Hi Dr. Lam
My doctor has published quite a bit on fat grafting including a book dedicated to the subject. In these works, he has put forward some interesting stem cell related claims and/or theories about its effects on patients based on his results from thousands of procedures. You are the only other surgeon I am aware of who has extensive experience with facial fat grafting along with a lot of good before and after photo examples. Thus, I hope you can share your professional opinion on the validity of couple of these claims/theories and expand on them a bit based on your own longer term results. I also added a couple more questions at the end.
a. Fat cell transplants often yield visible improvements in the quality and tone of surrounding skin which are ongoing from roughly 6 months to 3 years. After the 3 year peak point, aging catches-up and the skin quality gradually worsens.
b. Fat cell transplants do not necessarily continue to live as fat cells in the host site. They may transform into bone cells or muscle cells depending on where they are placed. For example, placement of fat immediately above the malar cheek bone could actually create new malar bone tissue and yield a cosmetic result similar to that of a hard cheek-bone implant.
3. Also, assuming transplanted fat cells survive and continue on as fat cells, do they behave metabolically like the surrounding fat at the host site or at the donor site. For example, if a patient tended to gain weight first in the abdomen area, then the love handles, then the thighs, and finally in the face pre-op, and fat is transplanted from his abdomen to his face, will that new fat in his face post op behave like the other abdominal fat cells or the original facial fat cells when he gains or looses weight again? If it behaves like donor area fat, wouldnâ€™t that cause cosmetic distortions in patients who undergo dramatic weight fluctuations?
4. Finally, is your book â€œComplementary Fat Graftingâ€ useful for patients or is it addressed just to other surgeons?