Fat transfer (also called fat injection), a technique that has been around for over 20 years, has had a recent resurgence in popularity. Think of fat transfer as another type of filler. It fills in hollows and replaces the volume we lose as part of the aging process. I have discussed how “fillers fill and lifts lift” in a previous post, so I won’t belabor that point again, but fat is essentially just another filler. The procedure involves taking one’s own fat, usually from the area under the belly button, through a small incision about 3 millimeters (less than an eighth of an inch) inside the belly button. Using a micro-liposuction technique, smooth fat is harvested, then concentrated, and re-injected into the areas of concern. The advantage of fat transfer is that in most patients, it lasts much longer than the other available fillers such as Restylane®, Juvederm®, and others. The disadvantage of fat transfer is that it usually causes some bruising and swelling that can last 5 to 10 days. Therefore, it is more of a “recovery time necessary” procedure, whereas Restylane® injections generally require no downtime. Fat transfer can be performed in the office, although it requires that most of the area under the belly button out to the hips be injected with a local anesthetic, to numb the area for harvest. Once this area is numb, there is no pain, but the injection of local anesthetic for that size an area can be quite uncomfortable. Therefore, it is most comfortable for the patient to have this done in the operating room with sedation. The main reason that most people have fat transfer performed in the operating room, is that it causes bruising and swelling. So it makes sense to combine fat transfer with other procedures that also require downtime. Fat transfer can be performed in the office or in the operating room, and this, as well as the many other factors that are important in deciding which filler option is best for you, is discussed in consultation with me and my staff. We will guide you to the treatment option that will help you achieve your goals and still fit in your busy schedule.