some questions about fat grafting and scar tissue and liposuction

[COD4]

Dear Doctors,
is fat grafting successful ? , those fat doesnt good in the motion ? is that true ?
and how long will it take the scar tissue to disappear ? im talking abt internal scar tissue . hard skin like thing

and another question , do fat returns to liposucked areas ? when we do a liposuction on the belly area , and after some time when the person gets fat all those fat goes into other places ?

[Miguel Delgado MD]

This is a very complex question and takes a 15 minute discussion.  However, I will summarize my thoughts. Fat transfer isa wonderful technique which is used to replace volume loss.  The science behind this is massive and we are learning how to use it best all the time. It may be the perfect volume replacement.  It is fast to perform, most people have an endless source, and is fairly reliable.  We can now freeze fat for future use.  Fat does not take well if placed in scar tissue due to reduced blood supply and a tighter constricted area that will not expand normally.  The "take" is less so in areas with more mobility like the lips which move constantly oppose to the cheeks that do not move as much. The technique of how to liposuction the fat and prepare the fat is discussed constantly.  A great resource about fat grafting is http://www.plasticsurgery.org/Documents/medical-professionals/health-policy/guiding-principles/ASPS-Fat-Transfer-Graft-Guiding-Principles.pdf

You have a good understanding of liposuction. Yes, the fat can return to the liposuction areas in the fat cells that are still present. Yes, if you gain weight it will tend to go to other places because it has a normal population of fat cells, unlike the suctioned areas.

[DrPensler]

In addition to Dr Delgado's remarks I would add that the number of fat cells you are born with does not change as you gain or loose weight.What happens is the existing cells increase or decrease in size. When liposuction is performed there is a reduction in the number of fat cells in the area of the surgery. If you eat excessively after surgery and then gain weight the reminiscing fat cells in your body increase in size.

[COD4]

Thank you for both of u doctors. Just another question came up to my mind. Im going to have a revision surgery on december. One side is fatty than the other. So my surgeon will remove the excess fat on the side which they are present. He will use liposuction. So i need to know that after this procedure, do the fat melts and spread equally in the removed area ? Because im afraid that this procedure will leave margins ? Between the fat removed areas and normal areas ?  Sorry my english is bad. I need to know is after liposuction, does the surface gets smooth ? And can u please tell me how do surgeons avoid crater deformity. I meant if they leave a thin fat layer between muscle and the skin the crater wont happen no ?  How is the areola gets stucked in the muscle ? I saw that on internet.  Thanks

[DrPensler]

Without a photo it is not possible to precisely  comment on the situation .