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Fat Grafting Technique For Body Contouring - Explained by Dr. Joseph Perlman

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Article courtesy of Joseph M. Perlman, M.D., P.A.
July 14, 2010

Fat grafting

In the last 20 years, there have been significant advances in treating patients with unwanted fat. In a previous report, I discussed the various surgical and nonsurgical treatments out there. Liposuction and it's more advanced techniques, such as laser assisted and ultrasonic assisted liposuction, have improved results with less downtime, less pain and faster recovery.

Instead of sending all of the suctioned fat to the waste disposal, techniques for autologous fat grafting have been refined and its uses increased. By autologous means that the fat is your own fat. Plastic surgeons have learned that as we get older, we lose soft tissue volume such as in our face. This is one of the reasons why our face sags as we age. Fat grafts have been around for decades but they have not been very reliable. There is been discussion as to whether fat grafts live better if they are taken as actual tissue grafts versus fat that has been suctioned and then reinjected.

Dr. Sidney Coleman, a New York City based plastic surgeon, is probably the most well known developer of fat reinjection techniques. New instrumentation allows us to remove fat causing less damage to the fat cells.

When patients undergo liposuction and desire fat reinjection, the procedures are done at the same time. The removed fat is washed, centrifuged into a more concentrated volume and then reinjected with small injection cannulas.
Although reinjection into the face is the most common area, fat can be reinjected to correct defects from previous liposuction, for buttocks augmentation, and to repair traumatic soft tissue defects.

It has always been controversial as to whether fat can be reinjected into the breasts as a safe means of breast augmentation, without the necessity of breast implants. The concern is that, if some of the fat doesn't survive, it could cause more of a deformity. In addition, calcifications may develop in the dead fat, which could cause confusion on future mammograms as to whether breast cancer exists.

In 2009 the American Society of Plastic Surgeons had a task force review a multitude of evidence-based cases to study this very real concern. The report stated that there was no indication that fat grafting was an unsafe procedure, however, the report did not make strong recommendations in favor of or against fat grafting, for specific applications or treatment regions, just that more research was needed

Plastic surgeons at the University of Tokyo has done some studies, treating 400 patients with fat grafts augmented with stem cells, for breast augmentation and have gotten very impressive results. It would be nice if this proves to be the case, that breasts could be augmented with the patient's own fat.

One thing that is definite, and that is that successful fat grafting is a tedious procedure that even in the best of hands may not give consistent results. If you are interested in soft tissue augmentation, consult with your plastic surgeon if using your own fat as a soft tissue graft is feasible.

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