Structural Fat Grafting

Autologous fat grafting

sfg-surgeryWith ageing the tissue that keep our skin looking youthful and 'plumped up' begin to break down. Loss of dermal ground substance contributes to wrinkling of the skin. Ageing is also characterized by loss of facial fat and along with alterations in skin elasticity, leads to sagging of facial tissue, evidenced by the naso-labial folds and jowls.

Fillers can help to fill out facial wrinkles, creases and folds. They can restore volume to sunken cheeks and can also add a fuller, more sensuous look to the lips. Specific mention is made of wrinkles caused by muscular activity (mimetic wrinkles i.e. frown lines and forehead wrinkles.)  Fat is most frequently used to fill sagging cheeks, naso-labial folds or to correct skin depressions or indentations and to enhance the lips.  

Fat is withdrawn using a syringe with a specialized large-bore needle. The fat is then prepared by removing the oils and excess fluid. The fat cells are then carefully injected into pre-determined sites with a 'fat injection cannula'.

To survive and maintain the correction live fat cells require a new blood supply at the recipient site. This may be somewhat unpredictable which is why overfilling is recommended. In addition, like all injectable fillers, the procedure may require repeating.



Arrange to have a responsible adult over 18 years of age stay with you the first evening after surgery. The procedure will be cancelled if you do not have support.


Smoking increases the risks of complications significantly and should be ceased 4 weeks prior to surgery.


No alcohol 48 hours before surgery.


Be well nourished, hydrated and rested before your surgery.


A script will be issued for antibiotics and pain tablets. You will need to purchase them from a chemist and bring them with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over the counter products and prescription medicines can cause complications before and after surgery. They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery.

These include medications containing aspirin & anti-inflammatories (Voltaren, Brufen etc) they should not be taken 2 weeks prior to your procedure.

Avoid Vitamin C & E supplements and red wine 3 days before your operation.

Stop all herbal medications 1 week before surgery. These include Echinacea, Ephedra, Garlic, Ginseng, Ginkgo, Kava, St. John's Wort, and Valerian.

*(Please ask us for a more comprehensive list if required.)

Please consult Dr Geldenhuys before ceasing any chronic medications. Arrange to have someone fetch you on discharge & stay with you for 2 nights.


Report any signs of a cold or infections; skin (boils, bites scratches etc) dental etc within two weeks of your surgery. These may increase the risk of surgical infections and may require delaying your surgery for a few days/weeks.

Obtain any desired "comfort items" for after surgery e.g. music, comfortable clothing, pillows, healthy prepped meals, anything that will facilitate a pleasant environment for your recovery.

Avoid sun/UV exposure for two weeks prior to surgery. Any evidence of sunburn will result in your surgery being cancelled.

Do not save questions for the morning of your surgery. This is a busy time for us and it should be a relaxing time for you. Please contact the office PRIOR to your surgery if you have any questions.


On arrival at the clinic you will be offered a pre-med, this is to ensure you are relaxed & calm for the procedure. Prior to surgery, Dr. Geldenhuys & your anesthetist will see you in the ward. You should have nothing to eat or drink for 6 hours before your operation. If you are required to take chronic medication during this time please do so with a sip of water.


  • Any current medicines and those which have been prescribed.
  • Medical Aid membership card
  • ID Document
  • Credit Card or other agreed means of payment
  • Toiletries if required.


Medicated soap will be provided to be used on the morning of your operation.


Do not apply make-up, perfume/deodorant, nail polish or hair products after washing.


Remove all jewelry.


Wear loose, comfortable clothing and footwear. Front opening garments with buttons or zips are ideal.

Post-Operative Instructions


During the first week, you will sleep on your back. Get out of bed every 2-3hrs and walk a little bit, then back to resting. Avoid any strenuous movements and heavy lifting. Keep your head slightly elevated and avoid bending over.


Return to normal activity should be a gradual process and should never cause discomfort. Stop if you are uncomfortable!


  • Avoid cooling of the skin in the areas of fat grafting.
  • Avoid unnecessary activity during the first week, keep your head elevated.
  • Take Arnica tablets as prescribed.
  • Make use of our 'Omnilux' light therapy unit to speed up your recovery. (R690 - 3 sessions)


  • Do not rub or apply pressure to area treated.
  • Applying moisturiser with a soft patting motion can be done 2 days after surgery.
  • Possible side-effects include swelling, bruising, numbness & bleeding.


UV Exposure break down collagen and elastin fibres, an essential in collagen formation. Wear a sunscreen with a skin-protection factor (SPF) of at least 30 at all times.

MEDICATION - Take medications as directed.

Contact Dr Geldenhuys if you develop nausea, heartburn, diarrhea, constipation or bloating. If pain persists despite pain medications please contact Dr Geldenhuys.


Have 3 meals a day with plenty of fiber, protein & carbohydrates. Hydrate yourself with plenty of non-carbonated drinks: water & freshly squeezed juices.

HEALING Requires time. How much swelling you develop depends on the extent of the surgery, surgical technique and your physical condition. Healing continues over a long period of time, up to 18 months. Most of the swelling develops in the first 48 hours. As healing progresses, swelling and bruising decreases. About sixty to eighty percent of your swelling will disappear in the first two months and the remainder gradually thereafter until a year later. We will evaluate your result after three, six and twelve months.

CALL ROOMS (021) 424 5218 IF YOU HAVE

  • A temperature greater than 37'C.
  • Excessive bleeding from the incision sites.
  • A sudden increase in pain, or swelling in the area of incision site.
  • Any questions regarding your care.