Fat Grafting

Conveniently located to serve San Francisco, Walnut Creek, and the Bay Area, SF

Fat is one of those things… most of us have enough, it’s just not in the right places!  Removing fat from one area of your body and transferring it to another part is called fat grafting.  Once the fat is moved or transferred, it develops a new blood supply and lasts indefinitely.

Where is fat commonly placed during fat grafting procedures?

Fat grafts can be injected almost anywhere in the body. The areas most commonly grafted are the face, eyelids, lips, the back surface of the hands, the breasts, and in areas where too much fat has been removed during liposuction.

Where is the fat used in grafting removed from on the body?

Common areas are the abdomen, hips, inner or outer thighs, and the buttocks.

When I do fat grafting, do I get a “free” liposuction?

While the fat removal does allow for contouring of the donor areas, most of the time the amount of fat required in fat grafting is less than what would need to be removed when doing a standard liposuction. If you would like to have a standard liposuction at the same time as the fat grafting, that is certainly possible.

How is the fat removed for fat grafting?

Fat cells are quite fragile and must be removed and handled carefully.  Fat for grafting is removed with a low suction method using a syringe.  This is different from the way we remove fat when doing liposuction, as in liposuction alone I am not concerned with the viability of the fat cells I am removing.

Once the fat cells are removed, they must be cleaned and concentrated before re-injection.  Different techniques can be used to prepare the fat.  At this time, there is no definitive proof as to the best method.

Does the fat survive after it’s re-injected?

As the fat is your own living tissue, it tends to be extremely long lasting, so the correction is considered permanent.   But, because fat cells are very fragile, and the cells don’t always survive the injection process, the final result is not known for about three months.  Touch ups, meaning additional fat injection procedures or using synthetic hyaluronics (like Restylane© or Juvederm©) or Sculptra©, are often necessary.  Also, as the fat cells are living cells, if you gain weight or lose weight, fat cells all over your body, including your face, will respond.  The perfect result can become less than perfect if excessive weight gain results in a fat face!

Can I store fat in a freezer for later use, or have a friend or family member donate fat for injection?

Freezing fat for later use, which was popular a number of years ago, has fallen out of favor as the fat which is frozen and then re-injected rarely survives.  Transplants from friends or family members are not an option because the fat is an actual transplant, and tissue rejection means the fat will be identified by your immune system as foreign and destroyed by your immune cells.  The one exception would be a genetically identical twin.

“I highly recommend Dr. Barnett”


After thoroughly consulting with 5 top surgeons in the Bay Area, I chose Dr. Barnett. My surgery for neck, lower face, upper lip, brow lifts, upper eyelids and facial fat transfers was done two months ago. He is incredibly talented, skillful-a fantastic surgeon! And my results are fabulous and I hear will only get better with time I’m very happy! About me, I am a RN in the Bay Area and as a RN I am very thorough and knowledgeable. And, I am very picky. Dr. Barnett from the first consult (which he spent over 1 hour with me, no one else did) and throughout the whole course (pre and post op) of surgery has been wonderful! He’s a patient (I’m a list person), considerate, hands on, pleasant and caring surgeon. He always puts me at ease at every step. 10 days post-op I bumped and opened up the incision in my upper eyelid (I had watched 3 episodes of GOT before bedtime and had a nightmare-not recommended :(. I called him at 1am and he was so supportive and kind and mended me the very next morning. I highly recommend Dr. Barnett.

by Karen S., Morgan, CA

What is the most common area for fat injections?

Because of the excellent blood supply, fat grafting to the face is by far the most common area.  Fat grafting can be performed at the same time as a facelift or other facial procedures.

Does facial fat grafting replace filler injections like Restylane©, Juvederm©, or Voluma©?

Both fat and fillers are effective for replacing volume but they are different and complementary.  I perform both and like both.  Fat grafting is a surgical procedure and is more costly, but when replacing larger volumes, fat can be far more economical as you provide the raw material (fat) for free!  The surgery is where the cost lies.  With the off the shelf fillers, the material cost is high and large volumes can be extremely costly.

Cost aside, fillers are not living tissue and do not respond like living tissue.  They are stiffer and can produce a very unnatural result when used in larger quantities.  While they are predictable as to the outcome, they do not become living tissue and will disappear over time. To maintain the result with fillers, one must be committed to periodic re-dos.  Fat, on the other hand, is living tissue and will last indefinitely.  Unfortunately, however, the survival rate is less predictable.  While it is unusual to create asymmetries with fat grafting due to differential survival when comparing sides of the body (such as the right and left cheek), re-dos are common to obtain the maximum result.  Fat is also not good for small wrinkles.  So, neither fat nor fillers are better – they are complementary and using them together is often the best approach.

What about fat grafting of the breasts – does that replace implants?

Fat grafting of the breasts is limited to smaller enlargements and to patients who are willing to undergo multiple procedures to reach their goal.  Patients who are adverse to implants, or who are hoping to obtain only a small enhancement, may find that fat grafting is the way to go.  For most women who are interested in a larger augmentation, or have more limited funds, conventional breast augmentation with an implant is the way to go.

Fat grafting of the hands?

Aging in the hands is often seen when volume is lost and the veins and tendons under the skin become very visible.  Fat grafting, usually about an ounce in each hand, can return the softer look of the young hand.   Downtime is very limited, and the results are generally long-lasting.

Are there risks and complications with volume injections?

As with all procedures, there are risks.  I’ve mentioned a few in this information sheet, but there are others and they will be discussed in detail at your consultation.

To learn more about what you can expect during a Fat Grafting Procedure, or to schedule your consultation with Dr. Barnett at either his San Francisco or Walnut Creek office, please complete the form on this page or call (415) 362-1221

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