Effect of Various Methods of Fat Harvesting and Reinjection

Abstract

Introduction: Autologous fat transplantation is an excellent tool for filling defects and augmenting tissue. The literature has provided a variety of reports with different degrees of success or failure. The procedure is operator dependent and relies on the techniques of harvesting, cleansing, and reinjection. The author evaluates the various techniques to see their effect on the viability of the fat cells. Materials and Methods: Fat was removed from 4 patients for collection and reinjection by use of various cannulas, needles, suction pressures, and centrifugation. External ultrasound was evaluated before the operation, as was 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 that the central core of fat and edges of the core had 95–100% intact cells (presumably viable) in every specimen except when a −700 mm Hg vacuum was used for fat collection and cell damage was >10%. Preoperative external ultrasound did not appear to damage the fat cells but did disrupt some of the fibrous tissue holding the fat cells in large bundles. Discussion: The variety of techniques used to collect, clean, and reinject fat do not damage the fat cells except for the collection of fat in a −700 mm Hg vacuum. External ultrasound before the operation does not destroy fat cells but produces smaller bundles of fat. The ratchet gun does not result in increased fat cell loss.