Fat Transplantation

  • Dana L. Ellis
  • Lisa M. Donofrio


The changes that happen as an intrinsic part of aging occur deeper in the subcutaneous tissues and are atrophic in nature (Donofrio, Dermatol Surg 26:1129–1134, 2000). This volume loss can be corrected through several means, including tissue repositioning, implants, synthetic fillers, or autologous tissue (Modarressi, World J Plast Surg 2(1):6–13, 2013). More recently, autologous fat grafting has come to be considered an ideal filler, as fat grafts are biocompatible, nonallergenic, nontoxic, easy to obtain, and synergistic with natural skin (Sinno et al. Plast Reconstr Surg 137:818–824, 2016). Neuber first reported the technique in 1893, followed by Illouz who then pioneered liposuction in the 1980s. In the modern day, Coleman demonstrated techniques for long-term fat graft stability (Sinno et al. Plast Reconstr Surg 137:818–824, 2016). Its first indications were for aesthetic surgery of the face, and more recently in hands (Modarressi, World J Plast Surg 2(1):6–13, 2013). Fat grafting is also useful for tissue loss due to an accident, operation, congenital disease, or lipodystrophy. In addition to a volumizing effect, the injected fat leads to neoangiogenesis, thereby improving the cutaneous elasticity. This technique is also used for wound healing, scar reduction, treatment of radiodermatitis, correction of acne scars, and breast reconstruction and augmentation in plastic surgery (Modarressi, World J Plast Surg 2(1):6–13, 2013).


Fat transplantation Fat grafting Techniques Postoperative care Alternative procedures 


  1. 1.
    Donofrio LM. Structural autologous lipoaugmentation: a pan-facial technique. Dermatol Surg. 2000;26:1129–34.CrossRefPubMedGoogle Scholar
  2. 2.
    Modarressi A. Platlet rich plasma (PRP) improves fat grafting outcomes. World J Plast Surg. 2013;2(1):6–13.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Sinno S, Wilson S, Brownstone N, Levine SM. Current thoughts on fat grafting: using the evidence to determine fact or fiction. Plast Reconstr Surg. 2016;137:818–24.CrossRefPubMedGoogle Scholar
  4. 4.
    Kim WS, Park BS, Sung JH. Protective role of adipose-derived stem cells and their soluble factors in photoaging. Arch Der- matol Res. 2009;301:329–36.Google Scholar
  5. 5.
    Meier JD, Glasgold RA, Glasgold MJ. Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg. 2009;11:24–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Lilleth H, Boberg J. The lipoprotein-lipase activity of adipose tissue from different sites in obese women and relationship to cell size. Int J Obes. 1978;2:47–52.Google Scholar
  7. 7.
    Rohrich RJ, Sorokin ES, Brown SA. In search of improved fat transfer viability: a quantitative analysis of the role of centrif- ugation and harvest site. Plast Reconstr Surg. 2004;113:391–5. discussion 396CrossRefPubMedGoogle Scholar
  8. 8.
    Small K, Choi M, Petruolo O, Lee C, Karp N. Is there an ideal donor site of fat for secondary breast reconstruction? Aesthet Surg J. 2014;34:545–50.CrossRefPubMedGoogle Scholar
  9. 9.
    Klein JA. The tumescent technique. Anesthesia and modified liposuction technique. Dermatol Clin. 1990;8:425–37.CrossRefPubMedGoogle Scholar
  10. 10.
    Moore JH, Kolaczynski JW, Morales LM, et al. Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Aesthet Plast Surg. 1995;19:335–9.CrossRefGoogle Scholar
  11. 11.
    Moore JH Jr, Kolaczynski JW, Morales LM, et al. Viability of fat obtained by syringe suction lipectomy: effects of local anes- thesia with lidocaine. Aesthet Plast Surg. 1995;19:335–9.CrossRefGoogle Scholar
  12. 12.
    Kim IH, Yang JD, Lee DG, Chung HY, Cho BC. Evaluation of centrifugation technique and effect of epinephrine on fat cell viability in autologous fat injection. Aesthet Surg J. 2009;29:35–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Smith P, Adams WP Jr, Lipschitz AH, et al. Autologous human fat grafting: effect of harvesting and preparation techniques on adipocyte graft survival. Plast Reconstr Surg. 2006;117:1836–44.CrossRefPubMedGoogle Scholar
  14. 14.
    Kurita M, Matsumoto D, Shigeura T, Sato K, Harii K, Yoshimura K. Influences of centrifugation on cells and tissues in lipo- suction aspirates: optimized centrifugation for lipotransfer and cell isolation. Plast Reconstr Surg. 2008;121:1033–41.CrossRefPubMedGoogle Scholar
  15. 15.
    Condé-Greena A, Ferreira N, de Amorima G, Pitanguya I. Influence of decantation, washing and centrifugation on adipocyte and mesenchymal stem cell content of aspirated adipose tissue: a comparative study. J Plast Reconstr Aesthet Surg. 2010;63:1375–81.CrossRefGoogle Scholar
  16. 16.
    Coleman WP. Autologous fat transplantation. Plast Reconstr Surg. 1991;88:736.CrossRefPubMedGoogle Scholar
  17. 17.
    Matsumoto D, Shigeura T, Sato K, et al. Influences of preser- vation at various temperatures on liposuction aspirates. Plast Reconstr Surg. 2007;120:1510–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Chung MT, Paik KJ, Atashroo DA, et al. Studies in fat graft- ing: part I effects of injection technique on in vitro fat viability and in vivo volume retention. Plast Reconstr Surg. 2014;134:29–38.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Fournier PF. Liposculpture: the syringe technique. Paris: Arnette Blackwell; 1991.Google Scholar
  20. 20.
    Erdim M, Tezel E, Numanoglu A, Sav A. The effects of the size of liposuction cannula on adipocyte survival and the optimum temperature for fat graft storage: an experimental study. J Plast Reconstr Aesthet Surg. 2009;62:1210–4.CrossRefPubMedGoogle Scholar
  21. 21.
    Piasecki JH, Gutowski KA, Moreno KM, Lahvis GL. Purified viable fat suspended in matrigel improves volume longevity. Aesthet Surg J. 2008;28:24–32.CrossRefPubMedGoogle Scholar
  22. 22.
    Kleinman HK, Martin GR. Matrigel: basement mem- brane matrix with biological activity. Semin Cancer Biol. 2005;15:378–86.CrossRefPubMedGoogle Scholar
  23. 23.
    Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgefff KR. Platelet-rich plasma: Growth factor en- hancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:638–46.CrossRefPubMedGoogle Scholar
  24. 24.
    Garg AK. The use of platelet-rich plasma to enhance the success of bone grafts around dental implants. Dent Implantol Updat. 2000;11:17–21.Google Scholar
  25. 25.
    Mooren RECM, Merkx MAW, Bronk- horst EM, Jansen JA, Stoelinga PJW. The effect of platelet-rich plasma on early and late bone healing using a mixture of par- ticulate autogenous cancellous bone and bio-Oss: an experimental study in goats. Int J Oral Maxillofac Surg. 2010;39:371–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Villela DL, Vera Lucia C, Santos G. Evi- dence on the use of platelet-rich plasma for diabetic ulcer: a systematic review. Growth Factors. 2010;28:111–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Pallua N, Wolter T, Markowicz M. Platelet- rich plasma in burns. Burns. 2010;36:4–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Lacci KM, Dardik A. Platelet-rich plasma: support for its use in wound healing. Yale J Biol Med. 2010;83:1–9.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Lubowitz JH, Poehling GG. Shoulder, hip, knee, and PRP. Arthroscopy. 2010;26:141–2.CrossRefPubMedGoogle Scholar
  30. 30.
    Peerbooms JC, Sluimer J, Bruijn DJ. Go- Sens T. positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticos- teroid injection with a 1-year follow-up. Am J Sports Med. 2010;38:255–62.CrossRefPubMedGoogle Scholar
  31. 31.
    Creaney L. Platelet-rich plasma for treat- ment of Achilles tendinopathy. JAMA. 2010;303:1696–8.CrossRefPubMedGoogle Scholar
  32. 32.
    Tayfun TS, Altintas YN, Yildiz O, Kursat D, Ender S, Yusuf C. The effect of sub- conjunctival platelet-rich plasma on cor- neal epithelial wound healing. Cornea. 2010;29:664–9.CrossRefGoogle Scholar
  33. 33.
    Kau E, Kagami H, Kato R, Yamada Y, Ueda M. Regenerative medicine for anti-aging. Nippon Rinsho. 2009;67:1402–6.Google Scholar
  34. 34.
    Cervelli V, Gentile P, Scioli MG, Gri- maldy M, Casciani CU, Spagnoli LG, Or- landi A. Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods. 2009;15:625–34.CrossRefPubMedGoogle Scholar
  35. 35.
    Adler SC, Kent KJ. Enhancing wound healing with growth factors. Facial Plast Surg Clin North Am. 2002;10:129–46.CrossRefPubMedGoogle Scholar
  36. 36.
    Man D, Plosker H, Winland-Brown JE. The use of autologous platelet-rich plasma (platelet gel) and autologous platelet-poor plasma (fibrin glue) in cosmetic surgery. Plast Reconstr Surg. 2001;107:229–37.CrossRefPubMedGoogle Scholar
  37. 37.
    Natsuko K, Tatsuya M, Toshihito M, Sato- shi K, Zefanya NF, Kenji K. Proliferation- promoting effect of platelet-rich plasma on human adipose-derived stem cells and hu- man dermal fibroblasts. Plast Reconstr Surg. 2008;122:1352–60.CrossRefGoogle Scholar
  38. 38.
    Shinichiro N, Masayuki I, Megumi T, Kaoru M, Satoko K, Shingo N, Satoshi Y, Sa- toshi K, Naoto Y, Tomoharu K. Platelet- rich plasma (PRP) promotes survival of fat-grafts in rats. Ann Plast Surg. 2010;65:101–6.CrossRefGoogle Scholar
  39. 39.
    Cervelli V, Gentile P. Use of cell fat mixed with platelet gel in progressive hemifacial atrophy. Aesthet Plast Surg. 2009;33:22–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Dana L. Ellis
    • 1
  • Lisa M. Donofrio
    • 2
  1. 1.Yale School of MedicineNew HavenUSA
  2. 2.Yale University School of MedicineNew HavenUSA

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