0109-819 Shiffman
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 Sep;27(9):819-26. PMID: 11553171
BACKGROUND: Autologous fat transplantation is an excellent tool for filling
defects and augmenting tissue. The literature provides a variety of reports with
varying degrees of success or failure. The procedure is operator dependent and
relies on the techniques of harvesting, cleansing, and reinjection. OBJECTIVE:
To evaluate various retrieval and reinjection techniques to see their effect on
the viability of the fat cells. METHODS: Fat was removed from five patients
utilizing various cannulas, needles, suction pressures, and centrifugation for
collection and reinjection. Preoperative external ultrasound and massage were
evaluated as well as the use of the ratchet gun for injection. The fat was
routinely cleansed of blood and tumescent solution products by means of washing
with normal saline and then decanting repeatedly until the infranatant solution
was clear. RESULTS: Histologic examination of the fat cells showed the central
core of fat and edges of the core had 98-100% intact cells (presumably viable)
in every specimen except when -700 mmHg vacuum was used for fat collection where
cell damage was greater than 10% and when preoperative massage was performed
where cell damage was 30%. Preoperative external ultrasound did not appear to
damage the fat cell but did disrupt some of the fibrous tissue holding the fat
cells in large bundles. CONCLUSION: The variety of techniques used to collect,
clean, and reinject fat do not damage the fat cells except for the collection of
fat at -700 mmHg vacuum. External ultrasound, preoperatively, does not destroy
fat cells but produces smaller bundles of fat. The ratchet gun does not result
in increased fat cell loss. Preoperative massage causes 30% cell loss and
deformation of 80% of the remaining cells.
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