For a beautiful figure

When is fat transfer treatment the right method for me?

Fat transfer treatment / autologous fat transplantation is the suitable method for you if you desire a long-lasting result (years to decades) without the use of foreign bodies or artificial filling materials, if you suffer from contour irregularities or scars, wish for moderate breast or buttock augmentation, and possibly want to get rid of bothersome fat deposits at the same time.

Can fat transfer treatment be performed on multiple areas simultaneously?

Just like liposuction, fat transfer treatment can certainly be performed on multiple areas simultaneously. However, the amount of fat is limited to your own reserves, so the augmentation of the desired body area with fat transfer treatment is also limited.

Does the fat transfer treatment procedure need to be repeated multiple times?

For example, on the breasts, an increase of half a cup size can be achieved per fat transfer treatment. For building a larger breast, at least three months should pass between the initial and subsequent procedures; further augmentations are then also possible every three months. If you desire a single-stage procedure with more significant augmentations, fat transfer treatment is not recommended.

For breast augmentation surgeries or buttock augmentation procedures, there is also generally the option of inserting silicone implants.

For facial wrinkle treatment or desired skin rejuvenation, usually only one fat transfer treatment procedure is necessary.

What do I need to consider before the surgery / fat transfer treatment?

For underweight patients, fat transplantation / lipofilling is excluded due to insufficient fat deposits, as simply too little fat is available for the operation. If you still desire lipofilling, we advise a weight gain of at least 5 kg before the procedure. Smoking patients are also not readily candidates for large-volume lipofilling, as adequate blood supply to the fat graft cannot be guaranteed due to nicotine. Therefore, you should refrain from smoking for at least two weeks before the procedure or at least reduce it. Furthermore, fat transfer treatment cannot be performed if the donor or recipient region is infected (e.g., cold sores or acne) or infiltrated by a malignant tumor (cancer). For patients who have suffered from breast cancer, breast reconstruction or correction/augmentation with autologous fat is only recommended after three years of healing, because the aforementioned stem cells in the fat tissue and their products are suspected of increasing the risk of tumor recurrence.

If the procedure is to be performed on you, you must not consume any solid food for six hours before the start of the operation.

Are preliminary examinations necessary for fat transfer treatment?

Whether fat transfer treatment / lipofilling is right for you, what risks and complications exist, and whether it is feasible for you, will be discussed in a consultation with Dr. Rippmann or Christian Roessing. Should you have pre-existing conditions or desire extensive lipofilling, we will arrange the appropriate preliminary examinations.

Which medications should not be taken before surgery and which stimulants should be avoided beforehand?

Before the operation, you should refrain from smoking and discontinue all medications that inhibit blood clotting (e.g., Aspirin). If you are taking other medications, please consult with us, your family doctor, or our anesthesiologist.

How quickly can I get an appointment for lipofilling?

You can schedule an appointment for fat transfer treatment / lipofilling at our practice clinic in Berlin-Mitte, depending on the availability in our surgical calendar. An appointment during colder months is recommended, as a compression garment usually needs to be worn. To arrange a consultation, we welcome your call or email. We would appreciate knowing in advance whether you prefer to be treated by Dr. Rippmann or Christian Roessing.

How long should I take time off?

Since you will need to wear compression garments around the donor area after the operation, and bruising and pain may occur after fat aspiration and injection, we recommend taking one to two weeks off.

What documents are required before fat transfer treatment?

The necessary documents will be provided by us and requested at the appropriate time.

How is fat transfer treatment performed, and are there different methods?

Different methods are available for fat transfer treatment. In most cases, before fat aspiration, a so-called tumescent solution, consisting mostly of saline solution, is injected after a small stab incision to loosen the tissue and simplify aspiration. Additionally, it contains the hormone adrenaline to constrict small blood vessels and minimize bleeding.

With the water-jet assisted liposuction (WAL) method, the tumescent solution is delivered into the tissue as a water jet, loosening the fat, which is then directly aspirated and collected in a container. Blunt cannulas are used for fat harvesting, and low suction is applied to minimize damage to fat cells. Furthermore, relatively narrow cannulas with multiple openings are used to obtain the smallest possible fat lobules. The integrity of the cells and the size of the lobules are of high relevance for transplantation: only intact fat cells remain in the recipient region, and only small fat lobules can be adequately supplied with nutrients centrally.

After aspiration, the material is processed, during which excess water, oil, and cell debris must be removed after gentle centrifugation or simple settling by gravity. In WAL, the harvested fat is separated from the oil-water fraction in the lipocollector. Oil and free cell components would lead to strong inflammatory reactions and thus damage to the fat cells during transplantation. Even when injecting fat with blunt cannulas (after a small puncture with a sharp cannula), low pressure is used to ensure that the cells reach the recipient area undamaged.

The different lipofilling methods primarily differ in their equipment, aspiration technique, and preparation procedure, but all follow the principle described above.

How long does the procedure take?

The duration of the procedure largely depends on the amount of fat to be transplanted, but due to the many small steps and careful handling of the cells, larger grafts can take several hours. The consulting physician will inform you of an approximate operating time during the preliminary discussion.

Is the procedure performed on an outpatient basis?

Whether the procedure is performed on an outpatient basis or if you stay for one night in our facility in Berlin depends on the extent of the fat transfer and your wishes. If you stay inpatient, you will be cared for around the clock by highly trained nursing staff. It is usually recommended to stay 1 night in our practice.

Is only local anesthesia used?

Local anesthesia is not an option for autologous fat transfer, as it has been proven that local anesthetics damage fat cells, leading to unsatisfactory results. Therefore, general anesthesia is always necessary for harvesting autologous fat.

In exceptional cases (corrections in the face, etc.), general anesthesia can be avoided. For this, the preparation of the harvested fat is more complex to wash the local anesthetic out of the harvested fat. We will be happy to advise you accordingly.

Is the result of fat transfer treatment immediately visible?

After the operation or fat transfer treatment, the final result is not yet visible, as not all transplanted fat cells heal in and the injected area is still swollen. Small puncture sites and bruises may also be visible, but in most cases, they heal without problems. After approximately four weeks, with a cell survival rate of about 60 to 80 percent, the final result can be discussed. However, it can take up to six months for the aspirated areas to fully de-swell.

How often can fat transfer treatment be repeated in the same area?

As long as sufficient fat is available for transplantation, fat transfer treatment can be repeated as often as desired. However, donor regions should not be used more than three times, as scar tissue resulting from previous liposuctions can complicate the procedure and lead to subcutaneous defects. Overfilling of fat in the recipient area must also be avoided. This creates excessive pressure in the tissue, which prevents adequate blood supply and thus leads to the death of the transplanted cells.

Is it necessary to take pain-relieving medication?

Whether you need to take painkillers after a fat transfer treatment depends on your individual pain tolerance. Medications are sufficiently available in our practice clinic for the period immediately after the operation. Furthermore, you will receive a prescription for painkillers when you leave our practice clinic in Berlin.

To what extent are corrections necessary after fat transfer treatment?

If too little fat has been injected, a correction is possible but involves another operation. If too much fat has been introduced, it can potentially be aspirated again. However, in the face or hand, only a few milliliters are transplanted, so a correction is usually not necessary.

What should be considered after fat transfer treatment?

After the operation / fat transfer treatment, a compression garment must be worn in the donor region for four to six weeks. This can, of course, be washed. The recipient area is often shaped with tapes for three to four days and should initially be cooled and not mechanically overstressed or heavily compressed, as this can lead to displacement (migration) or death of the fat. We also advise maintaining a constant weight, as the body's own transplanted fat is also subject to weight fluctuations and can be lost with significant weight loss.

Which activities should I avoid after the procedure?

After the procedure, you should also refrain from exercising for four to six weeks to prevent renewed swelling. Showering is allowed, but bathing only after the sutures have been removed.

Are puncture marks, bruises, or similar visible after fat transfer treatment?

Hematomas and swelling after fat transfer treatment are possible but usually subside. The puncture sites are discreet and are made with such thin cannulas in exposed areas like the face or hand that they are not visible for long. The stab incisions in the donor region are sutured with one or at most two stitches, and the sutures are removed after seven to ten days. Fluid usually drains from the puncture sites for 24 hours after the procedure.

When can I resume sports?

After removing the compression garment (i.e., after four to six weeks), sports activities are allowed again. Before that, exercise is only permitted in moderation, as it can cause renewed swelling.

When can I return to work?

Whether and when you can return to work is also your decision. For physically demanding work, we advise a longer leave of absence. We recommend staying away from professional life for about 1-2 weeks.

Are there specific cosmetics/creams that can be used after the procedure?

You are welcome to use your daily skincare. However, if you are unsure, simply ask one of our doctors. There are special care products that support the result of liposuction. Please contact our staff during your follow-up appointments.

How can I positively influence the result of fat transfer treatment?

The behavioral guidelines we provide are designed to achieve an optimal result. Consistent wearing of the compression garment and cooling in the first few days reduce swelling.

Which care creams are recommended after the treatment?

For the puncture sites, nourishing oils or ointments can be used (possibly after suture removal). A silicone gel, which can be purchased at our practice clinic, is ideal for caring for remaining scars and is applied and massaged into the scars after suture removal and crusts have fallen off. We will be happy to advise you on scar treatment during your follow-up appointment.

Do scars remain after fat transfer treatment?

Small linear or punctiform scars remain at the puncture sites, the location and size of which will be gladly explained to you during the consultation.

How much does fat transfer treatment cost for different regions?

The costs for fat transfer treatment vary individually and are calculated separately for the breasts, buttocks, or face. Additional costs include anesthesia, compression garments, and possibly an overnight stay. The exact costs will be calculated with you during the consultation.

Are there financing options like installment payments?

We work with an external credit institution; financing models are applied for through Medipay.

Do health insurance companies cover fat transfer treatment?

For purely aesthetic reasons, health insurance will not cover fat transfer treatment. However, if you have a pathological condition (scar, burn, etc.), health insurance may cover the costs of the treatment. We will gladly explain the exact circumstances to you during the consultation.

What are the general risks of fat transfer treatment?

Generally, fat transfer treatment is a very low-risk operation, yet complications can occur. In most cases, swelling, pain, and hematomas appear in the aspirated and injected areas. Additionally, dysesthesia (paresthesia) or numbness may occur, but in most cases, these subside and disappear after a maximum of six months.

What can cause complications?

Hematomas result from small hemorrhages. Swelling and pain are signs of an inflammatory reaction and delayed lymphatic drainage, which are normal after such a procedure. Fat necrosis is a consequence of insufficient blood supply to fat cells and can occur if fat lobules that are too large are transplanted, whose center cannot be adequately supplied with nutrients. The released oil can then only be broken down very slowly, so it is encapsulated by phagocytes, creating an oil-filled cavity that progressively calcifies over time. Oil cysts rarely require puncture or surgical removal.

What is the risk of infection with fat transfer treatment?

The puncture sites for fat transfer treatment through the skin are very small, and the operation is performed under sterile conditions, thus minimizing the risk of infection. Additionally, you will receive a prophylactic antibiotic during the operation, which will be further administered to you in tablet form post-operatively for larger procedures.

Can nerves, muscles, or blood vessels be damaged?

Unfortunately, damage to small cutaneous nerves, blood vessels, and lymphatic vessels during autologous fat transfer cannot always be prevented with the available methods, despite the use of blunt cannulas. However, the damage is usually temporary and manifests as bruising (due to hemorrhage), swelling (due to impaired lymphatic drainage), and numbness or sensory disturbances in the affected regions. After the operation, muscle pain may occur, but this is due to irritation of the fascia surrounding the muscle. Since we only aspirate in the subcutaneous fat tissue, muscle damage generally does not occur during fat transfer treatment.

What is the risk of too much fat being aspirated?

Due to the expertise and many years of experience of our doctors, the risk of "over-aspiration" is low. However, fat transfer treatment in very slender patients, patients with connective tissue weakness, or those with previous liposuction procedures is generally associated with an increased risk of indentations and retractions.

What is the risk of too much fat being injected?

A slight overcorrection is initially normal with fat transfer treatment, as 20 to 40 percent of the transplanted cells do not remain in the target area. However, permanent overfilling is also unlikely here due to the refined technique and experience of Dr. Rippmann and Christian Roessing.