Washington, D.C. (202) 785-4187
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Cosmetic Fat Transfer

Have you ever wished you could take fat from one part of your body where you don't want it and move somewhere more useful? Thanks to recent medical advances, this process is actually a simple and effective option for facial rejuvenation, breast augmentation, and body contouring. The surgeons at West End Plastic Surgery specialize in fat transfer at our Washington, D.C. practice and offer it as a natural alternative to facial fillers or implants.

Patients from Alexandria, Reston, Bethesda, Chevy Chase, Potomac, and other areas surrounding Washington, D.C. considering fat transfer can request a consultation online to meet with one of our surgeons to determine whether you're a good candidate for the procedure. You can also call our office at (202) 785-4187 to schedule an appointment.

Before & After Cosmetic Fat Transfer

Before photo
After photo

Before

After

For more photos of our patients, please view our photo gallery.

Are You a Good Candidate for Fat Grafting?

The best candidate for facial rejuvenation with fat grafting is a man or woman who has begun to notice a sallow appearance to the face. Many see deep nasolabial folds, marionette lines, deflation of the cheek bones, narrowing of the temples, or shadows and depressions under the eyes. These changes can start as early as the early 30s. Successful fat grafting requires skin that is not too loose. Most patients are in their late 30s to 50s, but facial rejuvenation with fat grafting can be successfully performed on people well into their 60s and 70s. If you are generally healthy, have a realistic view about the results that can be achieved with facial rejuvenation with fat grafting, and have any of the following conditions, you may be a good candidate for the procedure:

  • Loss of facial volume in isolated areas, regions, or globally
  • Wrinkles or furrows on your face or neck
  • Deep creases forming between the bottom of your nose and the corner of your mouth
  • A diminished jawline

Loss of facial volume leads to a loss of structural support in the face and the sagging that ultimately follows. Restoration of volume is like blowing up a partially filled balloon, revealing the smooth, youthful contours once again. Facial rejuvenation with fat transfer uses one's own fat and the stem cells that come along with them to restore volume and stimulate changes in the surrounding tissues to restore youthfulness.

Paul G. Ruff IV
M.D., F.A.C.S.

Personalized, compassionate patient care is the foundation of West End Plastic Surgery's philosophy. Our board-certified surgeon, Dr. Paul G. Ruff IV embraces innovative techniques to ensure our patients get the best treatments available.

Meet Dr. Ruff Request a consultation

Meeting With Your Plastic Surgeon

Your consultation with Dr. Ruff and their staff is the time to describe your cosmetic goals. Your plastic surgeon evaluates your facial and neck structure, your skin elasticity and facial volume, and your underlying muscle tone to determine whether facial rejuvenation with fat grafting is right for you. Adjunctive procedures will be recommended if needed to create a harmonious rejuvenation. Those might include a neck lift, eyelid surgery, or laser resurfacing. Dr. Ruff thoroughly explains each technique along with its risks, benefits, and recovery times. You will be asked to describe in detail how you want your face and neck to look after your facial rejuvenation with fat grafting. Good-quality pictures of the face when you liked what it looked like are helpful in understanding your facial volume changes. Working together, you and your plastic surgeon will decide which technique will give you the results you desire.

Your plastic surgeon and his staff at West End Plastic Surgery will:

  • Review the facial rejuvenation with fat grafting and adjunctive procedures with you
  • Clearly discuss the potential risks of each procedure
  • Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
  • Provide detailed cost and payment information
  • Answer all your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medications you currently take, including over-the-counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

How the Procedure Is Performed

Your facial rejuvenation with fat grafting procedure will be performed in our state-of-the-art, AAAASF-certified surgical suite. The procedure will take from 1 to 2 hours to complete and can be performed either under local anesthesia or local anesthesia with sedation/general anesthesia depending on what you and the doctor prefer. With general anesthesia, you will be completely asleep throughout the procedure. With local anesthesia, you will be awake and the areas to be treated will be numbed. The type of anesthesia used, our surgical facility, and other recommended procedures will be discussed with you at your initial consultation.

Your plastic surgeon will mark the areas of the face to be injected as well as the area or areas from which the fat grafts will be harvested. All of the areas will be numbed with local anesthesia for comfort during and after the procedure. Only small, inconspicuous puncture sites are required for harvest and re-injection of the fat grafts. Once the areas are numbed, grafts are harvested with low suction in order to enhance the proportion of living cells. Instead of using a centrifuge to purify the fat, our surgeons use the advanced Puregraft® system to optimize results. Puregraft uses a proprietary filtering system to isolate, purify, and concentrate the transferable cells. Any liquid, oil, and other undesirable components are discarded.

The concentrated fat grafts are transferred into 1 cc syringes that allow for smooth transfer. Small packets of cells are layered from deep to superficial in the desired areas to restore facial volume and shape. All areas are approached from at least 2 access points to optimize a uniform and smooth transfer. Very small, blunt cannulas specifically designed to enhance graft survival are used, which also minimize trauma to the surrounding tissues. Ensuring an even, layered transfer helps increase graft survival by placing them proximate to a new nutrition source that allows them to learn to live in their new environment.

Once the transfer is complete, sutures are used to close the harvest site incision to improve healing. The insertion sites rarely need a suture as they are very small. Patients are provided cool packs and encouraged to sit semi-upright which helps control swelling and bruising.

Breast & Body Contouring With Fat Grafting

Fat transfer is becoming more and more popular for patients interested in enhancing the contours of their bodies as word of its effectiveness spreads. Other than facial rejuvenation, the primary ways our surgeons use fat transfer are for breast and buttock augmentation procedures.

  • Breast augmentation using fat offers patients a natural alternative to breast implants, although there are some limitations. Breasts can be enlarged about 1 to 1½ cup sizes in a single procedure using fat transfer, so women interested in a larger augmentation are better suited for breast implants or serial procedures. Good candidates for this procedure also need enough fat to harvest, usually from the abdomen, thighs, hips, or lower back. For those who are good candidates, however, fat transfer has the advantages of being a soft, natural, and permanent alternative to implants.
  • Brazilian butt lift surgery is also performed using the fat transfer technique. It is an option for patients who want to enhance the contours of their buttocks but don't want implants.

Our surgeons use VASERlipo™ to collect the fat used for breast and buttock augmentation procedure. Using ultrasonic energy, VASERlipo selectively targets fat cells without damaging surrounding tissue, allowing the fat to be extracted with less force than used in traditional liposuction procedures. This is important because the fat used in grafting procedures must be viable and healthy when it's injected. Not all the fat used for grafting survives the process, but the percentage is generally much higher when we use VASERlipo compared with other liposuction techniques.

What To Expect After Your Surgery

Activity When
Drainage Tubes Removed Not Required for Fat Grafting
Bandages Removed 1 to 5 Days After Surgery
Shower & Shampoo Hair The Day After Bandages are Removed
Stitches Removed 5 to 7 Days After Surgery, Most Are Dissolving and Do Not Require Removal
Return to Work 3 to 14 Days After Surgery
Driving As Soon as You Feel Comfortable and Do Not Require Narcotic Pain Medication
Strenuous Activities 2 to 2 Weeks After Surgery
Fading of Scars Several Months to 1 Year

Before & After Photo Gallery

We're as thrilled with our patients' results as they are. Check out our before-and-after photo gallery and see for yourself the kind of work our talented surgeons do.

Immediately After Your Surgery

In most cases, facial rejuvenation with fat grafting surgery is performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy from the anesthesia and the surgical area will be sore so you will need to have someone drive you home unless only local anesthesia was used. There will be some bruising, swelling, and numbness. You will need to keep your head elevated and avoid any strenuous activity for a few days after surgery to help reduce the swelling and avoid complications. Pain medication will be prescribed to alleviate as much post-surgery pain as possible. Cool packs to the treated areas will help with comfort, swelling, and bruising for the first 2 to 3 days. Avoid ice or ice packs applied directly to the skin.

The First 24 to 48 Hours After Your Surgery

You may experience some numbness and temporary discomfort around the incisions and treated areas. Most of the discomfort is likely to be felt at the harvest sites. Any pain or discomfort you experience can be controlled with prescribed medication if needed. You will also experience swelling and some bruising. You will need to keep your head elevated for the first few days after surgery to reduce the swelling of your face. Your discomfort level will improve rapidly after the first 2 days.

Dr. Ruff will remove your bandages at your first postoperative visit. There may be a small amount of bleeding around your incisions. This is normal and can usually be controlled by applying light pressure to the area. If the bleeding does not respond to light pressure or becomes heavy, call West End Plastic Surgery for further instructions.

You can usually wash your hair 24 hours after surgery. However, if you dry your hair, keep the dryer on the lowest setting because your scalp may be numb and there is a risk that you might burn yourself.

The First 2 Weeks After Surgery

Although you will be up and around in the first few days after your surgery, please keep in mind that you should take it easy for the first week after surgery. Any non-dissolving stitches will be removed within 5 to 7 days after surgery. You can begin using makeup 2 days after your stitches are removed. Most patients are back to work within 2 weeks of surgery, frequently sooner.

You will notice that you will become increasingly more comfortable during the first few weeks after your surgery. You may also notice:

  • Mild to moderate swelling, tenderness, and bruising in the area of the incisions. This will gradually disappear within the first 2 weeks after surgery with most of the noticeable swelling and bruising disappearing within a month. The swelling may cause it to feel funny when you make certain facial expressions.
  • Numbness in the area of your incisions; this is normal and may take several weeks to months to disappear completely.
  • Itching as a result of the healing of the nerves near your incisions or treated areas. This feeling is more pronounced with surgical procedures and may take up to 6 months to disappear completely.

Resuming Your Normal Routine

Everyone heals at different rates and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work within 2 weeks of your surgery.
  • You can resume driving as soon as you feel comfortable doing so and are not on any narcotics.
  • You can most likely return to your physical exercise program within 2 to 6 weeks of your procedure. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • Most of the visible signs of your procedure should fade within about 3 weeks.
  • Prolonged exposure to heat and sun should be limited for several months.
  • The scars caused by the incision should be protected from sunlight for at least a year after the procedure.

Things to Be Aware of After Your Surgery

  • Bruising and swelling usually decrease enough so that you can comfortably go out in public about 10 to 20 days after your procedure.
  • You may experience a loss of sensation or numbness in the area of your procedure. This is entirely normal and may take several weeks to months to disappear.
  • Your face and neck will feel dry. Apply a good, fragrance-free moisturizer frequently. We can recommend one that will enhance your healing if you like.
  • Avoid saunas and steam baths the first 2 months after your surgery.
  • Protect your scars with sunscreen for at least 6 months after your procedure. Use an SPF 15 (or greater) sunscreen every time you are outside. Apply the sunscreen before applying makeup.

What Are Possible Side Effects or Risks?

All surgical procedures have some degree of risk, however, major complications from facial rejuvenation with fat grafting surgery are unusual. During your initial consultation with Dr. Ruff and the staff of West End Plastic Surgery, your individual risks will be assessed and discussed. As with any procedure, you can help reduce the risks by closely following the pre- and post-procedure instructions provided to you. Your surgeon and his staff will be with you every step of the way to ensure a safe and pleasing outcome.

Most likely risks include the following:

  • Infection
  • Nerve damage
  • Bruising
  • Asymmetry
  • Blood or fluid collection
  • Partial or complete graft loss
  • Prolonged swelling
  • Donor site contour irregularities

How Long Will the Results of Your Facial Rejuvenation With Fat Grafting Last?

Facial rejuvenation with fat grafting restores facial volume lost with the natural aging process to create a more youthful appearance. These results generally last between 5 to 10 years and longer in many cases. It is important to keep in mind that the effects of aging, gravity, and environmental factors will continue to affect the smoothness, sagging, and wrinkling of your face and neck. Meticulous skin care is critical to maximize the effectiveness and longevity of your surgical results.

Questions You May Have

Are there other procedures that could be done along with facial rejuvenation with fat grafting to enhance the overall appearance of my face?

Facial rejuvenation with fat grafting is often performed in conjunction with a face lift, neck lift, brow lift, eyelid surgery, or laser resurfacing to enhance the overall youthful appearance. BOTOX® Cosmetic injections are a non-surgical alternative that may temporarily reduce the amount of lines and wrinkles in your face and neck.

Will my insurance coverage pay for my facial rejuvenation with fat grafting?

Facial rejuvenation with fat grafting is considered cosmetic surgery and, therefore, is not covered by insurance. You are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation.

Are there alternatives to facial rejuvenation with fat grafting surgery?

BOTOX Cosmetic injections and fillers are non-surgical alternatives to a facelift. These injections can reduce or eliminate lines and furrows that cause wrinkles. Meticulous skin care may also help improve the tone, texture, and occasionally the contour of your facial skin. Although frequently performed in conjunction with fat grafting, laser resurfacing and chemical peels may also provide a less invasive alternative.

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West End Plastic Surgery 2440 M Street Northwest #200
Washington, District of Columbia 20037 (202) 785-4187 Monday–Friday: 8 a.m.–4:30 p.m. Get Directions
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