A dermal fat graft is a surgical procedure that uses a patient’s own tissue to restore volume and improve contours. Also known as autologous fat grafting, this technique is used in reconstructive and cosmetic surgeries to address volume loss, enhance features, and correct deformities. The graft consists of living fat cells and a segment of the overlying dermis. Because the graft uses biological material from the individual, it minimizes the risk of rejection and can yield natural-looking, long-lasting results that integrate with the surrounding tissue.
The Dermal Fat Graft Procedure
The procedure begins with harvesting the graft from a donor site with sufficient tissue, like the abdomen or thighs. A surgeon excises a strip of skin, including the dermis and the attached underlying fat. This method ensures the fat cells remain connected to the dermis, which contains a rich network of blood vessels that aid in the graft’s survival.
Once harvested, the graft is prepared for transfer. The excised tissue is trimmed to the precise shape and size needed for the correction. Unlike fat injections that require centrifugation to purify fat cells, a dermal fat graft is transferred as a solid piece of composite tissue. This preserves the structural integrity of the fat and its dermal component.
The final step is placing the graft into the recipient site. The surgeon makes an incision, creates a pocket within the subcutaneous tissue, and carefully inserts the graft. Placing a solid piece of tissue allows for more substantial and predictable volume augmentation than injecting liquefied fat.
Common Treatment Areas
Dermal fat grafts are used for facial rejuvenation to address age-related volume loss. They can be placed in the cheeks, nasolabial folds, and temples to restore a fuller, more youthful appearance. Using the body’s own tissue provides a natural alternative to synthetic fillers for smoothing wrinkles and reversing a hollowed look.
In breast surgery, these grafts are used for reconstruction and cosmetic enhancement. Following a lumpectomy, a graft can correct contour deformities and fill the tissue deficit to restore a more natural breast shape. For cosmetic purposes, fat grafting can provide a modest increase in breast size as an alternative to implants.
The procedure is also effective for revising depressed or atrophic scars. Placing a dermal fat graft beneath the scar lifts the indented tissue to be level with the surrounding skin. The added volume provides structural support that helps smooth the indentation and can improve the skin’s texture.
Hand rejuvenation is another application. As hands lose volume over time, tendons and veins become more prominent. A dermal fat graft placed on the back of the hand restores lost volume, concealing underlying structures and creating a smoother look.
Recovery and Expected Results
Recovery involves managing swelling, bruising, and discomfort at both the donor and recipient sites for several days to a week. For facial grafts, head elevation is often recommended to help minimize swelling. Most individuals can return to work and light activities within one to two weeks, though strenuous exercise should be avoided for longer to ensure proper healing.
Achieving the final outcome is a gradual process. Surgeons intentionally place a slightly larger volume of tissue than ultimately needed to compensate for the portion of the graft that will be naturally absorbed by the body. This absorption occurs in the months following the procedure as initial swelling also subsides.
The graft’s long-term success depends on revascularization, where new blood vessels from the surrounding tissue grow into the transferred graft. This new blood supply provides the oxygen and nutrients for the fat cells to live permanently. Once the graft has stabilized and integrated with the local tissue over several months, the results are long-lasting.
Candidate Suitability and Considerations
Ideal candidates for a dermal fat graft are individuals who have sufficient donor tissue available for harvesting. Because the procedure uses the patient’s own fat, an area like the abdomen or thighs with enough subcutaneous fat is a prerequisite. Candidates should also be in good overall health and be non-smokers, as smoking can compromise blood flow and negatively affect graft survival.
Realistic expectations are another important factor. Patients should understand that there will be an initial period of swelling and that the final volume will be less than what is seen immediately after surgery due to partial fat absorption. A thorough consultation with a qualified surgeon can help establish clear goals and ensure the patient understands the likely outcome.
While a safe procedure, potential complications must be considered. As with any surgery, there is a risk of infection. Other considerations include the possibility of asymmetry, the development of fat necrosis (firm lumps), or poor graft survival, where a larger than expected portion of the fat does not survive the transfer.