Fat Processing Techniques

Abstract

Autologous fat grafting is an aesthetic and reconstructive procedure in which an individual's own fat is harvested and injected into the soft tissues to correct contour and other abnormalities. Fat graft is considered the ideal soft tissue filler for its biocompatibility, lack of immunogenicity, and availability. The entire procedure of harvesting, processing, and transfer of fat graft affects fat graft take and effectiveness of fat grafting. This article will focus on the most common methods of fat graft processing, including centrifugation, cotton gauze rolling, sedimentation, and filtration/washing. The fragility of the harvested adipocytes makes the technique of fat graft processing of utmost importance, as blood and other unnecessary cellular fragments are removed. Each fat graft processing method has its own merits and shortcomings; however, due to a lack of well-defined prospective studies, there is no evidence to support one processing method as superior to another.

Response to Letter to the Editor: Fat Injection Pharyngoplasty for Velopharyngeal Insufficiency Management

“…Processing of adipose tissue prior to injection is hardly evidence-based. 2 In contrast to many studies using liposuction with centrifugation, we excise abdominal fat en masse. Fibrous attachments are sharply excised to reduce irregularity and scarring, while every attempt is made to maintain the integrity of adipocytes and preserve volume.…”

“…Countless methods of processing fat exist, none consistently superior. 2 These subtle differences may be less significant with pharyngeal augmentation compared to facial aesthetic injections, which require greater predictability. Nevertheless, multiple recent reviews have found a greater percentage of graft retainment (40% vs 60%) when fat is enriched with adipose-derived stem cells or platelet-rich plasma.…”

Evaluation of a new adipose tissue processing method for breast and buttock fat grafting procedures

“…Numerous techniques for fat processing have been described and evaluated, including centrifugation, cotton gauze rolling, sedimentation, and filtration/washing [5]. A common goal of these techniques is to purify the fat in order to lower fat resorption as much as possible.…”

“…A common goal of these techniques is to purify the fat in order to lower fat resorption as much as possible. The reported fat resorption rate varies between 20 and 80% of the total injected volume [5]. Despite the considerable number of clinical studies on the topic, there is no real consensus about the most efficient way to process fat to achieve optimal results [5].…”

“…The reported fat resorption rate varies between 20 and 80% of the total injected volume [5]. Despite the considerable number of clinical studies on the topic, there is no real consensus about the most efficient way to process fat to achieve optimal results [5]. While fat centrifugation, as proposed by Coleman, was shown to be linked to lower adipocyte viability [6] and more complications [7], specifically fat necrosis [8], there is still debate about the superiority of the other available techniques in terms of safety and effectiveness [5,[7][8][9][10].…”