Fat transfer can be used to replace tissue loss due to aging, trauma, or disease, or to achieve rejuvenation and contouring in the face, hands, and other parts of the body. Many aesthetic and reconstructive problems can be solved with this minimally invasive method, but patient selection is crucial. It is an effective and long-lasting method for older patients to restore fullness to the face due to volume loss, reduce wrinkles and skeletal appearance; and for younger patients unhappy with their facial appearance to create a volumetric effect in the cheeks and chin and treat lines around the lips. It can also provide a safe and effective treatment for certain congenital disorders such as impaired facial development and syndromes; tissue loss due to trauma; and deformities resulting from aesthetic procedures. In aging individuals, the decrease in soft tissue, thinning of the skin, and loss of muscle volume on the backs of the hands leads to more prominent tendons and veins. This “worn-out” hand appearance can be reversed by not only creating fullness but also thickening the skin, making sharper features less visible and resulting in a rejuvenating effect. It can also be used to treat unwanted depressions that occur after liposuction.

Fat injection can also be safely used for augmentation; since it is obtained from the patient’s own tissue, it is a very good option, especially for breast and buttock augmentation, eliminating the disadvantages of prosthetics. The volumetric increase achieved with this method is permanent; it integrates with surrounding tissues as soon as it begins to be nourished in the area where it is injected, giving a more natural appearance; however, the only disadvantage is that it is not possible to predict in advance how much of the injected fat tissue will be absorbed and how much will remain permanent. In buttock augmentation, since the problems associated with prosthetic use are quite numerous, fat injection is applied as the first option in our clinic. In body shaping, liposuction is always combined with lipoinjection. Because all patients who come to us unhappy with their body shape have disproportionate and irregular fat distribution. That is, there is excess fat in one area while there is a deficiency in another. This creates an unsightly contour irregularity. Moreover, most of these patients are not overweight or obese; on the contrary, they are of normal weight. In these types of cases, we apply not only liposuction but also “lipo-shaping.” In other words, we take from the “rich” and give to the “poor.” By taking into account certain anatomical points and red lines, we transfer the fat particles obtained as a result of liposuction under the muscle in the middle of the buttocks, providing growth, rounding, and rejuvenation to the buttocks. It is not necessary for your buttocks to be very small or very saggy for this method to be applied. Even with small amounts applied to patients of normal size, we achieve fullness in the buttocks, a smoother and more even surface, a significant reduction in the orange peel appearance, and a younger look with rounder, less sagging contours.

A new application of fat injection stems from its significant healing properties. Particularly in the treatment of ulcers developing after radiotherapy, it promotes the healing of damaged tissues, restores tense and elastic tissue to its normal consistency and structure, and corrects contour deformities.

Small amounts of fat injection can be performed under local anesthesia, but injections exceeding a few milliliters generally require sedation (superficial anesthesia). Since large volumes are usually not necessary for the face, sufficient fat can be obtained directly from all patients, even those with thin bodies, using the negative pressure of the injector; however, for the hands, breasts, and other parts of the body, using fat harvested via liposuction is more convenient and faster due to the need for larger volumes. Fat obtained via liposuction is normally collected in a non-sterile container on the device, and since this fat is outside the surgical field and not sterile, it is not suitable for use. As a solution, we use a filtered apparatus that acts as an intermediate mechanism. We collect the fat harvested through liposuction sterilely on the operating table before it fills the reservoir, filter it, fill it into syringes, and inject it into the targeted area using cannulas. Thanks to this specially developed apparatus, we can prepare as much fat as we want, or even all the fat harvested through liposuction, for injection without removing any. If we are performing fat injections for facial lines and lips, we use specially designed cannulas that finely grind the harvested fat. This is because injecting fat too thickly in the facial area can create palpable or visible irregularities after the procedure. If possible, fat injection should be avoided in the eyelids, which have very thin skin; or it should be done in a very thin and controlled manner in the deep layer; otherwise, problems that are very difficult to solve may be encountered.

After it was understood that adipose tissue contains a significant amount of stem cells, the use of stem cells extracted from fat is now widespread. These advancements in tissue engineering are also being developed through various experimental and clinical research conducted at our university. The research being conducted at our clinic on culturing and multiplying these stem cells to create targeted tissue is expected to lead to very exciting advancements in the field of medicine in the coming years.