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Stomach fat. Many of us have it, but it’s pretty safe to say that none of us want it. But now, this famously stubborn and hard-to-lose deposit of body fat has found a role that might finally give it a little respect: as a plastic surgery filler. We spoke to Dr. Ryan Mitchell of Henderson, Nevada about why an increasing number of plastic surgeons are using stomach fat as a surgical filler.

It’s called ‘fat grafting’- the procedure where a surgeon takes fat from one area of your body, and then injects that fat into another area of the body that is lacking in volume. The fat can be taken from the buttocks, thighs, hips, and increasingly, from the stomach. The grafted fat can then be transferred elsewhere in the body, such as the lips, breasts or buttocks. This benefits the patient in many ways- most notably because by grafting fat that was already part of the patient’s body, the surgeon is not introducing anything new or unnatural to the body. This increases the likelihood of the body "accepting" the fat transfer, it also looks and feels more natural than injecting synthetic materials would. There are of course some downsides to fat grafting, but according to Mitchell, those downsides are minimal.

"Unlike with synthetic fillers, fat grafting requires a bit more downtime following the procedure," Mitchell said. "This is because the fat first has to be harvested from the patient’s body via liposuction, so it’s not as simple as opening a container of Botox and sending the patient on their way."

Fat grafting is a two-step process, first the extraction, and then the injection. In some cases, the extraction may require local or general anesthesia, depending on where the fat is taken from, and how much fat is taken during the procedure.  

In the second step, the fat is then injected into another area of the body. Again, the anesthesia and recovery will depend on where the fat is grafted to. For patients using it as facial fillers, they may not require as much downtime as someone who is getting their fat grafted to the breasts or buttocks. Furthermore, because fat is a natural substance and thus less predictable than a synthetic like Botox or Juvederm, it is considered less stable

"As a rule of thumb, we tend to over-fill when using fat grafts," Mitchell said. "This is because due to the nature of fat, we expect a certain amount of movement of the graft."

Mitchell says if surgeons were to underfill or simply not over-fill, the results would be less noticeable and the patient would likely need to undergo a second round of injections. Unfortunately, while overfilling usually heals to the desired outcome, it can also increase the initial level of discomfort and swelling, but Mitchell insists that swelling will eventually go down.

Patients who receive fat grafts must also have their results monitored more closely than those with Botox, and may need to return for one or more follow-up exams after the procedure. But even despite the extra steps and longer recovery with fat grafts, the results can be well worth it in the long run. Fat graft injections are said to last much, much longer than synthetic fillers- and in some cases, may be permanent- and that’s just one-half of the procedure.

"The other upside to getting a fat graft is that you’re getting liposuction, too," Mitchell said. "You are essentially getting two procedures in one- and who doesn’t love a bargain?"

As for why patients are increasingly seeking grafts from the abdomen instead of other areas of the body, Mitchell has a theory.

"In the past, people were eager to reduce the size of their buttocks and thighs, but now the trend is to increase the size of those areas," Mitchell said. "On the other hand, stomach fat has never been trendy and most likely never will be. I’ve never had anyone come into my office and ask for a bigger stomach. Grafting fat from this area is trend-proof and essentially kills two birds with one stone."