grafting has undoubtedly opened new frontiers for plastic surgeons and other medical specialties. Its potential is only beginning to be fully understood, and it is evident that adipose tissue will play a pivotal role in the future of regenerative medicine. It’s astonishing to think that fat—often regarded as the most undesirable tissue—is now leading the charge into a new era where the body can heal itself.

Recovery Process

What to Expect After Face Fat Injection

The recovery process after face fat injection is relatively quick, with most patients experiencing swelling and mild bruising for the first 1–2 weeks. You may experience some tightness in the treated areas, but this will gradually subside as the swelling reduces. Most patients can return to light activities within a week, but it can take several weeks for the final results to fully settle.

Resuming Physical Activities After Surgery

Light activities, such as walking, can typically be resumed within a few days after the procedure. However, strenuous physical activities, particularly those involving facial movements or exercise, should be avoided for at least four weeks. Always consult your surgeon before resuming any form of exercise to ensure proper healing.

Maintaining the Results of Face Fat Injection

To maintain the long-term results of your face fat injection, it’s important to lead a healthy lifestyle. Significant weight fluctuations can impact the results, as the fat cells used in the procedure may expand or shrink. Maintaining a stable weight, staying hydrated, and following a good skincare routine will help preserve the results. Regular follow-up visits with your surgeon can also help monitor the outcome and address any concerns.

Scarring After Face Fat Injection

One of the advantages of face fat injection is that it involves minimal scarring. The incisions used to harvest and inject fat are very small, and they are typically placed in discreet areas. With proper care, any scars will fade over time and become nearly invisible. Your surgeon will provide instructions on how to care for the incision sites to minimize scarring.

Understanding the Risks of Face Fat Injection

While face fat injection is generally safe, there are some risks to be aware of. These can include infection, uneven fat distribution, or fat resorption over time. Choosing a skilled and experienced surgeon, such as those at ClinMedica, significantly reduces these risks. It’s also essential to follow all post-operative care instructions to ensure a smooth recovery and optimal results.

Benefits of Face Fat Injection in Turkey

Face fat injection offers numerous benefits, including the natural look and feel of the results, long-lasting volume, and the ability to address multiple areas of the face in one procedure. The fact that it uses your own fat makes it a safer option for many patients. In addition to adding volume, this procedure can enhance facial contours, smooth wrinkles, and provide a subtle lifting effect, resulting in a more youthful appearance.

Who Is Not a Suitable Candidate for Face Fat Injection?

Not everyone is a suitable candidate for face fat injection. Patients who have significant skin laxity, unrealistic expectations, or those who are not in good general health may not achieve optimal results. It’s also important that you have enough excess fat to harvest for the procedure. A consultation with your surgeon will help determine if this procedure is right for you.

Things to Do After Face Fat Injection

Key Post-Operative Care Steps

After your procedure, it’s essential to follow your surgeon’s post-operative care instructions carefully. This includes keeping the treated areas clean, applying any recommended ointments, and avoiding facial pressure. Swelling and bruising are normal during the first week, but cold compresses can help reduce these symptoms. Attending follow-up appointments is crucial to ensure that the results are settling properly.

Things to Avoid During Recovery

During recovery, avoid smoking, as it can impair healing and reduce the survival of the transferred fat cells. You should also avoid alcohol, as it can increase swelling. Sun exposure should be minimized, as it can affect the healing process and cause pigmentation issues in the treated areas. Strenuous activities, including exercises that could strain the facial muscles, should be postponed until your surgeon clears you to resume them.

How Long Should You Stay in Istanbul for the Procedure?

If you are traveling to Turkey for face fat injection, plan to stay in Istanbul for about 5–7 days. This allows time for the procedure, the initial recovery period, and any follow-up appointments with your surgeon before you return home.

How Many Nights Will You Stay in the Hospital?

Face fat injection is typically performed as an outpatient procedure, so an overnight stay in the hospital is usually not necessary. However, depending on the complexity of the procedure or if it’s combined with other treatments, your surgeon may recommend staying one night for observation.

Pre-Procedure Instructions for International Patients

If you’re traveling to Turkey for face fat injection, it’s important to prepare accordingly:

• Medical Preparation: Complete any required medical tests and provide your surgeon with a detailed medical history, including any medications you are taking.
• Packing: Bring loose, comfortable clothing, particularly tops that are easy to wear after surgery.
• Flexible Flight Plans: Arrange flexible flights in case your recovery takes longer than anticipated.
• Documentation: Carry all relevant medical records, including test results and pre-surgery clearances.

Do You Need a Companion for the Procedure?

While face fat injection does not require you to bring a companion, having someone with you during the first few days after surgery can be helpful. A companion can assist with daily tasks, provide emotional support, and ensure you’re comfortable during the initial recovery period. If traveling alone, you may want to arrange for post-surgical care at your accommodation.

Post-Surgery Instructions

What Should You Do After Face Fat Injection?

After the procedure, you’ll receive detailed post-operative instructions from your surgeon. These typically include applying cold compresses, avoiding excessive facial movements, and taking prescribed medications to manage swelling and discomfort. It’s also important to attend all scheduled follow-up appointments to ensure the fat grafts are settling properly.

Traveling Home After Surgery

Guidelines for Airport and In-Flight Care

If you’re flying home after your face fat injection in Turkey, especially on a long-haul flight, it’s important to follow these precautions:

1. Timing Your Flight
   It’s recommended to stay in Istanbul for 5–7 days post-procedure to allow for initial healing and follow-up care before flying home.
2. In-Flight Care
   During the flight:
   • Move Regularly: Walk around the cabin every 1–2 hours to improve circulation and reduce the risk of blood clots.
   • Stay Hydrated: Drink plenty of water to stay hydrated. Avoid alcohol and caffeine, which can increase swelling.
   • Wear Comfortable Clothing: Opt for loose-fitting clothes to avoid any unnecessary pressure on the body, and follow any specific recommendations from your surgeon.
   • Pain Management: Keep prescribed pain medications in your carry-on luggage and take them as directed during the flight.
3. Airport Assistance
   Navigating the airport post-surgery can be taxing. Consider requesting assistance, such as a wheelchair or help with luggage, to avoid overexerting yourself. Avoid carrying heavy bags, and use rolling luggage to minimize physical strain.
4. Long-Haul Flight Considerations
   For long-distance travel, make sure to move around regularly to reduce stiffness and swelling. Compression garments may be recommended to manage swelling, and planning for additional rest days once you arrive home will allow you to continue your recovery before resuming normal activities.

By following these post-surgery and travel instructions, you can ensure a smooth recovery and a safe journey home after your face fat injection procedure. ClinMedica provides all the necessary post-operative care instructions to help you achieve the best possible results.

When Will You See the Final Results?

While you may notice an improvement in facial volume soon after the procedure, the final results of face fat injection typically become visible after 2–3 months, once the swelling has completely subsided and the fat cells have settled into place. The results are long-lasting, but it’s important to maintain a stable weight to preserve the outcome.

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