Abstract
Introduction: Adipose grafting has had a long history for use in volume enhancement and has been significantly improved by the development of liposuction and more recently by advanced techniques in preparation. Additionally, no longer is fat successful solely as an agent for volume enhancement but has shown potential in tissue repair. In this review we will compare our patient cohort to current data in the literature to gain insight into the methods of harvesting, processing, and injection of fat grafting as well as the safety of this procedure.
Methods/Results: This chapter is a retrospective chart review of 125 patients undergoing fat graft procedures performed by a single surgeon on the face and body from September 2006 through September 2019. Charts were reviewed for donor and recipient sites, methods of harvest, fat processing techniques with injection methods, and complications. We will present the average amount of liposuctioned and processed fat grafted in each site and the complications associated with each procedure. Of this 125 patient cohort, the group of those undergoing fat graft volume enhancement consisted of 58 cosmetic faces, 33 patients for restorative breast surgery, and 6 patients for fat graft to the buttocks. Retracted scars were injected in 15 patients and into atrophic tissue or tissue defects in 13 patients. Only 10% of patients who received grafts to the face had two or more fat grafting sessions. Patients undergoing fat grafting to atrophic tissue needed more than one session in 15% of patients. Patients with fat grafts to the breast as well as the buttocks needed two or more sessions in 20% of patients. The highest percentage of patients requiring two or more fat grafting sessions were those being treated for densely adherent scars with 36% of patients having two or more fat grafting sessions. The categories of complications in this operative series included the following: hematoma, infection, cellulitis, dermatitis, granuloma, seroma, and cysts. There were no fat emboli and no occurrences of deep venous thrombosis or pulmonary emboli.
Conclusion: Autologous fat grafting is a reliable procedure which can provide expected results with safety. There were no episodes of fat emboli, deep venous thrombosis, or pulmonary emboli in this series. As regenerative strategies continue to be developed the success of these treatments will be further improved with even less morbidity.
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Acknowledgement
The artist’s drawing in Fig. 20.3 was by Matthew Kyle Collawn. His permission was obtained to use this artwork in our article.
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1 Electronic Supplementary Material
Video 20.1
Infiltration tumescent abdomen site of harvest (M4V 13412 kb)
Video 20.2
Fat washed with normal saline (M4V 6807 kb)
Video 20.3
Washed fat emulsified (M4V 11647 kb)
Video 20.4
Fat graft upper lip (M4V 13129 kb)
Video 20.5
Fat grafting buttocks ultrasound assisted (M4V 23624 kb)
Video 20.6
Injection site of morphea scleroderma right arm (M4V 46329 kb)
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Montgomery, M., Boyd, C., Kumbla, P.A., Swicord, W.B., Collawn, S. (2022). Classification of Safe Autologous Fat Grafting: Quantity and Location Site. In: Kalaaji, A. (eds) Plastic and Aesthetic Regenerative Surgery and Fat Grafting. Springer, Cham. https://doi.org/10.1007/978-3-030-77455-4_20
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DOI: https://doi.org/10.1007/978-3-030-77455-4_20
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