Lipostructure

Lipostructure, also known as lipofilling or autologous fat grafting, is a surgical technique involving the harvesting of fat cells from a donor area of the patient (by liposuction) and re-injecting them into a recipient area to restore volume, improve contour, or correct irregularities. It is suited to patients seeking natural volumisation (face, hands, breasts, buttocks, scars) using their own tissue, without recourse to a synthetic implant.

Common motivations include restoration of volume lost with age (face, temporal hollows), correction of scar depressions, improvement of the silhouette, or harmonisation of the breast following conservative surgery. The goal is a natural, harmonious result adapted to each patient's morphology.

This text is intended for general guidance and does not replace an individual medical consultation.

The Different Techniques

Harvesting (liposuction)

The fat is harvested by gentle liposuction from areas where fat is available (abdomen, flanks, inner thighs). Fine cannulas are used to minimise trauma to fat cells.

Fat processing and preparation

After harvesting, the fat is processed to remove blood, oil, and fluids. Common methods include decantation, filtration, or gentle centrifugation. The aim is to preserve as many adipocytes and stromal cells as possible to favour graft longevity.

Re-injection (lipomodelling)

The fat is re-injected in micro-droplets, in thin layers, distributed precisely to promote graft survival and achieve a natural appearance. The technique varies depending on the site (face, hands, breasts, buttocks, scars) and the goal (volumisation, reshaping, tissue regeneration).

Specifics, Advantages, and Limitations

• Advantages: use of autologous tissue (the patient's own), potentially very natural result, combined effect of volumisation and improvement of skin quality.
• Limitations: partial graft resorption (variable depending on the area and graft quality), sometimes requiring a complementary session or touch-up. Certain areas (e.g. buttocks) carry specific risks that must be carefully evaluated.

Pre-operative Consultation

During the consultation with Pr Ignacio Garrido, plastic surgeon in Paris, the process includes:

• Medical history (past history, medications, expectations, smoking).
• Clinical examination (donor and recipient areas, skin quality, photographic assessment).
• Explanation of the different technical options adapted to the case.
• Presentation of anaesthetic options, the surgical procedure, and typical post-operative course.
• Provision of a written quote indicating the nature and estimated cost of the procedures.
• Reflection period: in accordance with regulations, a mandatory 15-day reflection period is observed before any aesthetic surgery.

Procedure

• Anaesthesia: local anaesthesia with sedation, or general anaesthesia depending on the extent of the procedure and the areas treated.
• Duration: variable, generally between 1 and 3 hours depending on the extent of harvesting and the area of re-injection.
• Hospitalisation: most often day surgery (same-day return). Some cases may require one night's hospitalisation depending on the extent of the procedure or the patient's general condition.
• Main steps: fat harvesting by gentle liposuction, fat processing, methodical re-injection as micro-grafts. Each step is documented in the medical record to ensure traceability and safety.
• Safety: adherence to aseptic technique, use of sterile equipment, and compliance with best practices to minimise risks.

Post-operative Recovery

• Pain and discomfort: moderate pain treated by analgesics; possible muscle ache at the donor sites.
• Swelling and bruising: common, subsiding within a few days to a few weeks.
• Dressings and compression: local dressing on the re-injection areas; possible compression garment on the donor area for a few weeks.
• Care: local hygiene, monitoring for signs of infection, scheduled check-up appointments.
• Resumption of activities: return to work generally within 3 to 10 days depending on the extent of the procedure; light physical activity possible after 3 to 4 weeks and more intensive activity after medical clearance (generally 6 weeks).
• Follow-up: regular monitoring to assess graft take, healing, and to schedule a touch-up session if necessary.

Results and Limitations

• Evolution: the initial result may be affected by post-operative swelling; the definitive appearance stabilises over several months (3 to 6 months). Some of the grafted fat may be resorbed; the proportion is variable and unpredictable.
• Individual variability: skin quality, general health, smoking, and technique influence graft survival.
• Durability: some volumes may be lasting while others require a touch-up to achieve the desired outcome. Long-term monitoring is recommended to assess progress.

Risks and Complications

• General risks: haematoma, infection, prolonged pain, thrombosis, anaesthetic reactions (managed in an appropriate setting).
• Specific complications: partial graft resorption, nodules or small areas of fat necrosis (liponecrosis), oil cysts, palpable calcifications, asymmetries.
• Rare but serious risks: fat embolism (a rare but serious event), particularly monitored in certain deep re-injection types and in the gluteal region. This is why the technique and indication are scrupulously evaluated.
• These risks remain rare but will be explained in greater detail during the consultation.

Alternatives and Non-surgical Options

• Resorbable fillers (hyaluronic acid): may be an alternative for facial volumisation and offer a non-surgical solution, but with limited duration.
• Implants (breasts, buttocks): an alternative to fat grafting for volume augmentation, with their own advantages and disadvantages (materials, scars, specific risks).
• Complementary techniques: PRP (platelet-rich plasma) combined with fat to enhance regeneration, or laser/radiofrequency treatments to improve skin quality.
• Limitations: each alternative has its own benefits and limitations; the choice depends on the goal, anatomy, and patient preferences.

FAQ

Does lipostructure leave many scars? Scars are generally very short and discreet, related to the cannula entry points for harvesting and re-injection. They fade progressively.

How long do the results last? A portion of the injected fat may persist long-term, but initial resorption is usual. The definitive result stabilises over several months. A touch-up may be considered if necessary.

Can lipostructure be combined with another procedure (e.g. face lift, breast augmentation)? Yes, lipostructure can be combined with other procedures depending on the indication and surgical safety. This will be discussed during the pre-operative consultation.

Does smoking affect the result? Yes. Smoking reduces healing quality and graft survival; it is recommended to stop smoking before and after surgery.