With lipofilling, the body's own fat is removed from one area, processed, and reintroduced into another area where volume is lacking. It is the only filler that comes from the patient's own body: no foreign material, no risk of intolerance. Dr. Özdemir uses autologous fat transfer in two areas.
On the face. From the age of 30, fatty tissue, the dermis and the epidermis begin to shrink, especially on the cheeks and in the nasolabial area. The skin sinks, deep hollows form under the lower eyelids, and the face appears tired and sunken. Autologous fat fills these areas from beneath and pads out wrinkles from below, without changing the face.
On the breast. For a moderate wish for more volume, autologous fat is an alternative to an implant. It is also suitable for correcting slight asymmetry. The increase is considerably smaller than with an implant, around half a cup size per session.
Who is lipofilling suitable for?
Two conditions must be met. First, sufficient donor fat is needed on the abdomen, hips or thighs; in very slim patients, the available amount is limited. Second, the weight should be stable. The transferred fat behaves like any other fatty tissue: it grows with weight gain and shrinks with weight loss.
For the breast, there is an additional point: anyone wishing for a marked increase in size is better served by an implant. Autologous fat does not tighten a sagging breast; here, a breast lift is the right procedure, possibly combined with autologous fat.
How does lipofilling work?
First, the fat is obtained. Dr. Özdemir infiltrates a tumescent solution into the donor region, which makes it painless and low in bleeding and softens the fatty tissue. The fat is then gently aspirated using blunt cannulas. It is cleaned and separated from fluid and oil components, so that only living fat cells are filled into sterile syringes.
The processed fat is then introduced into the target region through small punctures, using fine, blunt cannulas, in many thin strands. Distribution in small portions is crucial: only fat cells that have contact with the surrounding tissue receive a blood supply and heal in.
Both procedures take place under general anaesthesia, including on the face, because the donor fat is taken from another part of the body. For the breast, correspondingly more fat is obtained and introduced. The procedure takes one to two hours and can usually be performed on an outpatient basis.
Healing: what remains of the fat
Not all of the transferred fat heals in. Part of it is broken down by the body within the first few months; how large this proportion will be cannot be predicted with certainty in advance. Dr. Özdemir therefore introduces somewhat more fat than should ultimately remain. The first few weeks show a surplus, which then recedes. The result, which is established after around twelve months, is permanent, as long as the weight remains stable.
For the breast, this means: anyone who wants more volume than one session provides needs a second session at an interval of twelve months.
After the procedure
A compression garment is worn at the donor site for a few weeks, so that the skin lies smooth. Swelling and bruising occur in the target region, which subside after about one to two weeks on the face, and somewhat later on the breast. The treated areas should not be pressed or massaged for the first six weeks, so that the freshly transferred fat cells are not displaced. Sleep on your back, and avoid heat, sauna and exercise.
Office work is possible again after a few days, exercise after about eight weeks.
What are the risks of lipofilling?
Lipofilling is considered a gentle procedure because no foreign material is used. It is nevertheless a surgical procedure with two wound areas, the donor site and the target region. Dr. Özdemir discusses the risks with you individually beforehand; the most important are:
Resorption of the fat. How much of the transferred fat heals in varies from person to person. Less may remain than hoped for, in rare cases considerably less. A second session is then needed to achieve the desired result.
Irregularities. If the fat heals in unevenly, asymmetries, small nodules or dents can form. At the donor site, irregularities of the skin are possible if suctioning was uneven. Both can usually be corrected with a follow-up treatment.
Oil cysts and calcifications. Fat cells that do not heal in can die off and form oil cysts or hardened areas (fat necrosis). In the breast, this can lead to calcifications that are visible on mammography. They are benign but must be distinguished from other changes; the radiologist should therefore be informed about the lipofilling at every later screening examination. Dr. Özdemir recommends current imaging (mammography or ultrasound) as a baseline finding before breast lipofilling, at any age.
Infection and bruising. As with any procedure, the puncture sites or the transferred fat can become inflamed. Bruising at the donor and target regions is common and resolves on its own.
Sensory disturbances. Skin sensation in the target region and at the donor site may be temporarily reduced; it generally returns.
Fat embolism. If fat is accidentally injected into a blood vessel, it can block it. On the face, this is the most serious complication, because displacement into the vessels of the eye can lead to blindness. It is extremely rare and is avoided through technique: blunt cannulas, small amounts, slow injection while withdrawing the cannula.
Result. Lipofilling compensates for volume loss; it does not tighten skin and does not treat dynamic wrinkles. Anyone expecting both will be disappointed; here, combining it with other procedures makes sense.
Are there alternatives to lipofilling?
On the face, hyaluronic acid is the most obvious alternative. It requires no operation and no donor site, can be dissolved again if needed, and is therefore well suited for a first attempt. However, it lasts only a few months and must be repeated. Autologous fat has the advantage for larger volumes and a lasting wish. Dynamic wrinkles, such as frown lines or crow's feet, are a case for botulinum toxin, not for volume. For drooping eyelids, an upper eyelid lift helps, not filling.
On the breast, an implant is the alternative if a marked and plannable increase in size is desired. It provides a reliable volume in a single session, but with foreign material and the risks of an implant, in particular capsular contracture. For a sagging breast, a breast lift is the right procedure.
Doing nothing is always an option. Volume loss in the face is not a disease, and a small breast is not a medical finding.
Why there are no before-and-after photos
You will not find any before-and-after photos on this page, and Dr. Özdemir does not show any during the consultation either. With lipofilling in particular, the result depends on how much fat heals in for you, and this differs from person to person. What you get instead: an examination, an honest assessment of what amount is realistic for you, and a statement on whether one or two sessions will be needed.
