Dr. Sam Lam Plastic Surgery Forum

Hello Dr. Lam,
Do you prepare the extracted fat for transfer by filtering it or using low G centrifuge to separate out the plasma and dead fat cells? Do you add any additives to adjust osmotic pressure? Could you please elaborate on this?
Thank you,
Peter

i centrifuge it. honestly, it does not matter if you centrifuge or if you filter it. i have worked with surgeons who have done both successfully. it does not matter if you add other ingredients. in fact, i have gotten this so good that adding anything to make the fat stick better can be a problem because the person can look overfilled. i have got it down to almost a perfect science now.

Hello Dr. Lam,
Thank you for your answer.
I have a follow up question: What size cannula do you use for the fat grafting? Is there a limit to how thin the cannula can be? Too thin and the fat cells might get damaged during injection and the cannula might get clogged?
Thank you,
Peter

i use a 1.2 mm for the face except i use a 0.9 mm for the temple. those work well. the fat can get through pretty small apertures without a problem or risk.
best,
sml

dr. lam wrote:i use a 1.2 mm for the face except i use a 0.9 mm for the temple. those work well. the fat can get through pretty small apertures without a problem or risk.
best,
sml

Do you advice others to use the same ?
Like you said they work well.
Gyms in Arlington

it is not the size of the cannula that matters but how you use it to inject fat honestly.

Hello Dr Lam,
What size of cannula do you use for extracting the fat? Can thin cannula be also used for the fat extraction? Do you use a liposuction device with vacuum or just a syringe to ensure that the fat is not damaged by low pressure during extraction?
Thank you,
Peter

small cannula (don't know size) used by low-pressure hand without machine suction.

I visited a lot of forums and read discussions like these xxx and I have a question. How safe is the procedure. How long does it takes and what consequences does it may have?

sorry, deleted the reference since i do not permit references to external sites. like any procedure, safety is dependent on the surgeon's experience and results. i have had a very safe track record because i perform the procedure almost every other day and have literally written the book on it. like any review site, you are going to find people bad mouthing a procedure because it was either done badly or someone simply is trying to ruin the reputation of a good doctor. i truly believe that fat grafting is a safe, reliable, and profoundly beautiful procedure if you have the right surgeon doing it. it can also be useless or dangerous if done by someone who has no idea what he is doing.
best,
sml

Hello Dr. Lam,
What is your view on stem cells? I read about the importance of treating the extracted fat enrich it it with stem cells that then help with development of blood supply. The claim I have read somewhere stated that without it 50 - 90% of the fat cells is absorbed during the healing phase where as with it about 90% survives as permanent results.
Do you do anything special to increase stem cell concentration?
Thank you,
Peter

great question. the answer is no i do not do anything special. the reason is that i do NOT want better take in my fat o/w you can look too fat. over the years, i have a very very good prediction of how much fat i put in will yield what kind of results at a year when the fat matures. having additional take can be problematic. i believe there are sufficient stem cells in the fat that there can potentially be good results in the skin with the stem cells that are there already. any more may risk problems with increased fat take. at least that is my current thinking.
best,
sml

Hi Doc,
My friend underwent lipo transfer at the hands of Board Certified, Dr. X. He was told that the doc was the guru of modern successful fat transfer, that many docs still do not know how to make fat "take", that those who have observed X were not let in on his "secret" for success. He understood that aside from technique, that it was due to special handling/and or treatment of the fat. Do you use X'S technique? If nothing special is done to enhance "take' of the fat, why did the attempts of late 80's, early 90's all resorb. Please enlighten. Don't want to travel that far and the Doc is way too expensive.

Thanks,
Jesse

hi,
sorry had to remove the doctor's name. this web site does not allow bashing other docs on it. however, i will say this much, my fat lasts and lasts well. my own mother is 4 years out from the procedure with zero touchups and still looks 20 years younger at least. however, besides finding a doctor whose fat lasts you MUST find one who has results that you find artistically pleasing. some docs whose fat lasts put either too much, too little, or have very unbalanced looking results (cheeks too big compared with the chin, etc.).
best
sml