EP 10: What is Fat Transfer? | DEEP FOCUS

In this episode, I break down the science of facial fat transfer, what it actually is, and how it differs from dermal fillers when it comes to restoring volume, structure, and long-term facial health. I explain who is (and isn’t) a good candidate, the regenerative role of fat in aging tissues, and how fat grafting works at the cellular level. You’ll also learn the most common misconceptions and mistakes so you can make informed decisions and avoid treatments that don’t align with your goals or anatomy.

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Website: https://clinic5c.com/ 
Instagram: https://www.instagram.com/chesnut.md/ 
YouTube: https://www.youtube.com/@chesnutMD 
LinkedIn: https://www.linkedin.com/in/cameron-chesnut-a6910baa/ 
 
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TIMESTAMPS 
00:00 — Intro
00:41 — Fat Transfer Is a Graft
01:42 — Fat Transfer vs Filler
05:25 — Best Uses for Fat Transfer
07:49 — How Fat Transfer Fits Into Surgery
09:36 — Can Fat Transfer Be Done on Its Own?
11:06 — Regenerative Benefits of Fat Transfer
14:38 — Where Does the Fat Comes From?
18:01 — Fat Transfer to the Face vs the Body
21:09 — Can You Do Fat Transfer If You’re Fit?
22:04 — How Long Fat Transfer Lasts
22:57 — Does Fat Transfer Migrate?
23:35 — Where Fat Transfer Can Be Used in the Face
26:28 — Fat Transfer to the Lips
27:31 — Skin Coloration
29:30 — Outro
 
ABOUT HOST 
Dr. Cameron Chesnut is the host of the 5 Codes podcast and the founder of Clinic 5C, where he leads a team dedicated to integrative cosmetic surgery, regenerative medicine, and functional health. An internationally recognized facial plastic surgeon, Dr. Chesnut is known for producing natural, refined results that enhance rather than alter one’s appearance. His approach blends surgical precision with biological optimization and disciplined restraint, drawing patients from around the world who value excellence, longevity, and holistic care. On 5 Codes, Dr. Chesnut uncovers the mindsets and evidence-backed strategies he lives by, helping high performers perform better, recover smarter, and feel their best in every area of life. 
 
DISCLAIMER 
The views shared on this podcast are my own and are not associated with, affiliated with, or representative of my clinical teaching role at the University of Washington School of Medicine. This content is for general educational purposes only and should not be considered individualized medical advice.

Transcript

0:00

Welcome to the Five Codes Podcast, where we discuss evidence-based methods to elevate yourself to the next level, through optimizing the way you look, move, perform, feel, and connect. On today's deep focus, we are talking about one of my favorite facets of facial plastic surgery and one that is greatly misunderstood, and that is fat transfer, or more specifically facial fat transfer, also called fat grafting. We're gonna talk about what facial fat transfer is, how it's different than filler, which is something that's commonly misunderstood. We're gonna talk about when to use it, and we're gonna talk about all of your frequently asked questions that surround facial fat transfer. So first and foremost, facial fat transfer is a graft. And in medicine, we define a graft as a tissue that's taken from one place, disconnected from its home and blood supply, and moved somewhere else. In facial fat transfer, we are borrowing fat from other areas of your body, very commonly around your belly button, your flanks, maybe your thighs, which is very strategic on why we select from those areas, and we are moving that fat into your facial fat pads. This is very much a like for like situation. As we age, our facial fat pads and our facial structure change because of aging changes within those facial fat pads. So we can take very regenerative fat from you, from other parts of your body, and use it to restore the aging changes that we have inside of our facial fat pads. It's much, much more than just volume into how those work. It gets very into the regenerative components of what the fat is capable of doing. And this gets to one of our first big branch points, which is how is fat transfer different than filler? Filler is a very different animal. Let's just think of it as an implant. These are synthetic or engineered types of gels or sometimes bio stimulators. People will call them other things that come that are not a talligast us. They're not coming from us and being placed into our face. They are a different purpose. They are passive volumeizers. They're taking up space inside of your fat pads and they are meant to volumeize just as an implant would do. There's lots, we could do a whole episode just on fillers themselves, but there are lots of differences with filler. Passively occupying space with the propensity to move or migrate throughout the tissue, which is a little bit of an uncontrolled phenomenon, a duration change to them that is very different. And the biggest one being that there is no regenerative benefit. Once the filler is in your face, it's not providing any benefit. In fact, we're starting to find out a lot more that they can be quite detrimental to things like our lymphatic drainage system of our face, which is very important to the aesthetics and function of how our facial soft tissues work. Fat transfer is much different than that. Fat transfer overlaps in a sense where there can be some volumizing nature to what the fat transfer is doing inside of our facial fat pads. This is the simplest way to think about it. If you have a fat pad that's lost volume and you add fat to it, it can physically become larger. There's this perfect slash terrible analogy that I love to use of breast tissue. And I use this because everybody can think of how a breast works. It's not perfect because there are other things in a breast like glandular tissue. But for the most part, we know that a large fat pad like a breast doesn't just age with a volumetric change, meaning it doesn't just get smaller. It changes size, it changes shape, it changes orientation, and it changes positioning vertically. The facial fat pads that we have have very similar ways that they age. And so just adding volume to that fat pad would be analogous to just adding a breast implant to a changing and aging breast, we all know that that's not going to necessarily be a great solution. Sometimes we need to restructure that fat pad. Sometimes we need to re-volumeize it. Sometimes we need it to regenerate and get a little bit stronger so it can reposition. And sometimes you have to physically just elevate that fat pad back up, which is a different discussion that often has to do more with surgery, which is something that fat transfer is commonly used as an adjunct for, for a lot of things. But as we get into where fat transfer has a lot of these benefits and what some of the differences are with filler, the biggest one becomes that they have a small overlap in their ability to both volumeize, but then filler stops there, basically, and may have some detrimental issues where fat has a lot of regenerative potential to it. So in addition to just volumeizing, it's making the collagen and elastin inside of your fat pads in your skin stronger in the way that the cells inside the fat, because it's a living tissue it communicates. Using filler is sort of viewing the face as a canvas, if you will, canvas to paint and change. And using fat on the face is viewing it more as a biologic system, which is how it works. And that biologic system is intended to communicate a lot of things about us. And this gets into one of my little nerdy obsessions with how we neuroanatomically interpret faces. And there's a lot of nuance into how our facial fat pads move when our muscles contract and what kind of emotions and what kind of natural human traits those things show. Fat transfer does a really good job of restoring those things. So we've gotten into some of the differences between what fat transfer is, how it differs from filler, and that big one being in the regenerative component, which gets into some of the best uses for fat transfer. I very commonly will get the question, that hey, I'm in my 30s or 40s, what's the best thing that I can do now if I'm not ready for surgery to have my face looking good so that I maybe don't need surgery in the future or look my best right now? My first answer to this is always sort of the simplest, the free things to do. And those are optimize your metabolic health. That means your blood sugar, how you're sleeping, all of those things we know will show up in the way that you look as the decades take on. So that's actually my real first answer is do all of those baseline things while sleep, exercise, eat well, all those types of great things. But fat starts to come into this conversation a little bit earlier. This is a little bit of a mind stretch for a lot of people because we're talking about an intervention here on faces that are-- let's just call it at their earliest signs of aging. And this is where fat transfer can fit into this fairly well because, again, reviewing this is an aging biologic system. There is some volume loss, but there's also some qualitative change in what's happening inside those fat pads. If we think about the orthobiologic, that means the joint world. It's very common that in that world, another place that stem cells are often used, which our fat is very rich in stem cells, the view there is to start preserving the soft tissue inside of the joint space. It's earliest signs of degrading. That means preserving the function that it has and then stopping the tissue degradation as it's on its way down. Early interventions, if you will, inside of a joint are going to have the best outcomes. There's been this mindset and aesthetics that is waiting until the tissue has degenerated a whole bunch, waiting until the fat pads have really aged a lot before we start to intervene in them. And there's probably a lot of social cues in this that have made things not acceptable to intervene early. But fat transfer is one of those beautiful things that we can do early on in an aging process to stop the aging that's already happening and change the long-term trajectory of the quality of those soft tissues, meaning fat pads and skin, and what would normally be their aging curve. You can actually blunt the aging curve by using something like this that's not just a passive implant. So these are really great areas to think about, maybe, early use. And this is a common question that comes up. I am most commonly using fat transfer along with my surgical procedures that I'm doing. So if we go back to that rest analogy, a lot of what I'm doing is often replacing fat pads to where they used to live before. If I could maybe nutshell explain my entire surgical practice, it is taking a fat pad that has moved to one location and trying to put it back where it was before. There's a little bit more sophistication to it than that, but that would be a very basic way to understand it. Well, in addition to moving that fat pad back to where it used to be, I also want to make sure that the fat pad is appropriately volumized and appropriately structural so that it can point in the right direction. That it can be in the right dynamic position when the muscles are moving it. That involves how strong the fat pad is, how big it is, and where it's located in relation to the muscles that surround it. So there's that benefit to all addressing all the aspects of the aging fat pad, the shape, size, position, and orientation, which surgery and fat transfer can do really well together. But then there's this other beautiful benefit that comes when you're using fat transfer along with surgery simultaneously in the same setting, which is all of the regenerative potential of the fat. This comes in the way that the stem cells and the fat communicate. We call the secretome and the extracellular matrix that are inside of that fat tissue. This is a living system. It has all the pillars-- we call those the three pillars of cellular regeneration. They all live inside of the fat. In addition to making the fat pad stronger and look better, they also help the surgery recover better. They are helping new blood vessels form. They're helping control the inflammatory environment around the surgery itself. So you have this beautiful double benefit when you're using fat transfer along with surgery. So I'll get the question, well, I know that you're using fat transfer with your surgeries, but can you do fat transfer by itself as well? And the answer is absolutely yes. You can do fat transfer by itself. It hits a lot of those aspects of these aging fat pads and does help with the skin. Oftentimes when I'm using fat transfer without surgery, I will be pairing it with some sort of a late monomy laser cocktails. I would call it something that's very customized to that patient that's right in front of me, because now I'm getting the benefit of the skin qualitative improvements, along with the fat pad qualitative improvements. Also knowing that the fat is helping the skin changes recover from that laser, that would be a very non-surgical type of plan to do. So you can do fat transfer by itself. We just have to understand what the limitations of fat transfer by itself are. It is not physically changing or lifting the position of a fat pad. That's where surgery really comes into it. And in my opinion, that's often one of the failed deliveries of filler promises. When somebody's telling you that filler is going to lift something up, I would say, run, don't walk away from that. That is not a situation that's realistic. It's creating unrealistic expectations. And if somebody's volumizing a fat pad with filler enough to lift it, they are way over volumizing it. You don't want a basketball sitting on your cheek to make it look higher, right? So fat transfer has that limitation within there. But we know that it does really well by itself when paired with laser or in my world, when it's paired with surgery as well. So we know what fat transfer is and how it works. We know how it compares to filler. We know some of the situations of when we might use it. And we can get into the real, nerdy, and scientific regenerative parts of it, which are what I love. I already mentioned this in that fat is one of our richest sources of mesenchymal stem cells. These are a very specific type of stem cell we have in us. And I said it contains all three of those pillars of cellular regeneration. That's the stromal cells. This is what creates new blood vessels. These are the actual stem cells that help things communicate, help control inflammatory environment. That's great. Has extracellular matrix in it? Extracellular meaning the parts outside of the cell, the scaffolding. It provides those types of substrates to improve the structural integrity of the fat pads that we're in. And then there's this amorphous term called the secretome. This is the growth factors. We call this the paracrine communication of how this fat transfer communicates with all of the cells around it, because doing fat transfer in your fat pads, as I mentioned, improves the quality of the surrounding skin and the musculature. So this is a beautiful marriage of how all of these cellular regeneration techniques work together. Your muscles get better. And that controls all of those neuroanatomic parts of how we interpret faces, the structural integrity of the fat gets better, and your skin improves. And you see this. It's very interesting. Even years after fat transfer, you can see this slow improvement of the skin that comes with time just simply from the type of communication that's coming from the fat transfer itself. So there is a deeper gender world. There's a lot of history behind this. And it gets very cross-pollinated into other specialties. I mentioned orthobiologics in the orthopedic literature. This is all over medicine. How these cells can control it. In my practice, I'm often working with Dr. Meadows, who's one of my regenerative medicine colleague, who works in practice with me. And he can use fat, and specifically the stem cell rich portion of the fat, which we call the stromal vascular fraction of that fat. And he'll use it for ortho or joint-based purposes. He can take your stem cells out of your fat and regenerate your joints with it, which is a beautiful option. And I then find a lot of my patients during their procedures with me are often doing procedures with Dr. Meadows simultaneously. Or I am taking the fat that I'm already harvesting for their fat transfer. And we are banking the stem cells from that fat, so that they have them for future use. So it's this really beautiful marriage of my practice of cosmetics, facial plastic surgery, very specifically, with what turns into regenerative medicine down the road. Because those stem cells can be used for many purposes in the future, from future facial rejuvenation procedures with me, to hair restoration, to procedures and orthobiologics. So a really beautiful marriage of regenerative medicine with the facial fat transfer that I'm already doing. I love having somebody's previously banked stem cells to use with a subsequent facial rejuvenation procedure. I'll call this cell-assisted lipotransfer, which is a fancy way of saying mixing their other stem cells with their own fat for rejuvenation of their face. It's a really, really beautiful way that that helps to restore the qualitative nature of their tissues. So there's a lot to dig into there and to what the regenerative medicine component of fat is, which makes it so beautiful and unique and is so misunderstood. And why I said at the very beginning, this is one of my favorite parts of facial plastic surgery but that it's often misunderstood, because it's often just compared to filler. So when we get into some of the frequently asked questions about fat, I get over the decade of my practice, but decade plus, I've gotten a lot of the same questions. The first and foremost one is, where does the fat come from? Where do you physically get it from? And there's some science to this, but in general, I'm getting it. I could get it from anywhere. Any of your subcutaneous fat is great, but the fat around your belly button, your flanks, and your medial thighs, I always kind of tell people to think about the most central areas of your body. Those are the fat cells, which the technical name for them is a dipacite. So those are the fat cells, the dipacites, that I really want because of the stem cell density. I'm harvesting from those areas very purposefully and very strategically because I want the most stem cells per volume of fat that I can get out. Now, that's going to vary by location. So there's this interesting nuance in here, meaning that I can control the density of the stem cells that I get based off of where I'm harvesting it from. You can harvest that from your arm or something like that, but it doesn't tend to have the same stem cell density there that it does if I get it from one of those more core regions of yourself. So I can control the density of the stem cells that I get from you. The part that you get to control is the quality of the stem cells. So I get to control the density we harvest. You get to control how good the stem cells are once I get them out. More metabolically healthy people unquestionably have higher quality stem cells. Younger people tend to have higher quality stem cells, although that's not a lever you can pull as easily within your sphere of influence when you come see me is how metabolically healthy you are. That will control what's happening with your stem cells, how quality they are, which leads into one of the next questions of, well, I heard that fat goes away, that it doesn't survive. There's some truth to this question, because all of the fat that's grafted does not survive. That is true. It's not 100% rate. And viewing it that way is viewing it only through the lens of volume, though. And if we get nothing else out of this is that that is the most narrow view you can take a fat that it's just volume, because there's so much more to it. We do know that the take rates of fat tend to be relatively consistent through provider, because the factors that go into this are very centered on how the fat is processed, what the process of harvest looks like, how it's prepared, how it's physically placed, the volume that is placed, where it's placed. So this tends to be very cohesive from surgeon to surgeon, meaning that the way that I do it tends to be relatively uniform from person to person, but I might do a very different than my colleague does it. So we might have very different take rates. The type of fat that I'm choosing is very, very, very stem cell dense on purpose, because that gives me the most predictable take rate of the fat that I'm putting in. I know with as much certainty as I can get about the volume that I'm putting in and how much will live and stay. And it also gives me that beautiful regenerative potential. This is a very atypical way of doing it, because it is very labor intensive to do it that way. It's not a simply take the fat out, repackage it, and put it back in. There's much, much more to it in my process than that. This is something that I am very obsessed with and very nerdy about and am constantly evolving to be as precise and intricate as I can with my fat transfer that I'm doing, but this will affect the take rate. Where the fat is placed will also affect the take rate. And this gets into one of our other frequently asked questions about fat transfer to the face versus fat transfer to the body. These are very, very different animals for a lot of different reasons. The fat that's placed in the face needs to be near a blood vessel. And what I mean by that is the more vascular, the recipient area is, and our face is beautifully vascular, so vascular, the more vascular that surrounds this free graph that's going in, the better the chance that graph has of surviving. The blood vessels need to grow in to the new graph when it's placed there so that it can have all the nutrients and oxygen that it needs to survive. The stem cells, the stromal cells inside of that fat graph are the main orchestrator of the new blood vessels growing in. We call this angio-neo genesis, the making and creation of new blood vessels that's heavily driven to the fat graphs. As a side note, things that I do after surgery like hyperburetic oxygen therapy also really help the fat take rate survive. So that's a little side note. It's one of my recovery protocol options. Red light is doing something similar. But if we go back to the fat itself, when it's placed in the soft tissue in the fat pads of the face, it needs a blood supply to survive. When we're doing facial volumization, we have beautiful blood supply, and we need relatively small volumes in comparison to when you're doing body fat transfer. Body fat transfer is commonly done to the breasts or to the buttocks or something along those lines which are much higher volumes. As I'm sitting here today, the patient that I had yesterday in the operating room had had previous fat transfer to her breasts in the volume of 500ccs per breast. That's 500 milliliters per breast. As a reference point with me, I used about 50ccs, actually a little bit less than that for her entire facial re-volumization. So we have a significantly less volume or a significant lower threshold that we need to get the facial fat transfer to survive, to go in, to do its job. And it's going to do better anyway because our face has a much more rich blood supply than somewhere like our breast or our buttocks do. You can imagine that for that volume in our breast or buttocks, you're putting just a big ball of fat, part of it will survive, and part of it will resort. But in the face, I can do very fine, very precise layers through the different fat pad layers of our face, which have excellent vascularity. So very different to do fat transfer to the body, and to the face. And if I could put it in a nutshell, it's a much lower volume. It's much more reliable to do it that way. It has a much better blood supply. And it's much more ultimately impactful. The other aspect of this to think of is that when I'm harvesting fat from your body, wherever I'm getting it from, from your abdomen, your flanks, your thighs, I am trying to leave no trace that I was there. It's always a fun joke beforehand that a patient will say, oh, I've got lots of bacteria. You can take it. I'm actually trying not to do that. I want that fat to be there if should we ever need it for some subsequent purpose? Or so that you just don't know that I was there at all. A lot of my patients tend to be very, very thin and fit. Sometimes low single-digit body fat percentages. So I do not want to take a bunch of their fat away, which would be another common question. Is, hey, I'm really thin and fit. Are you going to be able to get the fat that you want for me? That answer is universally yes. Even with my very, very fit body builder types or some of my very low body fat male patients, I'm able to get the fat that I need because of what I just explained and that I don't need that much in the first place. We're not talking about a body procedure. And in those particular patients, they tend to be so metabolically healthy that the quality of the fat that I'm getting from them is so high that I don't need as much volume to make it work. So yes, I can get the fat that I need from you. I don't need high volumes and high quantities. It's very different than fat transfer to the body. And it differs quite a bit from filler and the way that it's working. So let me just look at some of our other frequently asked questions here. How long does the fat last? Well, if we've picked up anything from this, it's that the regenerative capacity of the fat is very, very high. And it is very much a long duration to how that works. I guess I'd even years after fat transfer, we can still see the qualitative improvements in the tissue around it. This fat becomes yours. It does not go away and it does not migrate, which is another commonly asked question. Once the fat sets up its blood supply, it's a living part of that biological system of your face. It will respond just like other types of fat will to weight gain, to weight loss, to hormonal changes. It will do the same thing that the neighboring fat cells at dipocytes around it do as well. It will behave like facial fat once it's placed in your facial fat. So there is a beautiful benefit to it. There's a beautiful harmony and union and balance into how that fat behaves like the rest of your facial fat does. As far as fat transfer migrating, this is coming from a mindset that's comparing it to filler, because filler certainly moves through muscular planes as they contract. I see this in surgery all the time. So this week's hot last week, filler moves from where it's originally placed. Fat does not have that ability to move once it's placed, because as I just said, the fat has to establish a blood supply to itself. Once it's placed in the tissue, and it's working really hard in those first days to get a new blood supply so that it can be fed, the nutrients, the oxygen that it needs, it is now bound in that location. It cannot migrate. It cannot move. It is going to be fixed in place, which is a different aspect than what's happening with filler. And this leads into our final frequently asked question about where fat transfer is used on the face. Where can it be placed? Some of the common areas and questions that I'll get are can it be placed under my eyes, can it be placed inside of my lips, which is a really hot topic there. And I will tell you this, that in general, I am using fat in a very pan facial way. I'm using it everywhere. All of the fat pads, the way that I think about this, especially in surgery, or even if I'm doing it by itself, as I'm quite literally going through your face, fat pad by fat pad. That's superficial fat pads. That's deep fat pads. I'm looking at the junction. I'm looking at how they're interacting with one another, where they're positioned, what their volume looks like. I really want to know how this biologic system is working together. And I'm going through one by one and deciding how much fat needs to go, where it needs to go, and what the type of regenerative fat that I'm putting in. There is structural fat, which is one unique type. And it varies all the way down. We'd call it millifat, a microfat, a nanofat. And there's regenerative types of fat. I'm using a whole spectrum of different types of fat, depending on what that individual fat pad in your face needs. I'm going through one by one in doing this. And that includes your forehead, your temples, your upper lids, your lower lids around your mouth, along your jawline, even people's earlobes and their hands. I'm looking all over at what's happening. So yes, fat can go in all of those places. If there's a fat pad there that needs volume, that's lost volume, that needs regeneration, that needs a structural change, a qualitative improvement, I'm going to be using it there. I will also use some of that more regenerative type of fat directly into the skin. This is especially helpful when I'm doing something like a laser cocktail, laser resurfacing. I'm going to those areas of skin that have usually aged from photo damage or time, or some other oxidative type of damage that exists in them. Think of the barcode, like the vertical lines around the mouth, or the wrinkles under your eyes. So in addition to using a laser that stimulates a whole qualitative response, I will also-- I will also be using the actual pure regenerative aspects of the fat, not the volumizing aspects, into those areas of skin to help them recover, to help them make more elastant tissue, to help them build collagen better. There's very interesting studies on this that show unquestionably that taking your fat-based themselves and putting them into your skin, even in areas where there's no other interventions, no other procedures, no lasers done. If we go biopsy, those areas down the line, give it a few months to do its job, we will see an up-regulation in elastin production, and interestingly, a recycling of broken down elastant tissue in that skin that's there. So we have that whole regenerative component to it. It's very unique in how it works, and it can be used all over the face. I quite literally use it everywhere. The lips are a very special and intricate nuance to this, because I mentioned earlier that if there's a fat pad there, that needs volumizing, we can use fat in it. The aging of our lips is somewhat related to fat pad aging, but in a very, very small amount, actually, there are not large fat pads inside of our lips. They don't exist there. When we look anatomically and a really great colleague of mine just published an article, mostly about filler, actually, in the lips, in sort of looking at the compartments of the lips with imaging and how much volume they can sort of take before the filler will migrate, it was very small amounts. We're talking about tents of CCs, like 0.3 CCs in the lip is the space that the filler, or in this case, the fat should actually go in. So you don't want to overvolume my lips with fat, because that's not a like for like restoration. There's not a large fat pad in the lip that has aged away. So you don't want to put too much fat in. It's an unnatural regeneration, you might say. This also illustrates a beautiful component of fat is that fat can control some of the coloration of our skin and our facial soft tissue. And the lips, this can be a bad thing in a way, where our lips have a very specific pink color. We call that the bermillion part of our lip, because of the way that the longer wavelengths of light reflect off of our lip tissue, which is largely related to the vasculature there, and give that normal pink color. If you put too much fat in the lip, it can create a yellowish hue to our lip, which is an unnatural reflection, essentially, of light wavelengths that our brain will pick up. We can pick that up. We can leverage this for positive things in other areas of our face, where we tend to get some shadows. When we get superficial fat pad loss in our face, we tend to get what look like shadows, but are actually just coloration changes in the superficial parts of our skin near the surface. And we can put fat specifically back into those areas to change the way that light reflects off of those spaces to give a more natural, sometimes brighter appearance to our face that's not particularly just a shadow, but has to do with actual light reflection itself. So there's a pro there in the way that fact and interact with superficial fat pads and soft tissues of our face to improve light reflection. But in somewhere like our lip, we have to be really thoughtful about that so that we are not yellowing your beautiful pink lip, trying to do too much with volume. As a side note, in those situations, where somebody is thinking that they need a lot of fat in their lip, it's often partially deflation, but mostly lengthening and an inversion of their lip that's happening, which is really amenable to something like a very focal, small, deep plane lip lift that can lift and revert the lip, which I'm often using, fat transfer along with that as well. And often using nanofat in the skin that's around there. So you get a brightening of the skin, a repositioning, a re-aversion, a proper elevation, and proper volumizing. In this very small procedure, utilizing fat and surgery together. So that was a very deep dive into fat grafting, fat transfer, what it is, when to use it, how it differs from some other things, and what specifically filler, and what types of commonly asked questions I'm getting from it, those frequently asked questions. I would really encourage you to digest this, think about it. If you have any other questions about fat, please let me know. But I hope this opens your eyes to, again, which is something that I love from a regenerative standpoint, from a rejuvenation standpoint. And as this often misunderstood, you now know so much more about this than anybody ever dreamed that they could, and it can be a really important adjunct to your facial plastic surgery, but specifically to applying that mindset of preserving tissue before it's degrading, while it's still healthy and blunting your aging curve as you move forward. It's a really unique aspect of this, and I hope that's kind of maybe the one thing that you take home from this. If you have any questions or topics you would like me to explore further, please leave them in the comments. I read them all, and they often help shape the future conversations here. If you would like to learn more about my surgical practice, you can visit clinic5c.com, where you will find additional information on my approach to surgery, recovery, and performance focus care. I also want to be clear that the views shared on this podcast are my own and are not associated with or representative of my clinical teaching affiliation with the University of Washington School of Medicine, nor should this be taken as individual medical advice. Thank you for spending your time with me. I appreciate you being here, and I will see you on the next episode.