fat grafting

1. Fat grafting Proff. Layth Mahmoud Alkattan

2. History • The first 'fat grafting' procedure dates back to the late 19th century, 1893, when a German Plastic Surgeon, Gustav Neuber(1850-1932) transferred fat from the arm to the orbital (eye) region to correct scars formed from osteomyelitis (bone infection).

3. Fat grafting • Fat grafting, also referred to as fat transfer or fat injections, is the surgical process by which fat is transferred from one area of the body to another area. • The surgical goal is to improve or augment the area where the fat is injected. • The technique involves extracting adipose fat by liposuction, processing the fat, and then reinjecting purified fat into the area needing improvement.

4. Adipose tissue is viewed as ideal filler because it is readily available, is host compatible, and can be harvested easily • and repeatedly as needed without complications arising from allergic or foreign body reactions

5. The process of fat grafting involves three steps: 1. Extraction of the fat from the donor area with liposuction. 2. Decanting, centrifugation, and processing of the fat. 3. Reinjection of the purified fat into the area needing improvement.

6. Lipofilling • Lipofilling is the broad term which covers the process of extracting fat from one area of the body and then inserting this fat into a different area where volume, mass or reshaping is desired

7. Tumescent technique • The tumescent technique allowed patients to undergo liposuction under local anaesthesia administered using small cannulas • Can handling of fat during liposuction? • His technique consisted of three steps: • Manual lipoaspirationunder low pressure. • Centrifugationfor 3 min at 3400 rp • Reinjection in 3D. • This technique remains the gold standard for liposuction and lipofilling,

8. Fat is a filler with ideal properties: it naturally integrates into tissues, is autologous, and is 100% biocompatible. • However, this is not the only function of • Lipofilling; fat is an active and dynamic tissue composed of several different cell types, including adipocytes, fibroblasts, smooth muscle cells, endothelial cells, and adipogenic progenitor cells called “preadipocytes”

9. Fat harvesting • Several techniques have been proposed for fat harvesting, and there is an ongoing debate in the literature as to which method • produces more viable and functional adipocytes. • The main techniques are vacuum aspiration, syringe aspiration, and surgical excision

10. Technique • 1. General anesthesia • 2. Fat was harvested from the lower abdomen using the super wet technique. • 3. Through a small periumbilical • incision, a solution containing normal saline • with 1:500 000 epinephrine was infiltrated into the area at a ratio of 1 mL of solution per milliliter of fat.

11. 4. A total of 80 mL of adipose tissue was aspirated for each patient using a 2.5-mm diameter blunt-tip cannula attached to a 10-mL Luer-Lok syringe. • 5. Light negative pressure was created by • slowly withdrawing the plunger in a gradual manner.

12. 1. Processing of Lipoaspirate by Decantation • 2. Processing of Lipoaspirate by Washing • 3. Processing of Lipoaspirate With Cell • Supplementation • 4. Fat Grafting