Dr. Guarav Bharti of H/K/B Dishes on Fat Grafting

If you’ve ever wished you could just take some fat from your thighs and put it into another part of your body, then fat grafting is the procedure you’ve been dreaming of. Dr. Guarav Bharti of H/K/B talks to Haute Beauty about all things fat grafting, what can be expected during the procedure and what to expect in recovery.

Dr. Guarav Bharti: Fat tissues which can be obtained practically anywhere in your body where you have excess, places like your tummy, your thighs, your hip rolls AKA muffin top. You know, really anywhere where there’s excess and what we can do with that fat is we can process that fat. What processing means is we can concentrate the fat down, remove any ruptured or injured fat, get rid of anything that’s not pure high-quality fat, which I like to call liquid gold, and then we can repurpose that fat somewhere else in your body. It’s almost like this, I always tell patients that I’m green because I like to repurpose and conserve. I don’t like to throw anything away, so we really are kind of subscribing to this idea of repurposing what you already have. So it’s your natural filler that you can use in different areas of your body. Fat grafting can be performed to the face, in small volumes, to your cheeks, to your lips, to the folds around your mouth, to your temples. And then it can also be utilized into larger volumes for areas of your body such as in patients for buttock contouring or buttock enhancement. In patients who want to have breast enhancements, maybe they don’t want implants or they want a lift with some volume and don’t want to have implants so you can actually get a nice volume enhancement to the breast with fat grafting. And there are other places you can use it on the back of the hands. So you can use it practically anywhere. It’s a very versatile tool that can give you a soft, natural fill and the big gain also is that you’re treating the donor sites. So, that area where you borrow the fat from, you’re improving the contour there.

Haute Beauty: And who are some of the patients that qualify for this procedure? Who are the ones that you usually see get this procedure?

GB: You know, it’s a huge spectrum. So it encompasses patients from ages 18 to 85. It’s all over the place. It’s male and female. The overwhelming majority of those are female but men are jumping into the mix also. The kid patient is going to be someone who has an area that they want to improve the contour or try to get re-volumized, but also they have an area of concern where they have excess. When you’re talking about facial fat grafting, you don’t need as much, so you could, even on a very skinny patient, you can actually get fat to treat that area. So, it’s really the patient who wants to have a natural, also the other word for this is autologous, which means getting the tissue or the agent from the body, called the augmentation versus, you know, using a synthetic thing like an implant or filler. Those are usually the patients who would do it. Obviously, in the press there is a lot of things about buttock enhancement and, you know, BBL, the Brazilian Buttock Lift. You know, in my practice it’s becoming much more sensible where you’re really doing reshaping and redistribution and repurposing the fat that you’re not going crazy and converting everyone to Kim Kardashian or Nicki Minaj. You’re doing things in a more classy aesthetic.

HB: Can you go through a little bit more of what other areas aside from like the hands and everything that you touched on and where most people are commonly getting this operation?

GB: So a lot of it depends on the amount and the volume of fat that is moved and transferred. You can imagine the bigger the volume and the larger the area, where you are liposuctioning and transferring fat, it is going to be a bigger procedure, meaning bigger recovery and longer operative time. So it really sort of depends on how many areas you’re going to treat with liposuction. If you have to get enough tissue to treat the front of the tummy, the back, the lower back and hip rolls and thighs, it’s a lot of area for treatment. They’re going to have a little bit of a longer recovery from the donor site where they’re having the fat removed. So, you know, hard-core heavy lifting, working out, killing it at the gym, that  can be expected about 3 or 4 weeks after, but they need to be up walking, doing normal stuff rapidly thereafter. Getting back to work, it sort of depends on what they do. Some patients work remotely and then get back to work after a couple of days. If they’re getting facial fat grafting, you know, they may have more bruising and stuff like that where someone would be able to tell they had something. They’re going to be fully functional, but they may want to be hiding out, not in the public eye, you know, probably for about two weeks before they’re totally out of the woods. They may be ready sooner, but it’s always good to give yourself a little bit more time.

HB: Can you kind of walk me through like how a day of procedure would go? Like if I was a patient coming in to get fat grafting like how would that go?

GB: So typically, what will happen is, so we see our patients for a consultation. That’ll be the first interaction formally with me as a provider and my team. And then we would typically see a patient again back for preoperative evaluation where they will see myself and my team again to go over details, go over consent, and make sure we have the plan solidified on what they want. And then they would see me the day of the procedure, which usually they’ll come in early in the morning about an hour before the surgery. We would go over everything with myself and our staff, do our marking and make sure the patient understands the plan, make sure that there wasn’t anything else they had questions about. The door is always open, of course, the patient can contact us whenever they want and make sure that all of their questions are answered. After mark-ups on the day of surgery, then they typically will come back to the operating room. They will have some form of anesthesia given depending on the degree of what we’re doing. A lot of times, they might get general anesthesia and we use a lot of numbing medicines too intraoperatively so that we don’t have to use a ton of overall general anesthetic agents so that they have an easier recovery. And procedures are kind of, its variable, depending on what we’re doing, how long they’re going to take. Some procedures may be a shorter duration, you know, 30 minutes to an hour. Whereas other procedures, depending on how extensive could last for 3 to 4 hours or potentially a little bit longer, but we try not to go too long from a procedural standpoint just to limit the patient’s risk and minimize their recovery. After that’s done and depending on how long the procedure is and what we did, sometimes for a really long procedure we might keep the patient overnight in our facility, but overall the majority of patients would actually go home after they finish the procedure. They’ll hang out with us for about an hour or two. We make sure that they’re stable, able to do normal things, that families are educated on how to take care of them and then we have the patient return the next day to make sure everything is good. We then call them the following day after that and usually see them the next week, the following week, and then see them a couple of weeks later, a couple of months later and then again a couple of months later. We always try to see our patients back postoperatively, even long term, for follow up just to make sure everything is good and they’re happy and, you know, that they have gotten exactly what they wanted.

HBThat’s good that you guys do all those follow-ups because I feel like most surgeons would just be like, “Oh, you’re good. Come back like if something falls out.”

GB: Yeah, and I think that’s, you know, that would probably be more convenient, but I think it’s a little bit better for us to see our patients. Especially the long-term, to be sure they have a good stable result and a lot of times, you know, there are other things they want to have addressed. And you know, they become an extension of our overall team and family. So it’s a patient, if you’re ever a patient with myself, you’re going to be a patient long term or for life, hopefully.