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Prof. asoc. Dr. Gress

Plastic Surgeon

Lipostructure Fat Grafting

Professor Gress is one of the top specialists internationally

With increasing age, the thickness and volume
of fatty tissue under the skin decreases
significantly, especially in the face.

As we age, the thickness and volume of the fatty tissue under our skin, particularly on the face, diminishes significantly. Face modeling with lipofilling (also called lipostructure) helps you appear fresher, younger and healthier. There are no scars. You will be “ready for action” again very soon and won’t need to take much time off. This is a minor plastic surgery with Prof. Gress in Munich that produces an incredible impact…

Lipofilling, the term for injections with the body’s own fat, is done to make angular areas appear more rounded thanks to the fatty tissue. This gives fullness and volume to the face so it appears younger, facial contours become softer. By increasing the fatty tissue, circulation to the face increases and it looks healthier and rosier. The procedure also smooths wrinkles, as the skin is stabilized and tightened from underneath, for example, on the nasolabial folds between the nose and the corners of the mouth. The chin and lips can also be modeled and enlarged with this procedure.

This method is especially suitable for:

  • Filling sunken checks and lower eyelids
  • Modeling the chin and lips
  • Correcting nasolabial folds
  • Smoothing visible edges (such as tear sacs at the lower lids)
  • Filling slack labia majora
  • Tightening the vagina to improve stimulation
  • Slight breast and bust enlargement
As the fatty tissue beneath the skin diminishes with age, the skins support slackens and wrinkles can appear.

The procedure is usually performed under local anesthesia. You do not need to have an empty stomach. Do not take blood-thinning medication (aspirin, Marcumar, ASS 100, etc.) 14 days before the procedure. 

Fat cells are suctioned as gently as possible from the inner sides of the knees or on the outer sides of the thighs. Abdominal fat is less suitable. After a special process, called the Coleman method, the body’s purified fat is injected by means of a fine cannula into the areas to be emphasized and modeled. The treated regions are then covered with a tape bandage that remains in place for three to four days. Bruising occurs very rarely. You are quickly “ready for action” again.

Filling the fatty pads underneath the skin. The fat must be injected using a “spaghetti technique”, which promotes optimal healing for the fat.
Steri-strips protect the injected areas.

Injection of the body’s own fat is usually performed under local anesthesia. When this procedure is properly performed, it can produce a permanent increase in volume and tissue fullness, including on the lips, cheeks and chin, and smooth wrinkles (but it can also be used on other parts of the body, such as to tighten the vagina, fill the outer labia, etc.).

  • Lie and sleep on your back with your upper body elevated and keep the treated facial area cooled.
  • Avoid any exertion. Minimize speaking and avoid expressive facial expressions
  • Wash your face carefully. During the initial period after the procedure, use only clear water or mild shampoo for washing hair.
  • Avoid direct sunlight on your face and the solarium for at least three months.
  • You should avoid sports, saunas and strenuous activities for two weeks after the operation.

The healing rate of the transplanted fatty tissue on the body varies greatly. In fact, there are even noticeable differences in the various facial regions. For example, when injected around the eye region, almost the entire amount of transplanted fatty tissue will be preserved; a follow-up corrective procedure is often necessary for the lips.
Using lipostructure to fill cheeks. Medically indicated procedure.

In Germany, it is not permitted to publicly display before and after pictures of cosmetic surgery. Of course, you can view sample photos at our office during your consultation.

Frequently asked questions about lipostructure using autologous fat

Autologous fat transfer is suited to:

  • Augment the lips
  • Rejuvenate the face by refilling empty subcutaneous fatty tissue pads
  • Cover projecting bones (e.g. around the eyes)
  • Lift sunken areas (e.g. around the eyes)
  • Highlight anatomical structures (eyebrows, zygomatic arches)
  • Fill up deep wrinkles and creases (nasolabial folds and marionette lines)
  • Eliminate skin defects (e.g. scars, dents resulting from liposuction)
  • Fill up the back of the hands
  • Fill up sagging labia

Whether the transferred fat is broken down again or remains in place for life substantially depends on two factors:

  • The correct performance of fat transfer: The fatty tissue needs to be treated very gently, because otherwise it cannot be used. The method of choice is the COLEMAN technique, which involves the purification of fat by centrifugation.
  • The body area: The transferred fatty tissue is better retained in the cheeks and the lower eyelids than in the lips, for example.

Once the fat cells are supplied with oxygen by blood vessels, they will remain in place for life, i.e. the increase in volume will be permanent!

Only when the swelling has completely subsided is it possible to tell how much of the transferred fat has actually remained. Any revision procedure should therefore not be performed until 6 months after the first transfer, when the swelling has completely gone down. Even if a certain percentage of the transferred fat (approx. 10-40%) is broken down again, too much fat should not be transferred during the first procedure, because it can happen that the entire fat is retained. In this case, the volume would be too high, which is difficult to correct.

Autologous fat transfer is usually performed under local anaesthesia.

If part of the fat is broken down again, a revision procedure can be performed. Minor swelling should always be expected. Bruising occurs rarely and is usually not severe.

Depending on the volume of transferred fat, the surgery takes 1.5 to 3 hours. The fees range between EUR 1,200 and EUR 2,800. A revision procedure costs EUR 600.

We will be happy to find the optimum financing option for you together with our partner MEDIPAY.

  • Avoid medications that increase the tendency to bleed (e.g. medicines containing acetylsalicylic acid, such as aspirin or ASS) 15 days prior to the surgery.
  • Get a cooling mask or cold packs for use after the surgery.

  • Lie and sleep on your back with your chest in elevated position and cool the treated area.
  • Avoid any physical effort. Speak as little as possible and avoid exaggerated facial expressions. Eat liquid or soft foods.
  • Wash your face carefully. During the first few days, only use clear water or mild shampoos for washing your hair.
  • Avoid direct sunlight and sun beds for at least 3 months.
  • Avoid any sporting activities, sauna and strenuous activities for 2 weeks after the surgery.

Fat cells are sucked out as gently as possible, for example on the inner sides of the knees. Following special preparation, referred to as the Coleman technique, the purified fat is injected into the areas that require augmentation using a fine needle. Autologous fat transfer is usually performed under local anaesthesia. If this procedure is performed correctly, the volume and fullness of lips, cheeks and the chin can be increased permanently.

The method commonly referred to as “autologous fat transfer” (lipostructure) consists in the use of autologous fat for reshaping the body’s surface. In the face, this method is particularly suited to:

  • Fill up hollow cheeks and lower eyelids
  • Reshape the chin and the lips
  • Correct nasolabial folds

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Unique combination of the highest demands in terms of precision and aesthetics

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Professor for Plastic Surgery

Professor and lecturer
in Plastic Surgery

Experience makes the difference

  • More than 10000 procedures
  • Over 30 years of experience
  • Inventor and developer of the “Composite Reduction Labiaplasty”
  • Internationally recognized top specialist
  • Author of the international textbook “Aesthetic and Functional Labiaplasty” (Springer Publishers)
  • Professor and Lecturer in Plastic Surgery

In the most important national and international specialist societies

American Society of Plastic Surgeons
German Society of Plastic, Reconstructive and Aesthetic Surgeons
International Confederation for Plastic, Reconstructive and Aesthetic Surgery
International Society of Aesthetic Plastic Surgery

The Aston Baker
Cutting Edge
Aesthetic Surgery

2018, New York

Faculty Member
The greatest honor for
a Plastic Surgeon