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Many stories have been featured in the media recently, regarding the risks of ‘DIY’ (do-it-yourself) plastic surgery, in particular fat grafting and other injectable augmentation procedures. The story of an American woman named Apryl Brown is an especially tragic example that has gained international news coverage, putting the spotlight on discounted medical procedures performed by non-medical personnel.

Apryl Brown’s story began when she was informed by a female acquaintance that Brown could have buttock enlargement with silicone injections at a cut-rate price. Brown agreed to the procedure, and received two courses of injections to her buttocks at the woman’s house. After experiencing severe pain and discomfort, Brown decided not to continue with the injections. Unfortunately, as time went on, her buttocks became progressively hard and painful, and the skin turned a dark colour. Five years later, the pain and disfigurement became so severe that she eventually had to have surgery to remove the silicone along with much of the buttock tissue. Complications from the surgery led to a severe life threatening infection that spread throughout her body. In order to save her life, surgeons had to perform more than twenty surgeries, including partial amputations of both of her arms and legs. Through the course of Ms. Brown’s treatment, doctors discovered that what she had in fact been injected with was silicone bathroom caulking.

Non-physicians performing quasi-medical procedures in basements and backrooms, using unknown substances is a troubling trend that puts the public at risk. Although this is an extreme case, it is not difficult to find stories of DIY plastic surgery disasters surfacing more and more frequently. Ms. Brown’s story may just be the tip of the iceberg, as most patients who have had poor outcomes are likely too ashamed or embarrassed to seek help. The popularity of television shows like “Botched”, which airs on E!, detailing extreme cases of plastic surgery gone wrong, has helped to highlight the importance of having your surgery performed in an accredited facility, by properly trained medical personnel .

The real procedure that Ms. Brown was likely seeking is popularly known as a Brazilian Butt Lift. This procedure uses a patient’s own fat to augment the buttock region. Fat transfers procedures are gaining popularity, and some details of the various benefits of fat injections when performed by a qualified plastic surgeon are discussed below.

What is fat grafting or fat transfer?

Fat grafting (also known as fat transfer or fat injection) is a procedure in which fat is harvested in one area (such as the abdomen or thighs) and injected into another area which is typically volume deficient (such as the face, breasts or buttocks). Every year thousands of successful fat transfer procedures are performed by board certified plastic surgeons, giving a safe, long lasting and natural looking result.

What are the benefits of fat transfer?

• Fat transfer uses your own fat, which eliminates the risk of allergic reaction or rejection as you are replacing “like with like”. This contrasts with dermal fillers or implants which are foreign substances to the body and carry a small risk for allergic reaction.

• In the face: compared to dermal fillers which are always temporary, the procedure is potentially permanent

• In the body: the procedure improves contours by removing excess fat in some areas and augmenting deficient areas (i.e. two benefits are achieved).

• Fat augmentation has the potential of being permanent, so repeated treatments may not be needed

• Fat transfer is also a minimally invasive procedure, requiring only small punctures in the skin as opposed to longer incisions, while still delivering a long lasting and natural looking result

What are the limitations of fat transfer?

• Patient should be aware that fat transfer has variable outcomes depending on how much of the fat survives. Typically one may expect anywhere between 20-50% of the fat to ‘melt away’ during the first 6 weeks.

• Many factors influence the survival. Smoking, which decreases circulation affects the success of the procedure, therefore ideal candidates should be nicotine free at least two weeks prior to surgery.

• Excessive movement of the area shortly after surgery also may negatively affect the fat survival rate.

• Some patients may wish to have a repeat fat transfer procedures in order to attain the look they are seeking.

Who is a good candidate for fat transfer?

The main purpose of fat grafting is to fill in or augment areas where there is a desire for more volume. Common areas are the face (including the cheeks, lips, eyelids, smile lines, and corners of the mouth), the breasts, buttocks, and hands.

• Prospective patients should be non-smokers, in good health, with no significant medical issues

• Prospective patients must have a donor site on their body from which the fat can be taken. In buttock and breast augmentation, the patient must have ‘enough’ fat to make the procedure feasible.

• Candidates must have realistic expectations and understand the limitations of the procedure

• Dr. Tong will determine whether you are a candidate for fat transfer during your consultation

If you have more questions regarding fat transfer or any other procedures, or would like to book a consultation with Dr. Tong, please contact our office.

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Dr. Lawrence Tong