The anaesthetic related to surgery depends very much on the treatment zone. For small treatments local anaesthesia is suitable both for harvesting and fat injection.
For more significant surgical interventions either general anaesthetic or local anaesthesia with intravenous sedation is more appropriate.
Having determined the donor site for harvesting, the area is frequently infiltrated and liposuction through a small caliber instrument is used to harvest the necessary fatty tissue.
Depending on the technique used the fatty tissue is then either filtered or centrifuged to isolate it from the infiltration fluid and to prepare it for use in the treatment area. Since the fatty tissue is known to carry also stem cells, this is believed to be part of the value of the treatment.
The injection of fatty tissue is carried out using fine blunt needles, with distribution of the volume in the fulness of the soft tissue treated, so that there is a more consistent augmentation and also to allow good contact between the fatty tissue transferred and the local blood supply.
The fat transfer, unlike filler injection, is living tissue and will require blood supply and nutrients as well as oxygen to stay alive and establish contact with the local tissues, much as a skin graft does when it is used for reconstruction.
During the surgery there is moderate bruising and swelling that decreases the ability to verify and control the asymmetry, but since it is well understood that a proportion of the fatty tissue injected will reabsorb, the treatment typically is slightly over corrected.
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