The Value of Fat in Cosmetic Surgery

By Charles A. Messa, III, M.D., F.A.C.S.

The future of plastic surgery lies in stem cell science and optimization of fat grafting for soft tissue augmentation. For years, patients focused on eliminating fat. Today, fat (or adipose) cells are utilized for restoration of soft tissue volume loss that occurs with aging.  Recent advancements in stem cell isolation have led to the application of stem cell enriched fat grafts.  

A fat transfer involves harvesting a patient’s own fat cells through a lipo-aspiration procedure, then separating the fat cells from the accompanying serum into a pure fat cell graft for transfer to the face, body, or breasts to restore soft tissue volume. Research has shown that when fat cells are enriched with stem cells to form culture expanded adipose desired stem cells (ASC), there is a higher quantity and quality of newly formed adipose and connective tissue. With this technique, the amount of fat which survives after a lipofilling procedure improves to 80 – 90% with more predictable and long-lasting results. Fat cells survive in the range of 50 – 75% with present techniques requiring over correction of the soft tissue defect to ensure proper enhancement.

The term stem cell when used in advertisements for facelifts and hair transplants is not applicable, because stem cells haven’t been isolated clinically for these procedures.  Using the term ‘stem cell facelifts’ is an attempt by the advertiser to mislead patients into thinking they are receiving a new cutting-edge procedure.  

Scientifically, fat cells do contain immature stem cells, as well as platelet rich plasma, which have a higher portion of stem cells than plasma alone. When fat is injected into the face, theoretically a small concentration of stem cells may be present in the newly grafted fat. For buttock enhancement, autologous fat transfer procedure has become the procedure of choice to improve size, shape, and lifting of the buttocks.

In recent years, fat grafts have been used in breast reconstruction procedures, both for post-mastectomy reconstruction and post breast augmentation contour irregularities. Autologous fat grafting procedures are being utilized for primary breast augmentation more often for women who desire a small increase in breast size and fullness. The technique is still being studied to determine its long-term effects, including issues with mammography and subsequent breast cancer detection. The techniques for maximizing results in fat transfer have evolved over the past several years. With ongoing research and clinical application, fat will be used universally for soft tissue augmentation and become the gold standard for such procedures.

Dr. Messa is certified by the American Board of Surgery and the American Board of Plastic Surgery. He is a member of the American Society for Aesthetic Plastic Surgery and has achieved the award Black Diamond with Allergan. As a Black Diamond Plastic Surgeon, Dr. Messa is in the top 1% of plastic surgery practices in the country by volume. 

  • To learn more about Dr. Messa and his practice, visit his website at His office is located at 2823 Executive Park Drive, Weston, Florida. To schedule your consultation with Dr. Messa, call the office at 954-659-7760.