Fat Transfer: Permissible or Not?

30th October 2023

 

Question: I would like to know what is the ruling on getting a fat transfer/grafting for my face by transferring some of one’s own body fat onto the face when the face looks sunken and unsymmetrical. And what if someone wants to transfer their own fat onto another body part such as the butt or breast to reshape their size then is this permissible?

 

الجواب حامداً و مصلياً

In the name of Allāh, the Most Gracious, the Most Merciful

 

Answer

To begin with, the cosmetic industry is a million-dollar industry profiting on peoples’ desires to undergo certain physical changes. Fat transfer or known as fat grafting is one of many modern medical procedures used to reshape, remedy or modify certain body parts to improve the physical appearance. Whilst Islām allows beautification for women in general, it demarcates the boundaries of permissible and non-permissible forms of beautification. To answer your question, we must first briefly explore its procedure and its effect on the physical body.

 

What is the medical procedure of fat transfer and what does it treat?

Fat transfer is a minimal invasive cosmetic procedure that transfers one’s own body fat from one place to another to increase the volume size of the desired area. The plastic surgeon harvests small amount of excess fat from those areas containing more fat such as the belly, thighs and hips using a liposuction needle and then injects its tiny droplets into the tissues of the face, cheeks, under the eyes, lips (lip augmentation), breast (breast augmentation) or buttocks (Brazillian butt lifts). The extracted fat is first purified and then an incision is made where the fat is reinserted. The area is then closed with dissolvable stitches. The procedure can last between one to four hours depending on where the fat is being injected. The larger the volume size required, the longer the procedure. Fat transfer is done for many reasons such as to add a natural look to the area by reconstructing the shape of the area, correcting uneven shapes or repairing damaged areas for instance repairing facial scars, and reducing wrinkles.[1] Given the details of the procedure, many opt for it mostly to enhance their youthful appearance in order to increase self-confidence and reduce anxiety. Some however opt for it to correct the deformity to restore the shape to its natural appearance as opposed to beautification.[2]

The treatment is permanent and surgeons advise patience of its potential risks after the surgery for instance bruises, swellings, soreness, bleeding under the skin nerve damage and build up of fluid. Fat transfer is significantly different from filler treatments. Fillers inject hyaluronic acid in the desired area that is synthetically manufactured in labs. It is a non-invasive procedure used to protrude a small area of the face and lips etc. It takes place in a very short period and the procedure is reversable and temporary. Contrarily, fat transfer uses the body’s own natural fat to treat large volume loss of an area. It is an invasive procedure that takes place in an operational theatre up to few hours where the patient is sedated. The procedure is non-reversible leaving a permanent effect. It is important to understand this distinction so as not to conflate both of their respective Islamic rulings.

 

Islamic Principles Concerning Fat Transfer

There are three important aspects to be considered for fat transfer procedure. First is whether such cosmetic treatment constitutes alteration of Allāh’s natural creation or not. Secondly, whether or not such medical procedure falls under necessity for the sake of restoring the natural look and finally, using one’s own body fat as a treatment. Concerning the first issue, Allāh Almighty created us in this natural body and entrusted human beings with it and prohibited any form of alteration that infringes its natural creation. Alteration (or known as taghyeer) entails a significant change to one’s natural body permanently that is contrary to its purposeful creation. Allāh Almighty states in the Quran quoting Iblis when he was permanently expelled from Jannah saying, “……..and I shall surely command them (of unlawful things) and they will most certainly alter the creation of Allāh.”[3]

Allamah Alusi rahimahullah comments on the word taghyeer used in this verse,

وتغيير فطرة الله تعالى التي هي الإسلام واستعمال الجوارح والقوى فيما لا يعود على النفس كمالا ولا يوجب لها من الله سبحانه زلفى.

“Alteration of Allāh’s innate creation is Islām (i.e. changing one’s natural religion) and using the bodily limbs and strength in a way that does not return (i.e. benefit) the person in its complete sense and neither does it necessitate in drawing one closer to Allāh”[4]

 

Using the bodily limbs in a way that does not benefit it completely is to imply that either it causes harm to the body or it is unnecessary. Shaykh Khalid Saifullah Rahmani summarises the explanation of taghyeer in light of the exegete scholars under the above verse stating that it means the alteration is so significant that the purposeful nature of one’s creation is lost or someone perpetrates a certain act that opposes one’s own natural creation. An example he discusses is the prohibition of sterilising oneself to permanently block pregnancy or insemination. This is due to permanently blocking something that Allāh naturally created in us.[5] Undergoing such changes requires a surgical operation which either adds or removes something unnecessary from the body and leaves a permanent effect. Citing Ibn Jareer Tabari rahimahullah, Allamah Ibn Hajr rahimahullah states that a woman is not permitted to change certain parts of her natural body by adding or removing something for beautification irrespective for her husband or for someone else.[6]  This also includes altering certain bodily parts to enhance one’s youthful appearance. The hadeeth for instance prohibits women from parting their teeth and attaching (human) hair with their own because women used to do that to make themselves look younger.[7] It also becomes a form of deception because tampering with the body by undergoing certain changes for beautification is to conceal one’s natural appearance.

The second issue is undergoing a medical procedure to restore one’s natural looks by treating an illness, treating the abnormal condition, removing harm or correcting a defect. A general survey of the classical fiqh corpora reveals that such procedures are generally permitted because the aim is removing the harm or an unnatural defect. Jurists for instance permit a person to amputate an additional finger or to surgically remove an illness through an invasive procedure.[8] Likewise, creating gaps in the teeth for beautification is prohibited but doing so for treatment or to remove a defect is permissible.[9] Restoring the natural look by removing the defect or an illness falls under the remit of dharuriyāt and hājiyāt meaning genuine duress and necessity, both of which the Shariah consider.[10] Arguably, in specific instances where the patient uses fat transfer only to treat the abnormal condition and remove the defect would fall under necessity.

Finally, using one’s own fat for medical treatment. As a general rule, fat and blood are considered impure and after exiting the body, they cannot be utilised. Moreover, one’s own body parts are a sacred trust which cannot be exploited for unnecessary purposes. Hanafi jurists have for instance disallowed transplanting bodily organs without necessity due to its sacredness.[11] However, if it is used to replace a dysfunctional organ to restore one’s health then it is permitted.[12] Likewise in a hypothetical scenario, if a qualified Muslim doctor prescribes drinking blood as the only form of cure then it is permitted only when there is no equally effective medicine to treat the illness.[13] Such examples imply that prohibitions are compromised in instances of genuine necessity but only to the extent that is necessary.[14]

 

Summative Points about Fat Transfer

In light of the above discussion, we conclude with the following points about fat transfer;

  1. The natural body is a trust from Allāh Almighty that must not be tampered with contrary to its purposeful nature.
  2. Beatification is generally permitted for women to please their husbands so long as it does not involve alteration of the natural creation as described above.
  3. Having fat transfer procedures done to enhance one’s youthful appearance and increase attraction such as a butt-lift and breast augmentation is not permissible as it constitutes a form of altering one’s natural creation and the use of impurity for treatment. Likewise, having it transferred onto the face would not be permitted unless the volume size of the face is significantly deformed.
  4. If the procedure is for treating abnormality by restoring the area to its natural condition, repairing damage such as removing facial scars and cuts or reshaping to its natural volume size that was significantly deformed or reduced due to an existing illness then this would be permissible and would fall under the remit of necessity. This should be left as a last resort after exhausting other permissible avenues not equally effective as fat transfer. Moreover, the risks involved must not lead to greater harm nor should its harm outweigh the benefits. We generally recommend people to consult a Muslim expert in the field the viability of the procedure in light of their circumstances whilst noting the Islamic principles as described above.

 

 [Allãh Knows Best]

 

 

Written and researched by (Mufti) Abdul Waheed

Answer Attested by Shaykh Mufti Saiful Islam

JKN Fatawa Department

 

 

 

[1] See Surgical fat transfer – NHS (www.nhs.uk),

Fat Transfer: Surgeries, Results, Risks & What to Expect (clevelandclinic.org),

Surgical fat transfer – NHS (www.nhs.uk),

Fat Transfer To Face – Fat Transfer Under Eyes | UK Aesthetic

What Does Brazilian Butt Lift Surgery Do? (webmd.com)

Breast augmentation – Mayo Clinic  [accessed on October 2023]

 

[2] Ibid

[3] Surah Nisa [4:119]

 

[4] Rooh Ma’ani vol 3 p. 144, Surah Nisa [4:119]

 

[5] Jadeed Fiqhi Masail vol 5, p. 98

 

[6] Ibn Hajr, vol 10, p. 377.

قَالَ الطَّبَرِيُّ لَا يَجُوزُ لِلْمَرْأَةِ تَغْيِيرُ شَيْءٍ مِنْ خِلْقَتِهَا الَّتِي خَلَقَهَا اللَّهُ عَلَيْهَا بِزِيَادَةٍ أَوْ نَقْصٍ الْتِمَاسَ الْحُسْنِ لَا لِلزَّوْجِ وَلَا لِغَيْرِهِ كَمَنْ تَكُونُ مَقْرُونَةَ الْحَاجِبَيْنِ فَتُزِيلُ مَا بَيْنَهُمَا تَوَهُّمُ الْبَلَجَ أَوْ عَكْسَهُ

Ibn Jareer however strictly disapproves of women removing any kind of facial hair whether on the beard or moustache. Majority of the scholars however allow it as that does not entail altering one’s own natural creation.

 

[7] Jadeed Fiqhi Masail vol 1 p. 303

 

Durrul Mukhtār wa hashiyah Ibn Ābideen Shāmi, Kitābus al-Hadhr wal Ibahat, vol 21 p. 454-455

فَصْلٌ فِي النَّظَرِ وَالْمَسِّ

وَوَصْلُ الشَّعْرِ بِشَعْرِ الْآدَمِيِّ حَرَامٌ سَوَاءٌ كَانَ شَعْرَهَا أَوْ شَعْرَ غَيْرِهَا لِقَوْلِهِ – صَلَّى اللَّهُ عَلَيْهِ وَسَلَّمَ – «لَعَنَ اللَّهُ الْوَاصِلَةَ وَالْمُسْتَوْصِلَةَ وَالْوَاشِمَةَ وَالْمُسْتَوْشِمَةَ وَالْوَاشِرَةَ وَالْمُسْتَوْشِرَةَ وَالنَّامِصَةَ وَالْمُتَنَمِّصَةَ» النَّامِصَةُ الَّتِي تَنْتِفُ الشَّعْرَ مِنْ الْوَجْهِ وَالْمُتَنَمِّصَةُ الَّتِي يُفْعَلُ بِهَا ذَلِكَ

(قَوْلُهُ «لَعَنَ اللَّهُ الْوَاصِلَةَ» إلَخْ) الْوَاصِلَةُ: الَّتِي تَصِلُ الشَّعْرَ بِشَعْرِ الْغَيْرِ وَاَلَّتِي يُوصَلُ شَعْرُهَا بِشَعْرٍ آخَرَ زُورًا وَالْمُسْتَوْصِلَةُ: الَّتِي يُوصَلُ لَهَا ذَلِكَ بِطَلَبِهَا وَالْوَاشِمَةُ: الَّتِي تَشِمُ فِي الْوَجْهِ وَالذِّرَاعِ، وَهُوَ أَنْ تَغْرِزَ الْجِلْدَ بِإِبْرَةٍ ثُمَّ يُحْشَى بِكُحْلٍ أَوْ نِيلٍ فَيَزْرَقُّ وَالْمُسْتَوْشِمَةُ: الَّتِي يُفْعَلُ بِهَا ذَلِكَ بِطَلَبِهَا وَالْوَاشِرَةُ: الَّتِي تُفْلِجُ أَسْنَانَهَا أَيْ تُحَدِّدُهَا وَتُرَقِّقُ أَطْرَافَهَا تَفْعَلُهُ الْعَجُوزُ تَتَشَبَّهُ بِالشَّوَابِّ وَالْمُسْتَوْشِرَةُ: الَّتِي يُفْعَلُ بِهَا بِأَمْرِهَا اهـ اخْتِيَارٌ، وَمِثْلُهُ فِي نِهَايَةِ ابْنِ الْأَثِيرِ وَزَادَ أَنَّهُ رُوِيَ عَنْ عَائِشَةَ – رَضِيَ اللَّهُ تَعَالَى عَنْهَا – أَنَّهَا قَالَتْ: لَيْسَ الْوَاصِلَةُ بِاَلَّتِي تَعْنُونَ. وَلَا بَأْسَ أَنْ تَعْرَى الْمَرْأَةُ عَنْ الشَّعْرِ، فَتَصِلَ قَرْنًا مِنْ قُرُونِهَا بِصُوفٍ أَسْوَدَ وَإِنَّمَا الْوَاصِلَةُ الَّتِي تَكُونُ بَغِيًّا فِي شَبِيهَتِهَا فَإِذَا أَسَنَّتْ وَصَلَتْهَا بِالْقِيَادَةِ وَالْوَاشِرَةُ كَأَنَّهُ مِنْ وَشَرَتْ الْخَشَبَةَ بِالْمِيشَارِ غَيْرِ مَهْمُوزٍ

 

Umdatul Qari vol 19, p. 225

(لِلْحسنِ) ، يتَعَلَّق بالمتفلجات أَي: لأجل الْحسن، قيد بِهِ لِأَن الْحَرَام مِنْهُ هُوَ الْمَفْعُول لطلب الْحسن، أما إِذا احْتِيجَ إِلَيْهِ لعلاج أَو عيب فِي السن وَنَحْوه فَلَا بَأْس بِهِ، وَقَالَ النَّوَوِيّ: يفعل ذَلِك الْعَجُوز وَشبههَا إِظْهَارًا للصغر وَحسن الْأَسْنَان، وَهَذَا الْفِعْل حرَام على الفاعلة وَالْمَفْعُول بهَا

 

[8] Fatawa Hindiyyah, Kitāb al-Karahiyyah, vol 5, p. 360

لَا بَأْسَ بِقَطْعِ الْعُضْوِ إنْ وَقَعَتْ فِيهِ الْآكِلَةُ لِئَلَّا تَسْرِيَ كَذَا فِي السِّرَاجِيَّةِ لَا بَأْسَ بِقَطْعِ الْيَدِ مِنْ الْآكِلَةِ وَشَقِّ الْبَطْنِ لِمَا فِيهِ كَذَا فِي الْمُلْتَقَطِ.

 

[9] Mirqat Sharh Mishkat vol 7, p. 2819

وَعَنْ عَبْدِ اللَّهِ بْنِ مَسْعُودٍ قَالَ: لَعَنَ اللَّهُ الْوَاشِمَاتِ وَالْمُسْتَوْشِمَاتِ وَالْمُتَنَمِّصَاتِ وَالْمُتَفَلِّجَاتِ لِلْحُسْنِ الْمُغَيِّرَاتِ خَلْقَ اللَّهِ

(وَالْمُتَفَلِّجَاتِ) : بِكَسْرِ اللَّامِ الْمُشَدَّدَةِ، وَهِيَ الَّتِي تَطْلُبُ الْفَلَجَ، وَهُوَ بِالتَّحْرِيكِ فُرْجَةٌ مَا بَيْنَ الثَّنَايَا وَالرُّبَاعِيَّاتِ، وَالْفَرْقُ بَيْنَ السِّنِينَ عَلَى مَا فِي النِّهَايَةِ، وَالْمُرَادُ بِهِنَّ النِّسَاءُ اللَّاتِي تَفْعَلُ ذَلِكَ بِأَسْنَانِهِنَّ رَغْبَةً فِي التَّحْسِينِ، وَقَالَ بَعْضُهُمْ: هِيَ الَّتِي تُبَاعِدُ مَا بَيْنَ الثَّنَايَا وَالرُّبَاعِيَّاتِ بِتَرْقِيقِ الْأَسْنَانِ بِنَحْوِ الْمِبْرَدِ، وَقِيلَ: هِيَ الَّتِي تُرَقِّقُ الْأَسْنَانَ وَتُزَيِّنُهَا، وَاللَّامُ فِي قَوْلِهِ: (لِلْحُسْنِ) : لِلتَّعْلِيلِ، وَيَجُوزُ أَنْ يَكُونَ التَّنَازُعُ فِيهِ بَيْنَ الْأَفْعَالِ الْمَذْكُورَةِ، وَالْأَظْهَرُ أَنْ يَتَعَلَّقَ بِالْأَخِيرِ. قَالَ النَّوَوِيُّ: فِيهِ إِشَارَةٌ إِلَى أَنَّ الْحَرَامَ هُوَ الْمَفْعُولُ لِطَلَبِ الْحُسْنِ، أَمَّا لَوِ احْتَاجَتْ إِلَيْهِ لِعِلَاجٍ أَوْ عَيْبٍ فِي السِّنِّ وَنَحْوِهِ فَلَا بَأْسَ بِهِ.

 

[10] Shaykh Khalid Saifullah Rahmani, Muhadharat Usul al-Fiqh p. 255

 

[11]  Fatawa Hindiyyah, Kitāb al-Karahiyyah, vol 5, p. 434-5

الْبَابُ الثَّامِنَ عَشَرَ فِي التَّدَاوِي وَالْمُعَالَجَاتِ

الِانْتِفَاعُ بِأَجْزَاءِ الْآدَمِيِّ لَمْ يَجُزْ قِيلَ لِلنَّجَاسَةِ وَقِيلَ لِلْكَرَامَةِ هُوَ الصَّحِيحُ كَذَا فِي جَوَاهِرِ الْأَخْلَاطِيِّ.

 

 

[12] See Jadeed Fiqhi Masail vol 5 pp. 65-85 for detailed discussion on organ transplantation

 

[13] Fatawa Hindiyyah, Kitāb al-Karahiyyah, vol 5, p. 434-5

الْبَابُ الثَّامِنَ عَشَرَ فِي التَّدَاوِي وَالْمُعَالَجَاتِ

يَجُوزُ لِلْعَلِيلِ شُرْبُ الدَّمِ وَالْبَوْلِ وَأَكْلُ الْمَيْتَةِ لِلتَّدَاوِي إذَا أَخْبَرَهُ طَبِيبٌ مُسْلِمٌ أَنَّ شِفَاءَهُ فِيهِ وَلَمْ يَجِدْ مِنْ الْمُبَاحِ مَا يَقُومُ مَقَامَهُ

 

[14] Ibn Nujaym, Al-Ashbah wa Nazair, p. 73

الضَّرُورَاتُ تُبِيحُ الْمَحْظُورَاتِ

مَا أُبِيحَ لِلضَّرُورَةِ يُقَدَّرُ بِقَدْرِهَا