Fat Transfer for the Correction of Divots from Liposuction

Abstract

Introduction:

As liposuction becomes more popular, divots and irregularities will be more common. These can happen to patients of new inexperienced operators or to those of the best technicians. The key to divot management is rapid correction. The objective of this study was to ascertain if the divot could be rapidly corrected with local liposhifting or free fat transfer from other liposuction sites.

Method and Materials:

Ten patients were examined for this study (either our patients or referrals). Results for three patients that received corrective fat transfer are presented in detail. As soon as a divot was discovered, whether intraoperatively or postoperatively, it was corrected by fat transfer. If necessary, in older cases the fibrotic trabeculae in the area of the divot were subcised. The fat was either shifted into the site locally or collected from another site following tumescent liposuction. This free fat was transferred to Lipoject injection guns or to 20-cm³ syringes. After allowing the fat to concentrate by gravity, the fat was infiltrated into the area of the divot in a retrograde fashion. A donut of Reston foam was applied around the infiltrate and allowed to stay in place during the first 5 days after the operation. Remaining fat was frozen for future use. If necessary, a second injection session was done in 2 to 3 months.

Results:

In each case, the divot was elevated and partially resolved during the first injection session and, usually, completely corrected with a second or third session.

Conclusion:

It is important to correct the divot early in the postoperative period, whether intraoperatively or as it is recognized postoperatively before the tissue develops fibrosis and contracts down. If the correction is done early in the course of recovery, the tissue is elevated easily with one or two transfer sessions. Older cases may require subcision before fat is placed in the pocket.