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Fat Grafting: Principles and General Concepts

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Atlas of Minimally Invasive Facelift

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Abstract

Soft tissue defects and asymmetries represent a common challenge for surgeons in their clinical practice. To correct these problems, surgical techniques are applied in order to obtain healthy tissue from other body regions. Alternatively, a variety of filling materials are available for use; however, although good short-term results are achieved with the vast majority of fillers, some of them are associated with significant complications such as extrusion or migration of the injected material, hypersensitivity reactions, and infections [1, 2].

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References

  1. Rzany B, DeLorenzi C. Understanding, avoiding, and managing severe filler complications. Plast Reconstr Surg. 2015;136(5 Suppl):196S–203.

    Article  CAS  PubMed  Google Scholar 

  2. Sorensen EP, Urman C. Cosmetic complications: rare and serious events following botulinum toxin and soft tissue filler administration. J Drugs Dermatol. 2015;14:486–91.

    CAS  PubMed  Google Scholar 

  3. Mojallal A, Foyatier JL. Historique de l’utilisation du tissu adipeux comme produit de comblement en chirurgie plastique. Ann Chir Plast Esthet. 2004;49:419–25.

    Article  CAS  PubMed  Google Scholar 

  4. Coleman SR. Lipoinfiltration in the upper lip white roll. Aesth Surg. 1994;14:231–4.

    Google Scholar 

  5. Coleman SR. Long term survival of fat transplants: controlled demonstrations. Aesthetic Plast Surg. 1995;19:421–5.

    Article  CAS  PubMed  Google Scholar 

  6. Mazzola RF, Mazzola IC. History of fat grafting: from ram fat to stem cells. Clin Plast Surg. 2015;42:147–53.

    Article  PubMed  Google Scholar 

  7. Serra-Renom JM, Muñoz-Olmo JL, Serra-Mestre JM. Fat grafting in postmastectomy breast reconstruction with expanders and prostheses in patients who have received radiotherapy: formation of new subcutaneous tissue. Plast Reconstr Surg. 2010;125:12–8.

    Article  CAS  PubMed  Google Scholar 

  8. Karmali RJ, Nguyen AT, Skoracki RJ, et al. Outcomes following autologous fat grafting in head and neck oncologic reconstruction. Plast Reconstr Surg. 2015;136(4 Suppl):49–50.

    Article  PubMed  Google Scholar 

  9. Laschke MW, Menger MD. Adipose tissue-derived microvascular fragments: natural vascularization units for regenerative medicine. Trends Biotechnol. 2015;33:442–8.

    Article  CAS  PubMed  Google Scholar 

  10. Avram AS, Avram MM, James WD. Subcutaneous fat in normal and diseased states: 2. Anatomy and physiology of white and brown adipose tissue. J Am Acad Dermatol. 2005;53:671–83.

    Article  PubMed  Google Scholar 

  11. Eto H, Kato H, Suga H, Aoi N, Doi K, Kuno S, Yoshimura K. The fate of adipocytes after nonvascularized fat grafting: evidence of early death and replacement of adipocytes. Plast Reconstr Surg. 2012;129:1081–92.

    Article  CAS  PubMed  Google Scholar 

  12. Kato H, Mineda K, Eto H, Doi K, Kuno S, Kinoshita K, et al. Degeneration, regeneration, and cicatrization after fat grafting: dynamic total tissue remodeling during the first 3 months. Plast Reconstr Surg. 2014;133:303e–13.

    CAS  PubMed  Google Scholar 

  13. Kakudo N, Tanaka Y, Morimoto N, Ogawa T, Kushida S, Hara T, Kusumoto K. Adipose-derived regenerative cell (ADRC)-enriched fat grafting: optimal cell concentration and effects on grafted fat characteristics. J Transl Med. 2013;11:254.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Serra-Mestre JM, Serra-Renom JM, Martinez L, Almadori A, D’Andrea F. Platelet-rich plasma mixed-fat grafting: a reasonable prosurvival strategy for fat grafts? Aesthetic Plast Surg. 2014;38:1041–9.

    Article  PubMed  Google Scholar 

  15. Forbes SJ, Rosenthal N. Preparing the ground for tissue regeneration: from mechanism to therapy. Nat Med. 2014;20:857–69.

    Article  CAS  PubMed  Google Scholar 

  16. Rohrich RJ, Sorokin ES, Brown SA. In search of improved fat transfer viability: a quantitative analysis of the role of centrifugation and harvest site. Plast Reconstr Surg. 2004;113:391–5.

    Article  PubMed  Google Scholar 

  17. Ullmann Y, Shoshani O, Fodor A, Ramon Y, Carmi N, Eldor L, Gilhar A. Searching for the favorable donor site for fat injection: in vivo study using the nude mice model. Dermatol Surg. 2005;31:1304–7.

    Article  CAS  PubMed  Google Scholar 

  18. Padoin AV, Braga-Silva J, Martins P, Rezende K, Rezende AR, Grechi B, et al. Sources of processed lipoaspirate cells: influence of donor site on cell concentration. Plast Reconstr Surg. 2008;122:614–8.

    Article  CAS  PubMed  Google Scholar 

  19. Kishi K, Imanishi N, Ohara H, Ninomiya R, Okabe K, Hattori N, et al. Distribution of adipose-derived stem cells in adipose tissues from human cadavers. J Plast Reconstr Aesthet Surg. 2010;63:1717.

    Article  PubMed  Google Scholar 

  20. Lim AA, Fan K, Allam KA, Wan D, Tabit C, Liao E, et al. Autologous fat transplantation in the craniofacial patient. J Craniofac Surg. 2012;23:1061–6.

    Article  PubMed  Google Scholar 

  21. Li K, Gao J, Zhang Z, Li J, Cha P, Liao Y, et al. Selection of donor site for fat grafting and cell isolation. Aesthetic Plast Surg. 2013;37:153–8.

    Article  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. Moore Jr JH, Kolaczynski JW, Morales LM, Considine RV, Pietrzkowski Z, Noto PF, Caro JF. Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Aesthetic Plast Surg. 1995;19:335–9.

    Article  PubMed  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. Shoshani O, Berger J, Fodor L, Ramon Y, Shupak A, Kehat I, et al. The effect of lidocaine and adrenaline on the viability of injected adipose tissue: an experimental study in nude mice. J Drugs Dermatol. 2005;4:311–6.

    PubMed  Google Scholar 

  26. Keck M, Zeyda M, Gollinger K, Burjak S, Kamolz LP, Frey M, Stulnig TM. Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes. Plast Reconstr Surg. 2010;126:1500–5.

    Article  CAS  PubMed  Google Scholar 

  27. Livaoğlu M, Buruk CK, Uraloğlu M, Ersöz S, Livaogğlu A, Sözen E, Agdoğan Ö. Effects of lidocaine plus epinephrine and prilocaine on autologous fat graft survival. J Craniofac Surg. 2012;23:1015–8.

    Article  PubMed  Google Scholar 

  28. Agostini T, Lazzeri D, Pini A, Marino G, Li Quattrini A, Bani D, Dini M. Wet and dry techniques for structural fat graft harvesting. Plast Reconstr Surg. 2012;130:331e–9.

    Article  CAS  PubMed  Google Scholar 

  29. Shiffman MA, Mirrafati S. Fat transfer techniques: the effect of harvest and transfer methods on adipocyte viability and review of the literature. Dermatol Surg. 2001;27:819–26.

    CAS  PubMed  Google Scholar 

  30. Özsoy Z, Kul Z, Bilir A. The role of cannula diameter in improved adipocyte viability: a quantitative analysis. Aesthet Surg J. 2006;26:287–9.

    Article  PubMed  Google Scholar 

  31. 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.

    Article  PubMed  Google Scholar 

  32. Kirkham JC, Lee JH, Medina MA, McCormack MC, Randolph MA, Austen Jr WG. The impact of liposuction cannula size on adipocyte viability. Ann Plast Surg. 2012;69:479–81.

    Article  CAS  PubMed  Google Scholar 

  33. Nguyen PS, Desouches C, Gay AM, Hautier A, Magalon G. Development of micro-injection as an innovative autologous fat graft technique: the use of adipose tissue as dermal filler. J Plast Reconstr Aesthet Surg. 2012;65:1692–9.

    Article  CAS  PubMed  Google Scholar 

  34. Alharbi Z, Opländer C, Almakadi S, Fritz A, Vogt M, Pallua N. Conventional vs. micro-fat harvesting: how fat harvesting technique affects tissue-engineering approaches using adipose tissue-derived stem/stromal cells. J Plast Reconstr Aesthet Surg. 2013;66:1271–8.

    Article  PubMed  Google Scholar 

  35. Rohrich RJ, Morales DE, Krueger JE, Ansari M, Ochoa O, Robinson Jr J, Beran SJ. Comparative lipoplasty analysis of in vivo-treated adipose tissue. Plast Reconstr Surg. 2000;105:2152–8.

    Article  CAS  PubMed  Google Scholar 

  36. Pu LL, Cui X, Fink BF, Cibull ML, Gao D. The viability of fatty tissue within adipose aspirates after conventional liposuction: a comprehensive study. Ann Plast Surg. 2005;54:288–92.

    CAS  PubMed  Google Scholar 

  37. Smith P, Adams Jr WP, Lipschitz AH, Chau B, Sorokin E, Rohrich RJ, Brown SA. Autologous human fat grafting: effect of harvesting and preparation techniques on adipocyte graft survival. Plast Reconstr Surg. 2006;117:1836–44.

    Article  CAS  PubMed  Google Scholar 

  38. Pu LL, Coleman SR, Cui X, Ferguson Jr RE, Vasconez HC. Autologous fat grafts harvested and refined by the Coleman technique: a comparative study. Plast Reconstr Surg. 2008;122:932–7.

    Article  CAS  PubMed  Google Scholar 

  39. Crawford JL, Hubbard BA, Colbert SH, Puckett CL. Fine tuning lipoaspirate viability for fat grafting. Plast Reconstr Surg. 2010;126:1342–8.

    Article  CAS  PubMed  Google Scholar 

  40. Lee JH, Kirkham JC, McCormack MC, Nicholls AM, Randolph MA, Austen Jr WG. The effect of pressure and shear on autologous fat grafting. Plast Reconstr Surg. 2013;131:1125–36.

    Article  CAS  PubMed  Google Scholar 

  41. Fisher C, Grahovac TL, Schafer ME, Shippert RD, Marra KG, Rubin JP. Comparison of harvest and processing techniques for fat grafting and adipose stem cell isolation. Plast Reconstr Surg. 2013;132:351–61.

    Article  CAS  PubMed  Google Scholar 

  42. Schafer ME, Hicok KC, Mills DC, Cohen SR, Chao JJ. Acute adipocyte viability after third-generation ultrasound-assisted liposuction. Aesthet Surg J. 2013;33:698–704.

    Article  PubMed  Google Scholar 

  43. Keck M, Kober J, Riedl O, Kitzinger HB, Wolf S, Stulnig TM, et al. Power assisted liposuction to obtain adipose-derived stem cells: impact on viability and differentiation to adipocytes in comparison to manual aspiration. J Plast Reconstr Aesthet Surg. 2014;67:e1–8.

    Article  PubMed  Google Scholar 

  44. Yin S, Luan J, Fu S, Wang Q, Zhuang Q. Does water-jet force make a difference in fat grafting? In vitro and in vivo evidence of improved lipoaspirate viability and fat graft survival. Plast Reconstr Surg. 2015;135:127–38.

    Article  CAS  PubMed  Google Scholar 

  45. Boschert MT, Beckert BW, Puckett CL, Concannon MJ. Analysis of lipocyte viability after liposuction. Plast Reconstr Surg. 2002;109:761–5; discussion 766–7.

    Article  PubMed  Google Scholar 

  46. Butterwick KJ. Lipoaugmentation for aging hands: a comparison of the longevity and aesthetic results of centrifuged versus noncentrifuged fat. Dermatol Surg. 2002;28:987–91.

    PubMed  Google Scholar 

  47. Ramon Y, Shoshani O, Peled IJ, Gilhar A, Carmi N, Fodor L. Enhancing the take of injected adipose tissue by a simple method for concentrating fat cells. Plast Reconstr Surg. 2005;115:197–201.

    CAS  PubMed  Google Scholar 

  48. Rose JG, Lucarelli MJ, Lemke BN, Dortzbach RK, Boxrud CA, Obagi S, Patel S. Histologic comparison of autologous fat processing methods. Ophthal Plast Reconstr Surg. 2006;22:195–200.

    Article  PubMed  Google Scholar 

  49. Kurita M, Matsumoto D, Shigeura T, Sato K, Gonda K, Harii K, et al. Influences of centrifugation on cells and tissues in liposuction aspirates: optimized centrifugation for lipotransfer and cell isolation. Plast Reconstr Surg. 2008;121:1033–41.

    Article  CAS  PubMed  Google Scholar 

  50. Khater R, Atanassova P, Anastassov Y, Pellerin P, Martinot-Duquennoy V. Clinical and experimental study of autologous fat grafting after processing by centrifugation and serum lavage. Aesthetic Plast Surg. 2009;33:37–43.

    Article  PubMed  Google Scholar 

  51. Condé-Green A, de Amorim NF, Pitanguy 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.

    Article  PubMed  Google Scholar 

  52. Condé-Green A, Baptista LS, de Amorin NF, de Oliveira ED, da Silva KR, Pedrosa Cda S. Effects of centrifugation on cell composition and viability of aspirated adipose tissue processed for transplantation. Aesthet Surg J. 2010;30:249–55.

    Article  PubMed  Google Scholar 

  53. Xie Y, Zheng D, Li Q, Chen Y, Lei H, Pu LL. The effect of centrifugation on viability of fat grafts: an evaluation with the glucose transport test. J Plast Reconstr Aesthet Surg. 2010;63:482–7.

    Article  PubMed  Google Scholar 

  54. Zhu M, Zhou Z, Chen Y, Schreiber R, Ransom JT, Fraser JK, et al. Supplementation of fat grafts with adipose-derived regenerative cells improves long-term graft retention. Ann Plast Surg. 2010;64:222–8.

    Article  CAS  PubMed  Google Scholar 

  55. Minn KW, Min KH, Chang H, Kim S, Heo EJ. Effects of fat preparation methods on the viabilities of autologous fat grafts. Aesthetic Plast Surg. 2010;34:626–31.

    Article  PubMed  Google Scholar 

  56. Botti G, Pascali M, Botti C, Bodog F, Cervelli V. A clinical trial in facial fat grafting: filtered and washed versus centrifuged fat. Plast Reconstr Surg. 2011;127:2464–73.

    Article  CAS  PubMed  Google Scholar 

  57. Ferraro GA, De Francesco F, Tirino V, Cataldo C, Rossano F, Nicoletti G, D’Andrea F. Effects of a new centrifugation method on adipose cell viability for autologous fat grafting. Aesthetic Plast Surg. 2011;35:341–8.

    Article  PubMed  Google Scholar 

  58. Pulsfort AK, Wolter TP, Pallua N. The effect of centrifugal forces on viability of adipocytes in centrifuged lipoaspirates. Ann Plast Surg. 2011;66:292–5.

    Article  CAS  PubMed  Google Scholar 

  59. Hoareau L, Bencharif K, Girard AC, Delarue P, Hulard O, Festy F, et al. Effect of centrifugation and washing on adipose graft viability: a new method to improve graft efficiency. J Plast Reconstr Aesthet Surg. 2013;66:712–9.

    Article  PubMed  Google Scholar 

  60. Pfaff M, Wu W, Zellner E, Steinbacher DM. Processing technique for lipofilling influences adipose-derived stem cell concentration and cell viability in lipoaspirate. Aesthetic Plast Surg. 2014;38:224–9.

    Article  PubMed  Google Scholar 

  61. Dasiou-Plakida D. Fat injections for facial rejuvenation: 17 years experience in 1720 patients. J Cosmet Dermatol. 2003;2:119–25.

    Article  CAS  PubMed  Google Scholar 

  62. Trepsat F. Midface reshaping with micro-fat grafting. Ann Chir Plast Esthet. 2009;54:435–43.

    Article  CAS  PubMed  Google Scholar 

  63. Mazzola RF. Fat injection: from filling to regeneration. St. Louis: Quality Medical Publishing; 2009. p. 373–422.

    Google Scholar 

  64. Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013;132:1017–26.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Plastic, Reconstructive, and Aesthetic Surgery, Universitat International de Catalunya Hospital Quirón Barcelona, Barcelona, Spain

    Jose Maria Serra-Renom & Jose Maria Serra-Mestre

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  1. Jose Maria Serra-Renom
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Serra-Renom, J.M., Serra-Mestre, J.M. (2016). Fat Grafting: Principles and General Concepts. In: Atlas of Minimally Invasive Facelift. Springer, Cham. https://doi.org/10.1007/978-3-319-33018-1_3

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  • DOI: https://doi.org/10.1007/978-3-319-33018-1_3

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