Fat grafting is increasingly becoming one of, if not, the hottest procedures in cosmetic and reconstructive surgery, but not all techniques are the same. As it continues to grow in popularity, plastic surgeons are proposing a new classification system to match the technique to the individual patient’s situation based on the method of fat harvesting, cell processing, fat transplantation and the management of the recipient site.
Some cases require smaller volumes of fat than others. For example, patients presenting with loss of fatty tissue in the facial area and/or needing reconstructive surgery on a chronic leg wound require small amounts of fat which can be manually harvested from the abdomen using a small syringe. By contrast, patients undergoing cosmetic breast augmentation or breast reconstruction after mastectomy need larger amounts of fat. In these cases, fat is harvested via liposuction of the thighs and some form of "pre-expansion" of the recipient site may also be needed. Different techniques may also be warranted depending on the state of the tissue in the recipient area such as inflammation in the chronic leg wound and tissue damage caused by radiation at the mastectomy site.
“Fat grafting, once thought to be a simple technique with variable results, is a much more complex procedure with at least four definable subtypes,” conclude study authors plastic surgeons Daniel Del Vecchio, MD of Boston, and Rod Rohrich, MD, of University of Texas Southwestern Medical Center in Dallas. “By defining the essential differences in the recipient site, the key driver in fat transplantation, the proper selection of technique can be best chosen."
The study appears in the September issue of Plastic and Reconstructive Surgery.