Autologous Fat Transfer: Eliminating the Centrifuge, Decreasing Lipocyte Trauma and Establishing Standardization for Scientific Study

Abstract

Introduction: The autologous fat transfer procedure has undergone a renewal of interest because of the need for larger quantities of economical filler (face, buttocks, hands, and breasts). Commercial fillers are cost prohibitive when large quantities are needed. Present instruments on the market are not specialized enough to perform well during the autologous fat transfer procedure. As a result, multiple techniques have evolved that produce extremely varied results that are not scientifically verifiable. The objectives of this paper are to (1) review the events that are traumatic for the lipocyte and review how those events can be improved through new instrumentation; (2) review the use of the centrifuge and consider replacement of the centrifuge with an effective filter system; (3) establish instrument standards that will encourage scientific technique verification; and (4) introduce a standardized autologous fat transfer instrument that will save time, reduce significant trauma, and have standardized features to promote accurate scientific study. Methods: Information was obtained via a questionnaire, internet investigation, trade show information, personal discussions with surgeons, and the author's experience. Information from the questionnaire was used in the design of a new, improved standardized instrument. Results: During this study, an instrument was designed that would reduce operating room time considerably. Most of the time reduction was secondary to keeping the fat in the harvest syringe without transferring or centrifuging. This change in procedure would also considerably reduce lipocyte trauma in all 12 of the commonly accepted lipocyte trauma categories. In addition, the instrument could be standardized with multiple features that would give the surgeon confidence that the surgical results would not change because of the instruments. Conclusions: The Tissu-Trans™ device that was designed during this study significantly saves time, simplifies the procedure, and has standardized features that allow for scientific studies that are more accurate. The equipment offers simplicity and “feature latitude,” allowing the surgeon to perform all of the major steps (harvest, filter, irrigate, treatment, and reinjection) from a single harvest syringe. Although all 12 of the traumatic events for lipocytes were reduced in intensity, one should not leap to the conclusion that this correlates with increased lipocyte survival. To date, this has not been proven. Further clinical testing will be necessary to obtain this information.