Medicine:Fat transfer

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Short description: Plastic surgery

Fat transfer, also known as fat graft, lipomodelling, or fat injections,[1][2] is a surgical process in which a person's own fat is transferred from one area of the body to another area. The major aim of this procedure is to improve or augment the area that has irregularities and grooves.[3] Carried out under either general anesthesia or local anesthesia,[4] the technique involves 3 main stages: fat harvesting (extracting adipose fat), fat processing (processing the extracted fat), fat injection (and then reinjecting the purified fat into the area needing improvement).[5][6]

Applications

Autologous fat transplantation is a widely used treatment modality because of its biocompatible properties and availability of fat for transplantation.[7] The technique has become increasingly popular in recent years for soft tissue augmentation and volume replacement in both reconstructive and aesthetic plastic surgery.

Breast reconstruction

Breast reconstruction is the surgical process of rebuilding the natural shape and look of a breast, using autologous tissue, prosthetic implants, or a combination of both.[8] The procedure is most commonly performed in women - as part of their treatment - who have had mastectomy or surgery to treat breast cancer. A doctor harvests fat from one or more areas of the patient's body where excess fat is available and grafts it to the breast for breast reconstruction surgery after a mastectomy or lumpectomy. As the procedure uses the patient's own fat, the structural fat grafting for breast reconstruction surgery is a more natural process than implants and creates a smooth, more symmetrical, look.[9]

Breast augmentation and correcting asymmetry

Fat transfer breast augmentation is a natural solution to restore shape and volume to the breasts, which may have been lost due to factors such as aging, pregnancy/breast feeding, or weight loss.[10] Breast asymmetry can be corrected using the fat transfer procedure, and to give the breasts the same shape and size. Breast augmentation and correction of asymmetry using fat transfer is considered to be an overall safe procedure. Any major weight gain or loss could have an impact of the procedure results because the fat transferred will behave like the fat in any other body part. The procedure is associated with certain risks such as fat necrosis or death of fat cells, a risk related to any type of fat grafting surgeries. Another risk is fat reabsorption, wherein the body may reabsorb the fat used (up to 50%) in the fat transfer augmentation procedure.[11]

Gluteal augmentation

Main page: Medicine:Buttock augmentation

Fat transfer in gluteal augmentation, also known as buttock augmentation with autologous fat grafting or gluteal lift (currently marketed as the "Brazilian butt lift"), represents one of the most rapidly evolving and increasingly popular operations in aesthetic surgery.[12] This is a "dual-benefit" body contouring procedure, because fat is harvested from areas with surplus body fat to enhance contouring using liposuction.[13][14] This fat is purified and prepared for transplantation into the gluteal region to increase buttock volume. The technique that can be performed under general and local anesthesia can also create an improvement in buttock shape, along with enhancing.[15]

Facial rejuvenation

The regenerative potential of lipofilling and the role of adipose-derived stem cells (ASCs) contribute to good results in facial fat transfer. In traditional techniques for facial rejuvenation, surgery was used involving the excision of muscle, skin, and/or fat. In contrast, modern techniques focus on using fat grafting[16] to add volume to the "empty" facial compartments. Now, with more comprehensive understanding of facial aging constituents such as fat atrophy and ptosis of the facial compartments, fat grafting is considered a plausible facial rejuvenation technique, especially of the eyelids.[17]

Hand rejuvenation

Structural fat grafting can be an ideal option to treat the signs of aging or other appearance-related issues – such as prominent-looking veins and tendons, loss of fullness, thinning skin, arthritis and wasting of the hand.[18] The procedure involves manually harvesting fat from one or more locations on the body via liposuction and placing it around the back of the patient's hand, and sculpting it into a smooth, uniform layer for an ideal appearance.[19] To "fine tune" the results, additional fat transfer or injection of dermal filler products can be performed.[20] Autologous fat transfer serves as a filler in the hand rejuvenation procedure. Besides, it also rejuvenates the soft tissue and skin on the posterior side of the hands.[16]

Rhinoplasty

Autologous micro fat transplantation is often used to correct a low dorsum and a short nose.[21][22]

Scars and burns

Scars and burns caused due to various reasons such as injuries, chicken pox, acne, sun or radiation exposure, and more can be repaired with structural fat grafting.[23] The procedure harvests fat from one or more areas of the body and places it anywhere on the body where tissue has been damaged.[24] Structural fat grafting can improve the quality of aged and scarred skin, reduce pain and itchiness, heal radiation damage, treat chronic ulcers and reduce the appearance of scars on the face and body - including dimpling and deep depressions, resulting in thicker, softer, healthier skin.

Complications

To ensure survivability, the fat graft should not be manipulated too much and it must be quickly reinjected. Possible complications are swelling, bruising, hematoma formation, paresthesia or donor-site pain, hypertrophic scarring, infection, contour irregularities, and injury caused by the cannula to the underlying structures.[16][3][25]

References

  1. Shektman, Dr Arthur (2020-11-15). "What are the Long Term Side Effects of Fat Injections?" (in en-US). https://www.wellesleycosmeticsurgery.com/long-term-side-effects-fat-injections/. 
  2. "Fat transfer or lipoifilling: price UK, pros and cons, before after pictures" (in en-US). https://clinichunter.com/fat-transfer/. 
  3. 3.0 3.1 "Cosmetic procedures – Surgical fat transfer – NHS" (in en). 2019-05-02. https://www.nhs.uk/conditions/cosmetic-procedures/surgical-fat-transfer/. 
  4. "Top Facts To Know About Liposuction and Fat Transfer in Las Vegas Top 10 Facts You Need to Know About Liposuction and Fat Transfer" (in en). https://vipplasticsurgery.com/blogs/top-10-facts-you-need-to-know-about-liposuction-and-fat-transfer. 
  5. Bellini, Elisa; Grieco, Michele P.; Raposio, Edoardo (2017-11-10). "The science behind autologous fat grafting". Annals of Medicine and Surgery 24: 65–73. doi:10.1016/j.amsu.2017.11.001. ISSN 2049-0801. PMID 29188051. 
  6. Ricardo Rodriguez, MD | Baltimore; Tuesday, December 15. "Fat grafting history and applications" (in en). https://www.plasticsurgery.org/news/blog/fat-grafting-history-and-applications. 
  7. Vasavada, Advait; Raggio, Blake S. (2022), "Autologous Fat Grafting For Facial Rejuvenation", StatPearls (Treasure Island (FL): StatPearls Publishing), PMID 32491783, http://www.ncbi.nlm.nih.gov/books/NBK557860/, retrieved 2022-09-28 
  8. "Breast Reconstruction: What Is It, Types, Procedure & Recovery". https://my.clevelandclinic.org/health/treatments/16809-breast-reconstruction. 
  9. "Breast Reconstruction" (in en). https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction. 
  10. "Fat Transfer Breast Augmentation: Procedure, Results & Risks". https://my.clevelandclinic.org/health/treatments/24033-fat-transfer-breast-augmentation. 
  11. Dunn, Eric (2018-12-10). "The Pros and Cons of Fat Transfer Breast Augmentation | BPS" (in en-US). https://buckheadplasticsurgery.com/the-pros-and-cons-to-fat-transfer-breast-augmentation/. 
  12. Chia, Christopher T.; Theodorou, Spero J.; Dayan, Erez; Tabbal, Georges; Del Vecchio, Daniel (2018-12-03). ""Brazilian Butt Lift" under Local Anesthesia: A Novel Technique Addressing Safety Concerns" (in en-US). Plastic and Reconstructive Surgery 142 (6): 1468–1475. doi:10.1097/PRS.0000000000005067. ISSN 0032-1052. PMID 30489520. https://journals.lww.com/plasreconsurg/Abstract/2018/12000/_Brazilian_Butt_Lift__under_Local_Anesthesia__A.16.aspx. 
  13. Karishma, Dr. "What is a Brazilian Butt Lift (BBL) Surgery?" (in en). https://www.kaesthetics.in/. 
  14. "Brazilian Butt Lift Ottawa | Butt Augmentation At Ottawa Plastic Surgery" (in en-US). https://www.ottawaplasticsurgery.com/treatments/brazilian-butt-lift/. 
  15. "Buttock Augmentation" (in sm). https://med.stanford.edu/cosmeticsurgery/aestheticservices/body/buttock-augmentation.html#:~:text=Buttock%20or%20gluteal%20augmentation%20is,combination%20of%20these%20two%20techniques.. 
  16. 16.0 16.1 16.2 Simonacci, Francesco; Bertozzi, Nicolò; Grieco, Michele Pio; Grignaffini, Eugenio; Raposio, Edoardo (2017-06-27). "Procedure, applications, and outcomes of autologous fat grafting". Annals of Medicine and Surgery 20: 49–60. doi:10.1016/j.amsu.2017.06.059. ISSN 2049-0801. PMID 28702187. 
  17. "Plastic surgery statistics full report 2013". http://www.plasticsurgery.org/Documents/news-resources/statistics/2013-statistics/plastic-surgery-statistics-full-report-2013.pdf. 
  18. "Hand Rejuvenation Overview: Cost, Recovery, Before & After | AEDIT" (in en). https://aedit.com/procedure/hand-rejuvenation. 
  19. "What is Hand Rejuvenation and How Long Does it Last? | Dr. Adams Plastic Surgery" (in en-US). 2021-09-02. https://www.dr-adams.com/blog/what-is-hand-rejuvenation-and-how-long-does-it-last/. 
  20. Khosravani, Nima; Weber, Lee; Patel, Rina; Patel, Anup (2019-01-14). "The 5-Step Filler Hand Rejuvenation: Filling with Hyaluronic Acid". Plastic and Reconstructive Surgery Global Open 7 (1): e2073. doi:10.1097/GOX.0000000000002073. ISSN 2169-7574. PMID 30859035. 
  21. gustavo (2019-04-16). "Autologous Micro Fat Grafting | Dr. Lamblet Plastic Surgery" (in en-US). https://drhebertlamblet.com/body-procedures/autologous-micro-fat-grafting/. 
  22. Simonacci, Francesco; Bertozzi, Nicolò; Grieco, Michele Pio; Grignaffini, Eugenio; Raposio, Edoardo (2017-06-27). "Procedure, applications, and outcomes of autologous fat grafting". Annals of Medicine and Surgery 20: 49–60. doi:10.1016/j.amsu.2017.06.059. ISSN 2049-0801. PMID 28702187. 
  23. Piccolo, Nelson Sarto; Piccolo, Mônica Sarto; Piccolo, Maria Thereza Sarto (2015). "Fat grafting for treatment of burns, burn scars, and other difficult wounds". Clinics in Plastic Surgery 42 (2): 263–283. doi:10.1016/j.cps.2014.12.009. ISSN 1558-0504. PMID 25827568. https://pubmed.ncbi.nlm.nih.gov/25827568/. 
  24. Piccolo, Nelson Sarto; Piccolo, Mônica Sarto; Piccolo, Nelson de Paula; Piccolo, Paulo de Paula; Piccolo, Natalia de Paula; Daher, Ricardo Piccolo; Lobo, Roberta Piccolo; Daher, Silvia Piccolo et al. (2020-01-01). "Fat Grafting for Treatment of Facial Burns and Burn Scars" (in English). Clinics in Plastic Surgery 47 (1): 119–130. doi:10.1016/j.cps.2019.08.015. ISSN 0094-1298. PMID 31739888. https://www.plasticsurgery.theclinics.com/article/S0094-1298(19)30095-1/abstract. 
  25. Yoshimura, Kotaro; Coleman, Sydney R. (2015). "Complications of Fat Grafting: How They Occur and How to Find, Avoid, and Treat Them". Clinics in Plastic Surgery 42 (3): 383–388, ix. doi:10.1016/j.cps.2015.04.002. ISSN 1558-0504. PMID 26116944. https://pubmed.ncbi.nlm.nih.gov/26116944/.