Step-by-Step:What to Expect Before, During & After Facial Fat Grafting

18 Nov

• By: Dr.Anup Dhir

When we think of getting older, we often think of wrinkles. However, one of the greatest indicators of aging is loss of volume. As we age, the natural youthful fat pads in our face become deflated and migrated downwards, resulting in hollows under the eyes, flattened cheeks and jawline, and less definition. While dermal fillers can help temporarily, many now want a more natural, longer-lasting and holistic approach to restoring volume.

Enter facial fat grafting.

This sophisticated Cosmetic Surgery procedure is often dubbed the "ultimate natural filler". Facial fat grafting is done with your own body's fat, restoring volume to help rejuvenate your face, with results that are aesthetically pleasing and long-lasting. As a surgical procedure, it is more intensive than an injection.

If you are considering Fat Grafting Surgery in Delhi, then this complete step-by-step guide will guide you through everything you need to know from the initial thoughts to your final beautiful result.

Part 1: The "BEFORE" Phase – Your Consultation & Preparation

This initial phase is the most important for ensuring your safety and achieving the results you envision. It’s all about research, honest conversation, and careful planning.

What Exactly is Facial Fat Grafting?

First, we need to clarify what it is. Facial fat grafting (or fat transfer) is a graceful three-step process:

1.) Harvesting - Utilizing a specialized low-pressure liposuction technique, a small amount of excess fat is delicately removed from another part of your body (such as the abdomen, thighs, or “love handles”).

2.) Purification - The harvested fat is then purified; it is typically spun in a centrifuge, which separates the pure, healthy, living fat cells from the excess fluid, oil, and blood.

3.) Grafting - The purified fat cells are meticulously injected in tiny droplets into the areas of your face that have lost volume, lost smooth contours, and need skin rejuvenation.

Because this process uses your own “autologous” tissue, there is no risk of allergic reaction, and the results incorporate smoothly into the structure of your face.

The Critical Consultation

Your journey will begin with a consultation with a board-certified plastic surgeon for a one-on-one meeting. This is not a sales pitch; it is an important medical and aesthetic consultation. Here is what to expect:

• Goal Discussion: You will have the opportunity to discuss in detail what you want. Are you disturbed by the hollowness of the under-eye area? Do you want fuller cheeks? An experienced surgeon will listen and give his professional opinion, using his artist's eye to explain what is going to look balanced and natural to your specific face.
• Medical History: This relates to your safety. Be prepared to be 100% honest about your medical history (ANY medications, including vitamins and herbal supplements) and your lifestyle (especially smoking).
• Physical Exam: This is important because the surgeon will look at not only your facial anatomy but also the potential donor sites. The most important thing is that you have enough fat to harvest to meet your goals.

Your Pre-Surgery "To-Do" List (The Weeks Before)

Once you are cleared for surgery and your date is set, you will be given a set of crucial instructions.

4-6 Weeks Prior:

• Quit Smoking. This is non-negotiable. Nicotine, in all forms (vaping, patches, cigarettes), constricts blood vessels. For your fat graft to be effective, the transplanted cells need to create a new blood supply. Smoking will deprive them of oxygen and nutrients, killing the graft, and resulting in a very poor outcome.

2 Weeks Prior:

• Stop Blood Thinners: Your surgeon will provide you with a list of medications and supplements to avoid. This will almost certainly include aspirin, ibuprofen (Advil, Motrin), fish oil, Vitamin E, and many herbal supplements. These can lead to excessive bleeding and bruising.
• Arrange Your Caregiver: You will be under anesthesia, and you cannot drive yourself home afterwards. You must have arranged for a responsible adult to come pick you up and to help you get settled and stay with you for the first 24 hours.

1 Week Prior:

• Fill Your Prescriptions: Your surgeon will prescribe you antibiotics and pain medication. Get these filled before surgery day, so they are easily available when you get home.
• Prepare Your Recovery "Nest": Set up a comfortable place (recliner or bed propped with pillows) where you will be for the first few days.

The Night Before:

• Adhere to the NPO instructions: This is the most important instruction. You will be given a specified time (usually midnight) to stop all food and drink to prevent the life-threatening risk of aspiration with anesthesia. You cannot even chew gum or have a sip of water.
• Shower: Shower according to instructions, often with a special antibacterial soap. Do not use any lotion, perfume, or makeup.

Part 2: The "DURING" Phase – The Day of Your Surgery

You’ve done all the prep work, and the day is finally here.

1. Arrival and Pre-Operation: You will arrive at your surgical facility, and you will have a dedicated team that will begin preparing you. Your surgeon will come in for one last time to finalize the plan, plus make their markings on your face and donor sites. You will have the opportunity to meet your anesthesiologist for your comfort.
2. Anesthesia: For your comfort and safety, facial fat grafting is typically done under general anesthesia or deep IV sedation or "twilight" anesthesia.
3. The Harvest: Your surgeon will then gently harvest the fat from your chosen donor site. The harvest process is more delicate than normal liposuction simply because you want the fat cells to stay alive and not damaged.
4. The Purification: While you are resting, the harvested fat is put into a centrifuge. The fat is spun out and purified, concentrating the healthiest "graft-quality cells".
5. The Grafting: This part is where the artistry happens. Your surgeon will be using small, special cannulas (blunt tip needles) and delivering the fat into your face. The entire process involves delivering the fat in tiny, multi-layers droplets maximizing blood supply that each new fat cell can receive to allow nourishment to the fat cells. The overall process takes time, but this is why you are avoiding lumps or bumps and why you are treating this time frame, along with the next few weeks, as the best chance of success in grafting!'
6. Post-Anesthesia Care Unit (PACU): After your procedure is finished, you will go to the PACU room where you will wake up from anesthesia and the nursing staff will keep a close eye on you. Your face will not have bandages on it as a rule, but you will likely have some compression garment in place at your donor site. Once you are awake enough and stable, your caregiver can take you home.

Part 3: The "AFTER" Phase – Your Recovery & Results

This phase requires patience. Your body has to heal in two places, and the "final" look will not be apparent for several months.

The First 48 Hours: The "Swelling" Phase

At this time, you will experience the most swelling and bruising. Your face will have swelling and look puffy, and the donor site will be sore.

• Rest Sleep Elevated: You must sleep on your back with your head supported by 2-3 pillows. This is a very important instruction to minimize your swelling.
• Gentle Cold Compresses: Your doctor will give you instructions for gentle cold compresses (like a bag of frozen peas wrapped in a towel) but never apply ice directly.
• Do Not Touch! Do not put any pressure on your face. You will want to protect the newly grafted cells.

Week 1: The "Hunker Down" Phase

The swelling will reach its highest point around day 3 or 4, and will gradually start to go down. You may look "overfilled" or "chipmunk cheeked".

• THIS IS NORMAL. Your surgeon purposefully overfilled the area as your body will absorb about 30-50% of the grafted fat. The initial puffiness is not your final result.
• Activity: You may take short gentle walks in the home to promote blood flow, but no bending, lifting or straining.
• Donor Site: You will probably wear your compression garment 24/7.
• Follow-Up: Your first follow-up appointment will probably take place this week.

Weeks 2-4: The "Getting Back to Normal" Phase

A significant amount of bruising and swelling will resolve. You will start to feel much more like yourself and will likely feel comfortable going out in public.

• Protect the Graft: You still need to be careful. No strenuous exercise, saunas, or hot tubs.
• No Smoking: Continue to abstain from all nicotine.
• No Pressure: Continue to sleep on your back. Sleeping on your side can put pressure on the graft and kill the fat cells.

Months 2-3: The "Settling" Phase

This is when the real magic happens. The transferred fat cells have (or have not) successfully established a new blood supply. The "overfilled" look will be gone as the unviable fat cells have been naturally absorbed by your body. What you are seeing now is much closer to your final result.

Month 6 & Beyond: The Final Result

At the 6-month mark, your results are considered stable and permanent. The fat that has "taken" is now a living part of your facial structure. It will behave like any other fat on your body, meaning it will age with you and can even fluctuate if you have major weight changes. Your face will look naturally refreshed, fuller, and more youthful.

Your Most Important Choice

As you can see, fat grafting is a far more complex and technique-dependent procedure than simple fillers. It is both a science and an art. The surgeon's skill in harvesting, processing, and—most importantly—re-injecting the fat will determine the smoothness, naturalness, and survival rate of your graft.

When considering a Fat Grafting Surgery in Delhi , your priority must be finding a board-certified plastic surgeon with extensive experience and a proven artistic eye for this specific procedure.

If you are ready to explore how facial fat grafting can restore your natural, youthful volume, we invite you to schedule a consultation with Dr. Anup Dhir. He is a leading expert in facial cosmetic surgery and is dedicated to providing the highest standard of patient-first, natural-looking results.