Breast Fat Grafting: Comparing Filtration-Centrifugation to Filtration-Washing Fat Processing

Abstract

Breast Fat Grafting: Comparing 2 fat processing methods and learned clinical experience. Introduction: Since alloplastic breast implants suffer from numerous potential complications and revision surgery, some practitioners and patients seek alternative treatment. Autologous fat grafting has gained popularity due to its safety and scientific advances yielding increased survival. Materials and Methods: Laboratory evaluation of fat specimens compared to ultrasound-assisted and suction-assisted fat harvesting is presented. The filtration-washing device (PureGraft) versus the filtration-centrifugation device (LipoKit) were compared using both clinical evaluation, laboratory analysis, and diagnostic ultrasound to assess fat thickness before and after surgical placement. Results: The study evaluated 12 women electing breast fat transfer, 6 undergoing PureGraft for processing (mean 29.2 years, Mean BMI 25.5), with 3 of these using suction-assisted harvested fat and 3 using ultrasound-assisted harvested fat. The initial group had 6 patients (mean 28.5 years, Mean BMI 25.1) that had undergone LipoKit fat processing, with 3 of these using suction-assisted harvested fat and 3 using ultrasound-assisted harvested fat. Fat placed ranged between 100 cc and 240 cc per breast in the subcutaneous plane, with a mean of 171.7 cc for LipoKit and 169.2 cc for the PureGraft group. LipoKit fat processing revealed fat grafted breasts to be 40% thicker via diagnostic ultrasound at 10 weeks and 29% thicker at a mean of 7 months and 10 days. The ultrasound-assisted fat harvesting using LipoKit found a mean fat viability of 91.5% compared to 81.8% with PureGraft. Suction-assisted fat harvesting using LipoKit found a mean fat viability of 92.1% compared to 91.5% with PureGraft. Discussion: Our clinical study revealed that in the patient population that elected breast fat grafting as the method of augmentation, there was a high patient satisfaction rate. The filtration-centrifugation system has several advantages: (1) centrifugation forces injuries the larger, more mature, less likely to survive adipocytes (2) the process removes the oil content much more efficiently and in greater quantities than PureGraft, (3) more efficiently and in greater quantities extracts the wetting fluid (4) absence of washing inhibits the removal of lipoaspirate containing growth factors and cytokines, (5) Compacts the fat, and finally (6) Concentrates adipose-derived stem cells and stromal vascular fraction progenitor support cells. There was no difference in fat viability comparing suction-assisted to ultrasound-assisted liposuction fat harvesting. Conclusions: Breast fat grafting using the Filtration-Centrifugation device (LipoKit) revealed superior volume results compared to the Filtration-Washing device (PureGraft), with no difference with suction or ultrasound fat harvesting.