Fat Grafting
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{ Fat Grafting }

What is fat grafting and fat transplantation?

Fat grafting and fat transplantation (they are the same names for the same procedure) is the use of the patient’s own fat transferred from an area, where there is too much fat and the fat is not desired and moving this fat to an area where there’s a need for volume, shape and form provided by the survival of the fat graft itself.

By taking fat from unwanted fatty areas and transplanting the fat to areas where fat is required, one can improve the contour in one area (the donor site) and add volume and shape to an area where fat is deficient (the recipient site). Essentially, large volume fat grafting to the buttock (“Brazilian Butt Lift”) or breasts (“Natural Breast Augmentation”), is total body contouring with liposuction where you have too much and using the excess fat where you don’t have enough. This “stealing fat from Peter to pay Paul” is very appealing to Toronto fat grafting patients.

Common donor sites for fat grafting include the abdomen, hips, outer thigh. Less common sites include the inner thigh, inner knee and arm.  In general, there is too little fat under the chin and submentum to provide any significant donor material for fat grafting elsewhere.

The most common areas to have fat grafting and fat transplantation include fat grafting to the face, fat grafting to the breast or natural breast augmentation and the Brazilian Butt Lift.

Common areas where liposuction is performed on Male and Female Toronto patients

Figure 1.  Toronto Fat grafting patients generally have extra fat in very common areas such as the hips, tummy, outer thigh, inner knee in women and love handles or tummy in men.

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Why you should choose Dr. Mulholland and SpaMedica for your fat grafting procedure

Quality and Experience

Dr. Mulholland has over 25 years of fat grafting experience

He initially trained with Dr. Sydney Coleman, a fat grafting expert, in the early 90s

Dr. Mulholland has taught doctors in the U.S and worldwide on the use of VaserLipo to harvest large volumes of fat for fat grafting to the breasts and buttock (Brazilian butt lift)

Dr. Mulholland provides some of the longest term fat grafting results in Canada


He is certified as a plastic surgeon by the Royal College of Physicians and Surgeons of Canada

He has dual training in ENT, head and neck oncology and craniofacial trauma

During his years of cancer and trauma reconstruction, fat grafting was an important procedure to help restore volume that was lost to trauma or cancer

Dr. Mulholland has taken these techniques in to the face and the body over the past 25 years and refined the aesthetic results that one can achieve with fat grafting to the face, breasts and buttocks


Dr. Mulholland appears in many television shows, news articles and magazines to discuss plastic surgery

The results of his work on fat grafting patients can be seen in television shows and before and after photos

Affordability and Payment Plan

Patients can have Medicard payment plans arranged for their procedure

Payment periods can be spread over 36, 60 and 72 months

Patients can have low interest rate payment plans and be approved in under 30 minutes

How is the fat grafting and fat transplantation procedure performed?

The fat grafting and fat transplantation procedure is relatively simple.  The area where the fat is to be harvested is prepped and draped in a sterile fashion and usually the procedure is performed under local anesthesia.  A small harvest needle is used to gently move back and forth the anesthetized fat donor material, harvesting fat cells.  The harvesting process and technique will depend upon the area and size of the area to be grafted or transplanted. Small zone fat grafting such as the face, or isolated body contour indentations (from inherited, trauma, or previous surgery, such as liposuction) can be extracted and removed with small harvest cannulas. These small zone fat graft procedures will not require much fat, so the patient does not usually see a sizeable difference in the donor site (where the fat is taken).

A patient is having their fat harvested. The fat is then prepared to be transplanted to the face or small body zone.

Figure 2.  A Toronto fat grafting, fat transplantation patient having fat taken with a specialized fat harvesting cannula from the donor abdomen. The  syringes will be removed, prepared and grafted to the face or small zone body indentations or irregularities.

Large zone fat grafting or fat transplantation, will require up to 1000 cc (one litre) of fat or more and these areas include fat grafting or transplantation to the breasts (also called “Natural Breast Augmentation”, or fat grafting or transplantation to the buttock (“Brazilian Butt Lift”). To be successful with large zone fat grafting, fat transplantation, a fat grafting plastic surgeon must invest in some expensive technology that will be able to harvest large volumes of fat in the least traumatic method possible to ensure enough fat is removed, BUT, the fat cells are not damaged in the process, as they must survive and pick up a blood supply to survive. It is acknowledged with the truly expert large zone fat grafting and fat transplantation specialists, like Dr. Mulholland, that the Vaser Lipo system is the best way to remove the large volumes needed to predictably and successfully augment the breast or the buttock without damaging the fat cells to be transplanted.

What are stem cells and how are they different from fat cells?

Fat cells are a mature form of a cell, well differentiated and store energy as fatty tissue (Trigylerides). Their anatomy and structural integrity of a fat cell lend themselves well to transplanting to form a well vascularized, structural support and shaping tissue for areas of volume deficiency, such as the face, breast, buttock and post liposuction irregularities. Stem cells are naturally occurring cells in human tissue, particularly in human fat. Stem cells are not differentiated, but rather, are immature cells that, depending up the environment can grow to become many different kinds of cells, fat cells, heart cells, collagen forming cells, called fibroblasts, etc. Fat derived stem cells are also included in a fat transplantation and fat grafting procedure, as they can cause localized stem cells in the face, breast, or buttock to become fat cells adding to the long term result, or themselves can differentiate into mature structural fat cells.

Fat grafting and Fat transplantation will include fat cells and stem cells harvested with gentle advance fat grafting harvesting technique.

Figure 3. Fat grafting and fat transplantation will include fat cells and stem cells harvested with gentle advance fat grafting harvesting technique. Both the mature fat cells and stem cells will be transplanted to the recipient tissue, commonly the fat, breast, buttock and body contour indentations.  Both the transplanted fat cells and stem cells will act to build structure and support in the soft tissue.

Can I use fat cells from another person?

This is a common question. “Can you use the fat from another person, who perhaps has lots to spare, harvest from them and transplant to you?” The answer, is unfortunately NO. The fat cells and stem cells harvested from another person would be recognized as foreign and your body’s immune system would reject the grafted and transplanted cells. It would attack these foreign transplanted cells, as they would for bacteria or a virus and destroy the cells and the fat grafts and fat transplantation would fail.

What is Vaser Lipo and Vaser Fat Grafting and Vaser Fat Transplantation?

The Vaser Lipo and fat transplantation and fat grafting system is a very high tech, high speed and elegant process of removal of the undamaged fat from the unwanted donor site. It then prepares the fat cells and perform standard fat grafting and fat transplantation procedure to augment the breast, buttock or body defects from surgery.

The Vaser Lipo and Fat Transplantation Device.

Figure 4.  The Vaser Lipo and Fat Transplantation Device.

The Vaser consists of a gentle ultrasound probe that is inserted in the fat painlessly, as the fat has been completely frozen with local anesthesia. The probe moves back and forth slowly in the fat to the grafting and the ultrasound waves gentle dislodge the fat cells so they can be easily extracted without trauma.

The left shows the anatomy of fat cells. The right image shows the Vaser emitts gentle sound waves and the fat cells are shown in yellow. They are tightly packed.A. The anatomy of the normal fat cells  B. The Vaser emitts gentle sound waves and the fat cells are shown in yellow. They are tightly packed.

Figure 5A and 5B .  The Vaser Lipo probe emits gentle ultrasound wave that loosen up the fat cells for fat grafting from the attachments, gently without traumatizing their integrity for grafting and optimizing the fat cell transplantation.

Once the Fat from the donor or harvest site has been disolodged gently with the Vaser lipo system, it is extracted with a power assisted aspiration system, under low pressure to minimze any trauma to the fat cells and stem cells. The Vaser Cannulas used to harvest the fat grafts are specially designed to minimize the trauma to the fat cells and stem cells during the actual harvest. The harvest cannulas are small, use low pressures and are able to remove the already loosened fat cells gently, almost like a “fat cell smoothie”.

Vaser Cannulas

Figure 6. Toronto fat transplantation and fat grafting patients under go Vaser lipo to loosen the fat cells from the tissue attachment without damage and then are gently aspirated using the atraumatic ventex Vaser cannulas which are small, blunt nosed and low pressure. They are specifically designed to remove fat after the Vaser and minimize trauma for survival during the fat the fat grafting and fat transplantation process.

Once the necessary amount of donor fat is harvested, the refinement in body contouring and liposuction is continued until the body contour shape is optimized in the donor site, providing the Toronto Fat grafting patient with greatly improved shape and contour in the donor sites.

Fat Grafting illustration

Figure 7.  After Vaser Lipo harvest the fat content in the donor site shrinks providing a localized body contour, or liposuction-like result.

Vaser lipo sterile canister

Figure 8.  The Vaser fat graft cells are collected in a sterile canister where they can be extracted in a sterile fashion in small syringes for sterilization.

Once harvested, the fat cells are transferred in a sterile fashion to a refinement process that often includes centrifugation or spinning the fat done and removing the unwanted elements of the fat graft material including unwanted blood, serum and local anesthesia.  Other forms of preparation, such as washing the fat tissue or segmentation and separation of stem cells and non-stem cell segments can also be performed.

Following the preparation phase, the purified fat and stem cell segments are then placed atraumatically into small injection syringes in preparation for injection into the recipient area or the area to be grafted.

Breast Fat grafting

Figure 9.  Vaser lipo fat graft cells are placed in small syringes, 1cc for small zone, delicate fat graft areas like the face and in 10cc syringes for large zone fat grafting zones like the breast or buttock. This figure shows Dr. Mulholland injecting, grafting and transplanting purified fat graft cells into the breast, as a breast fat grafting procedure, also called a “Natural Breast Augmentation”.

The area to be grafted is prepped and draped in a sterile fashion and local anesthesia is instilled.  Using small micro fat grafting needles, the fat grafts are expertly placed by Dr. Mulholland in multiple layers throughout the area to be fat grafted, enhanced or augmented.  The actual placement of the fat grafts in the recipient site is a highly-skilled and sophisticated procedure, as Dr. Mulholland will create multiple little recipient tunnels with the blunt injection needle and, pulling back, will place .1 to .2 ccs of fat graft material.  It is important that the amount and diametre of the fat graft material be less than one millimetre away from a new blood supply or neovascularization, or the process of getting blood supply to the fat grafts, will not occur optimally and your fat grafts will die.  Thus, you will rely on Dr. Mulholland’s over 20 years’ experience in fat grafting in various areas of the face and body to get the best possible fat graft survival.


Figure 10.  Using specialized fat grafting and fat transplantation micro cannulas, the fat cells are injected in the donor site soft tissue using a highly specialized structural fat grafting technique that creates multiple tunnels with small “tooth pick” sized fat grafts embedded securely in the donor site to pick up a blood supply for long term survival and viability.

Multiple layers of fat structure

A.  Multiple layer structural fat grafting  B. The new blood supply for the fat graft cells and the stem cells

Figure 11.  11A. Multiple layers of fat graft cells are injected throughout the donor site, the breast, buttock, face or body indentation. 11B. The fat cells must be close enough to each other to facilitate a smooth structural augmentation but just far enough away from each other to allow the in-growth of a blood supply to ensure long term survival. The structural fat grafting technique requires a skilled and experienced eye to ensure just enough fat to create the face, breast, buttock shape and contour.

Who is a candidate for fat grafting?

Good candidates for fat grafting are individuals who are realistic and well-selected.  At SpaMedica and under Dr. Mulholland’s expert guidance, well-selected fat grafting patients are those individuals that want modest enhancement and volume of their deflated areas of their face or upper or lower poles of their breast or areas of the buttock.  Other fat grafting areas include post-liposuction indentations and defects, as well as some deep cellulite pits.

Good candidates for fat grafting realize there are sometimes other augmentation procedures that could be performed, such as breast implant surgery or buttock implant surgery or facial implants, but would prefer to have a more natural, autogenous augmentation performed with their own fat material by taking it from where they don’t want the fat and transplanting it to where they need it.

Contraindications for fat grafting include any patient or individual who is unrealistic, who may be pregnant at the time of the procedure or any patient with inflammatory, infectious or cancerous lesions to the area to be harvested or grafted.

What kind of anesthetic is used during fat grafting and fat transplantation?

Commonly, Dr. Mulholland will perform fat grafting under local anesthesia alone with some oral sedation.  However, if a patient is already undergoing general anesthetic, fat grafting can also be performed during the procedure.

Is fat grafting and fat transplantation painful?

Once the local anesthetic is instilled, fat grafting and fat  transplantation is completely painless. Both the donor site and recipient site are filled gently with local anesthesia so they should not have discomfort or pain. Both the donor and recipient sites are “marked out” or diagramed out according to plan, to optimize the body contour results.

How long does the fat grafting procedure take?

The length of time for a fat grafting procedure depends upon the area that needs to be grafted and how much fat needs to be harvested in order for this to occur.  In general, facial fat grafting takes approximately one hour for both the harvest and the injection.  For substantial natural large zone cases, such as Natural breast augmentation with fat grafting, or buttock augmentation, more fat is required and, as such, generally the procedures will take 2-3  hours.

How long is the recovery following fat grafting and fat transplantation?

The recovery following fat grafting is relatively short.  Individuals that have undergone body fat grafting to the breast for breast augmentation or to the buttock for buttock augmentation or even for post-liposuction defects and indentations or cellulite, patients can return to normal activities the following day, as clothing conceals the areas.  Individuals that undergo facial fat grafting, even though the post-operative course is relatively comfortable, have a significant amount of swelling and generally require between five and seven days off following their fat grafting procedure until the swelling subsides to acceptable levels.

What kind of results can I expect following my fat grafting?

Dr. Mulholland is one of Canada’s most premier plastic surgeons and has been fat grafting to the face, breast, buttock and body area for 20 years.  He learnt his early fat grafting techniques from some of the earlier-generation fat grafters, such as Dr. Sydney Coleman in New York, and has been able to take fat grafting to a new refinement and level and you will benefit from his extensive experience.

In general, Dr. Mulholland finds that certain regions in the face, such as the temple, brow, under-eye, nose and jawline have a great longevity in take.  In general, the number of fat grafts that take is in the order of 30% to 60% and, as such, Dr. Mulholland will overgraft, understanding that between 30% and 60% of the fat grafts will not take.  Fat grafting to the breast tends to be very successful, with a high degree of fat graft take.  In the buttock and more mobile areas of the body, such as the thighs, the fat graft take is generally 30% to 50%.

Most patients undergoing fat grafting are very happy with their results and most patients who undergo breast, buttock and body fat grafting are told in advance that two sessions are often required, separated by 12 months.

Before and after fat grafting patient

Figure 12.  Toronto fat transplantation patient who underwent fat grafting to the smile lines, marionette lines and lips at the time of a neck lift.  The fat grafts and fat transplants provide an excellent improvement even at 2 years post op, like this photo.

What are SpaMedica patients saying about their fat grafting procedure?

Most patients are extremely happy with the results of their fat grafting and fat transplantation.  They have selected a natural way to provide volume, shape and form to their face, breast, buttock or body regions and have generally achieved a high degree of improvement with Dr. Mulholland’s refined techniques. Toronto Fat grafting and fat transplantation patients, who present for large zone augmentation of the breast and buttock, get the benefit of improving the contour and shape of their figure after harvesting fat AND an excellent improvement in the size, shape, contour, projection and proportion of their new BUTT, Breast or face.

How long will my results last from my fat grafting?

Dr. Mulholland has been performing Vaser Lipo and Vaser fat grafting to body and facial areas for over 20 years. He is acknowledged as one of Canada’s best plastic surgeons and taught many USA and international doctors, through weekend workshops, the science and art of Vaser Fat grafting.  In general, 30% to 60% of all fat graft and fat transplant material will receive a blood supply and become a permanent part of the recipient site, contour and shape.  However, normal aging mechanisms then ensue.  As Toronto Fat grafting patients get older, patients undergo deflation, descent and deterioration.  It’s a natural part of aging for the face and body to lose subcutaneous fat and this will also occur to your fat grafting material.  In general, stable fat grafts will last for some years and facial fat grafting may have to be repeated every two to five years and body fat grafting every three to five years.

Is there any maintenance required following fat grafting and fat transplantation?

There’s no specific maintenance required following your fat grafting to the face or body.  Once the fat grafts have taken, it is just then the fat graft shape and contour improvement that is subject to normal aging processes, such as normal aged related deflation and loss of fat volume.  If this occurs, repeat fat grafting and fat transplantation may be required several years following your initial sessions, as long as there is sufficient donor site fat.  It is, however, recommended during the consultation and patients are advised that with natural breast augmentation using fat grafts or buttock augmentation, a second session may be required one year following the first session to optimize shape and stability of the fat graft result.

How much will my fat grafting and fat transplantation cost?

The cost of fat grafting depends upon the area being treated and the amount of fat required.  In general, one can harvest the fat grafts from the donor site and then inject them into the recipient site, be that face or body, and generally this price can range anywhere from $3,000 to $6,000.  Some individuals undergo extensive liposuction following the harvest of their fat grafts and fat graft augmentation of their breast and/or buttocks and this is additional, although somewhat discounted, cost as well.  For large-volume fat grafting areas, such as the breast or buttock, more fat is required and more harvesting is required to procure the fat grafts and this will raise the cost to be commensurate with what one would spend for non-fat grafting breast augmentation or buttock augmentation.

Why choose SpaMedica and Dr. Mulholland for my fat grafting and fat transplantation?

By selecting Dr. Mulholland and SpaMedica, you will be selecting one of Canada’s most pre-eminent plastic surgeons with over 20 years of fat grafting experience.  You will get both his technical expertise as well as his aesthetic judgment in ensuring you get the most natural and successful result following your fat grafting procedure. Dr. Mulholland personally ran and taught the Vaser Fat grafting advanced teaching workshops to USA and Canadian doctors for years and in selecting Dr. Mulholland you are getting the teacher, NOT the student.

How can I show Dr. Mulholland my concerns and see if I am a candidate?

Toronto fat grafting patients should simply fill out the appointment request form or “ask a question” form and upload up to 3 photos for Dr. Mulholland to review.

How do I schedule a consultation for my fat grafting?

To schedule a consultation, simply call 877-695-2835 or book an appointment online and a SpaMedica client service representative will respond to you promptly.  Call or e-mail now to begin your fat graft journey today.


Cosmetic Surgery and Laser Skin Care Spa:
66 Avenue Road Suite 4
Toronto, Ontario M5R 3N8
Tel: 1-877-695-2835