Despite the popularity of fat grafting and its widespread use, it is far from a perfected procedure. Its most common problem is the unpredictability of its take or graft volume persistence. Despite what some physician’s claim, no one has developed a fat grafting method or technique that can give consistent and reliable results in all patients. It is not rare to have a patient happy with their fat grafting results for several weeks to months to then go on to have much if not all of the fat absorbed. More rarely, the reverse problem may occur with the fat graft growing beyond the desired contour change.
Many patients ask if they should do something special that will help the fat graft to take better in the early after surgery period. The initial important considerations is to avoid doing known things that can adversely affect fat graft take. Excessive pressure on the injected site can cause early graft resorption by pressure necrosis of fat cells that have not yet become revascularized. This is not a problem in the face or breasts but is a more important potential problem in the buttocks where some sitting is unavoidable. Smoking unquestionably interferes with oxygen delivery as the influence on the injected site would be not different than it would be on skin healing.
Diet may potentially have some influence on fat graft take. It is well known that insulin helps create or protect fat. Under stimulation of insulin, fatty acids are made into fat molecules and stored in fat cells as droplets. This has led to some surgeons suggesting that high carbohydrate diets may be beneficial as they increase insulin levels. But inducing fat cell growth or hypertrophy should not be confused with a fat cell surviving after transplantation. That is about the fat cell quickly acquiring a blood supply and nutrition to successfully take. Thus diet alone, other than adequate intake to maintain one’s weight, has no convincing role in fat graft survival.
But is there some supplement, vitamin or nutriceutical that may encourage the results from fat grafting? Some plastic surgeon’s advocate coenzyme q10. This is a fat soluble compound that is required for mitochondrial ATP synthesis and has a known antioxidant function in cell membranes. It has a known benefit in patients with hereditary mitochondrial disorders. It has also been touted that it is beneficial in preventing fat cell death through a published study in the 2007 journal of Plastic and Reconstructive Surgery. Through its positive mitochondrial effects, it was shown to strongly influence the resuscitation or the reversal of fat cells undergoing apoptosis or cell death. What dosage should be used and how it should be administered was not suggested. It is presumed that oral ingestion of coenzyme q10 by gel tablet of 300 to 1200 milligrams per day (as suggested for an anti-aging effect) would be a reasonable dose for a few weeks after surgery. (doses up to 3600 mg per day have been shown to be well tolerated in healthy people) Coenzyme q10 is best absorbed in an oil or lecithin binder..
Dr. Barry Eppley
Indianapolis, Indiana