Lipofilling

Plastic Surgeon

A consultation at Boerhaave always takes place with the plastic surgeon who will be treating you. During this initial consultation, we’ll determine whether the treatment can resolve your symptoms and meet your expectations. We’ll also go over a number of topics with you, such as your medical history, the medications you’re taking, and whether you have any allergies.

The plastic surgeon will then assess where fat can be removed and evaluate the quality of your skin. Older people often have reduced skin elasticity, which can lead to less-than-optimal results after fat removal. In some cases, a treatment that also tightens the skin may be recommended. This will need to be assessed on a case-by-case basis.

Other topics discussed during your consultation include the pros and cons, possible complications, and potential risks, and you’ll have the opportunity to ask questions.

Experience has shown that people sometimes have unrealistic expectations regarding the results. Lipofilling often improves body contour, but it is a method that is difficult to control precisely, which means irregularities in your skin’s surface may occur after treatment. Our plastic surgeons are highly skilled, but they do not always have control over the healing process of the treated area. It is therefore important to thoroughly discuss your expectations regarding the results during the consultation. We will also discuss with you whether multiple treatments may be necessary to achieve the desired final result.

Consultant
Following your initial consultation with your plastic surgeon, you will have a meeting with your consultant. The purpose of this meeting is to inform you about the general procedures that need to be arranged regarding your treatment.

On the day of your procedure, you are expected to arrive at the clinic half an hour early.

Whether your procedure is performed under local anesthesia or general anesthesia depends on the extent of your lipofilling. A minor procedure, such as one on the face, can be performed under local anesthesia, while a more extensive procedure will be performed under general anesthesia. Before the surgery, we will work with you to determine where the fat will be harvested; in most cases, this is from the abdomen or upper legs.

What else happens during the surgery? Through small incisions, about half a centimeter long, a liquid is injected using a small needle to loosen the fat cells, reduce bleeding, and numb the subcutaneous tissue. Once the solution has taken effect, the fat cells are removed using a suction cannula, and the incisions are closed with small dissolvable sutures.

The harvested fat is immediately processed using the Revolve or Puregraft system. This involves separating the living fat cells from the loose fat and fluid. These living fat cells are then carefully injected into the pre-marked areas. Please note that more fat cells are injected than may seem necessary. This is because some of the fat cells will not receive enough oxygen and will therefore be eliminated by the body.

After the surgery, you will first be taken to the recovery room, where your blood pressure and heart rate, among other things, will be monitored. This takes about half an hour. If your procedure was performed under local anesthesia, you’ll often be able to go home afterward. If your procedure was performed under general anesthesia, you’ll usually stay at the clinic for another three to four hours. You may only go home once the nurse and the anesthesiologist deem it safe to do so.

If you underwent treatment under general anesthesia, you may start eating easily digestible foods at home right away, such as water, tea, and crackers. Try to avoid nausea and vomiting, as this reduces the risk of post-operative bleeding and/or swelling at the wound site. It’s also important to keep drinking plenty of fluids.

Do not be concerned if some fluid and, occasionally, a little blood leaks from the wound sites during the first 24 hours. This will resolve on its own.

Recovery

As with any surgical procedure, your body needs time to recover. What exactly can you expect?

• The treated area will be quite swollen at first.
• Your scars may be red and raised immediately after the procedure; don’t be alarmed by this—it’s a natural reaction of the body.
• The skin around the treated area may turn blue or yellow.
• You may also experience reduced sensation in the skin.

Scars

Scars from lipofilling are small, averaging about half a centimeter. At first, they will be red and swollen, but after a few weeks, this will subside until they are barely visible. Keep in mind that scars take one to one and a half years to fully heal. It is therefore important to keep them out of the sun and apply the scar cream we provide twice a day. Also, use sunscreen with an SPF of 30 or higher for the first year to protect your skin.

Lipofilling can produce impressive results. However, the final result will not be immediately visible. Initially, your skin will be swollen and puffy, and the volume of the injected fat cells will decrease by another 20% to 40%. The remaining fluid and dead cells will be eliminated by the body. This process can take several weeks.

It is only after three months that it is possible to properly assess whether the treatment was successful, and the final result is not fully visible until one year later. By then, your body will have fully healed, and only then can we determine whether a follow-up treatment is necessary.

The effects of lipofilling are often permanent. Once the injected fat tissue has taken its final shape, it will not disappear. However, the natural aging process continues, and you may need to undergo another treatment over time.

It is important to know that any surgical procedure can involve risks and complications. In the case of plastic surgery, however, these risks are lower, since the patients are generally healthy individuals. Through our professional approach, thorough counseling, and comprehensive medical history, we further reduce these risks to an absolute minimum.

You can also help by carefully following the instructions you have been given.

Possible complications include:

• Hematoma (a collection of blood under the skin that requires removal)

• Adverse reaction to the anesthetic

• Postoperative bleeding

• Infection

• Changes in sensation

• Permanent visible scars

• Damage to underlying structures

• Unsatisfactory aesthetic result
  
  

Every year, many people undergo successful breast augmentation surgery at Boerhaave. The likelihood of a complication occurring is very rare.

Smoking
Patients who smoke or use tobacco or nicotine products before and/or after treatment are at a higher risk of complications, such as skin necrosis and impaired wound healing. People exposed to secondhand smoke may also be at an increased risk of similar complications. Furthermore, smoking can have a negative effect on anesthesia, potentially resulting in an increased risk of bleeding. It is important to refrain from smoking for at least four weeks before treatment and throughout the entire recovery process.

People who are not exposed to tobacco smoke or nicotine products have a significantly lower risk of such complications.