Patients are required to take one or two consultations with Dr. Richard Diacakis, plastic surgeon in Paris. During the first consultation, Dr. Diacakis will provide you with consent documentation, cost estimates, and prescriptions for medication necessary before and after the operation, as well as documentation for a pre-operative check-up with the anaesthetist (as necessary).
Areas from which fat tissue will be removed will be defined during the consultation.
Liposculpture of the silhouette (see buttock liposculpture) is often combined with lipofilling.
This is an aesthetic operation. It is not covered by social security, and we are unable to prescribe medical leave. It is important for patients to plan for a period of unavailability for eight to ten days after the operation.

Patients are required to abstain from any medication containing aspirin in the two weeks leading up to the operation.
Patients are required to fast (no food, beverages, or tobacco) for six hours before the operation.

Patients must refrain from smoking for one month before and up to one month after a lipofilling procedure, in order to allow for a smooth fat autograft, and to reduce the risks of necrosis to fat and skin tissue.

A lipofilling operation is usually performed under general anaesthesia.
Dr. Diacakis will see you in your room on the morning of the operation to take preoperative photos and draw the areas to be filled and to be removed.
Fat removal is performed with the help of liposuction cannulas. The diameter of the cannulas depends on the area concerned.
Once we have obtained the fat, we filter out everything (blood, water, fibrosis, etc) but fat cells. The fat is then reinjected through 1mm micro-incisions using cannulas designed for the area concerned. We use very fine cannulas for the face, for example, and much larger for the buttocks.
Dr. Diacakis injects fat into different layers of tissue (subcutaneous, glandular, muscular, and submuscular) and in multiple, intersecting directions so as to increase contact surface between injected fat cells and recipient tissue. This allows for a better fat grafting.

The duration of the operation depends on decisions made in consultation.

Facial lipofilling: Fat tissue is systematically filtered and reinjected using tiny cannulas specific to the face. Micro-incisions are invisible. We are able to perform this operation on any area of the face, from the forehead to the eyebrow arch, hollows under the eyes, the lips, cheekbones, chin, etc.

Lipofilling of the buttocks (cf. buttocks lipofilling) and breasts (cf. breasts lipofilling) are among the most commonly practiced procedures today.

Men’s intimacy: To increase the circumference of the penis, we make an incision in the balano-preputial groove. Fat is carefully placed and is injected under the skin in contact with the corpus cavernosum (cf. penoplasty)..

Women’s intimacy: To perform a vaginoplasty by lipofilling, we make two micro-incisions (2-3 mm) at the entrance to the vagina. Stitches are absorbable. The operation lasts approximately one hour. Fatty tissue is filtered and then deposited under the side walls of the vagina in order to narrow it.

Patients should refrain from sexual intercourse for four to six weeks.

Lipofilling of the labia majora helps to tone and energize sagging lips. Fatty tissue is filtered and then injected into different planes. Patients may decide to inject the entire labia majora, or only the upper part. Patients should refrain from sexual intercourse for one month.

Hands: Lipofilling of the hands is practiced with micro cannulas adapted to this area. Filtered fat is deposited under the skin of the hands.  The operation can be performed under local or regional anaesthesia (involving anaesthetization of the entire arm).

Calves: Lipofilling of the calves requires well-defined drawings in order to establish the exact desired shape and curvature. Compression bandages will be applied directly in the operating theater. Micro-incisions are closed with absorbable sutures.

We can also use lipofilling after a liposuction procedure to fill unsightly depressions. Preoperative drawings to establish the silhouette must be very precise.

Patients are typically discharged on the morning after the operation. You should plan for a rest period of eight to ten days.
Bruises and swelling may persist for about two weeks.
Discomfort is greater in aspirated areas than in injected areas, which are typically not very painful. You will be prescribed painkillers adapted to your individual needs. You may also be prescribed a preventative anticoagulation medication.
Dr. Diacakis often prescribes an antibiotic prophylaxis to be taken for one week.

In general, the result of a lipofilling procedure begins to take shape after one month, but it is only after three months that the grafting of the fatty tissue is considered to be definitive.
30% of injected fat may be resorbed. We take this into account during the operation.
If patients are unsatisfied with the sufficiency of the fill or wish to add more volume (especially in the breasts, buttocks, or penis), we may perform a second operation to perfect results.
Results, no matter the area performed upon, are generally satisfactory or highly satisfactory.