Fat Transfer (Lipofilling / Autologous Fat Grafting)

Terminology

The terms lipofilling, fat injection, and autologous fat grafting all describe the same procedure. Lipofilling — a compound of the Greek "lipos" (fat) and the English "filling" — is the term most commonly used in patient communication, while autologous fat grafting is the more precise scientific expression found in the medical literature. "Autologous" means "originating from one's own body" — a defining feature that fundamentally distinguishes this procedure from foreign materials such as hyaluronic acid fillers or synthetic implants.

Procedure

The procedure consists of three steps. First, fat tissue is harvested by liposuction from a suitable donor site — typically the abdomen, hips, or thighs — using a thin cannula and a gentle suction technique. The harvested fat is then processed: blood, free oil, tissue fluid, and damaged cells are removed, leaving behind as pure a concentrate of viable fat cells as possible. In the third step, the processed fat cells are introduced evenly into the target region in small portions using fine cannulas, where they integrate and network with the surrounding tissue.

Even distribution of the fat requires technical precision: injecting too large a volume at once risks necrosis of individual fat cells, which can compromise the final result through irregularities or hardened areas.

Use in Intimate Surgery

In male intimate surgery, lipofilling is used primarily for penis girth enhancement: the patient's own fat is introduced subcutaneously — beneath the penile skin — to visibly and perceptibly increase the girth of the shaft. At our center, lipofilling is the method of choice for girth enhancement, since we do not use hyaluronic acid fillers for this indication, given their documented risk profile — particularly regarding migration, granuloma formation, and long-term tissue reactions.

Lipofilling is frequently combined with ligamentotomy: while ligamentotomy increases the visible length of the penis, lipofilling adds to its girth. Together, the two procedures allow for a balanced ratio of length and girth and therefore a more harmonious overall result. Whether a combination makes sense is decided individually during the consultation.

Results and Longevity

An important point patients should be aware of: not all of the fat volume introduced remains permanently. Some of the fat cells are reabsorbed by the body; the literature describes long-term survival rates of roughly 60 to 80 percent. The final result can therefore only be properly assessed a few months after the procedure, once the fat has fully integrated and stabilized. In some cases, a second session may be advisable to achieve the desired volume — this is not a sign of failure, but a well-known characteristic of the procedure.

Aftercare

Rest is important in the first few days after the procedure; pressure on the treated areas should be avoided so as not to disturb the fat tissue as it integrates. Mild swelling and bruising typically subside within one to two weeks. Sport and physical exertion are usually possible again after four to five weeks. Wound care and regular follow-up appointments are an integral part of the healing process.

Comparison with Other Methods

Hyaluronic acid fillers can also be used to add volume, but their effect is only temporary and requires renewal after twelve to eighteen months. Specific risks for the penile region are also documented. Solid implants offer a permanent result but involve a more invasive procedure and a higher risk of complications. Compared with both alternatives, autologous fat transfer offers the advantage of biological compatibility combined with a comparatively low risk profile.