Turning The Volume Up Or Down: Liposuction And Fat Grafting


Fat cells can be frustrating things. Eager to grow in size when given the opportunity—such as during pregnancy—they do not always seem so eager to shrink back down. Since adults maintain a generally stable number of fat cells, this can be a problem for anyone who is seemingly living on celery and long morning runs in an effort to get their slimmer figure back. For two plastic surgeons in the San Francisco Bay Area, liposuction is a common suggestion for patients who want to flatten their flanks or bring in a bulging belly, but who can’t seem to achieve the desired contours with diet and exercise alone.


Dr. Stanley Jacobs and Dr. Eric Culbertson explain that fat cells in adults are generally fixed. That means they don’t disappear when subjected to salads and sit-ups, they simply change in size. That, at least, is the ideal goal. Sometimes, fat cells also remain stubbornly fixed in a larger state, which is why hips might continue to be wide or a double chin continues to wobble even as buttocks and breasts reduce in volume—sometimes dramatically.


There is no amount of calorie counting or jumping jacks that can target a specific part of the body for fat reduction. Similarly, we have yet to discover a way of isolating areas we wish would stay pleasantly round and plump despite other features dropping inches.


Fortunately, controlling the volume (as in ensuring fat goes wherever it’s directed) is possible with advanced and sophisticated surgical procedures that are both safe and effective.


First, reduction. Liposuction may be nothing new to many people, and that’s actually a good thing. It has been around for decades as a fat-reduction method, and the tried-and-true traditional technique known as suction-assisted liposuction is historically proven as both effective and safe. By inserting a specialized wand known as a cannula into the area where fat cells are targeted for removal, a plastic surgeon can artfully dislodge and remove the unwanted cells for results that are more sculpted than simply suctioned.


Liposuction can be used to reduce volume just about everywhere from the face down. It can provide new contours and better show off muscle definition.


But what about areas where more fat is actually desirable?


Fat cells removed via liposuction or similar techniques can be processed and refined to become a volumizing filler that adds natural roundness wherever it is injected. Very small amounts can smooth out contour deformities or address age-related volume loss in the face or hands. Larger collections of the cells can be used to augment key features, such as the breasts or buttocks.


The key to a successful fat grafting procedure, as this technique is called, is in ensuring the integrity and viability of the fat cells themselves. Damaged or destroyed cells do not make for good transfer material, as the cells need to essentially “set up a new home” where injected. In other words, they need to remain alive so they can continue to thrive and provide healthy volume.


Generally, fat grafting is an effective augmentation strategy, because the body readily welcomes its own fat cells, treating them far differently than it does implants or manufactured fillers. Though both of those options have proven to be safe and effective, some patients enjoy fat grafting due to the fact that their own fat is being used for a positive benefit—and that the possibility of an allergic or similar reaction is essentially nonexistent.


Anyone considering either of these procedures should know that neither is a substitute for healthy living, including a well-balanced diet and routine physical activity. Liposuction is not the answer for people dealing with weight-loss struggles, and the bulk added from fat grafting is exactly what it sounds like: fat. Muscle built from exercise has a different look and feel. That said, these procedures are ideal for patients who are in general good health and at or near a healthy weight for their height.


To find out more about liposuction, fat transfer, and how the two relate, contact the Bay Area plastic surgeons at The Jacobs Center for Cosmetic Surgery. Dr. Stanley Jacobs founded the center and focuses on facial surgeries and treatments, while Dr. Eric Culbertson performs breast and body procedures. Go to www.thejacobscenter.com, call the San Francisco office at (415) 433-0303, or call the Healdsburg office at (707) 473-0220.