FAT TRANSFER [FT]
The development of FT has been slow in the past because of the tendency to develop complications like oil cyst calcification and a poor survival rate of the grafted fat cells of 10 ~ 20% only.
Not any more! There is now a new technique that allows for complete closed-loop surgery with almost no contamination or exposure to air and that also gives highly concentrated pure fat cells – free of impurities and free-oils. This is possible due to specially designed 50ml syringes equipped with a squeezing piston. The resultant fat is both of high quality as well as containing 1 ~ 2 million fat stem cells per milliliter.
The use of highly concentrated pure fat cells, containing stem cells, is important for good survival rates when grafted onto the treated body areas. The presence of free oils and impurities prevent this. Further, the closed-loop helps ensure sterility, important in preventing complications of the past. Between 70 ~ 90 % of the grafted fat survive eventually, varying with areas treated and surgeon’s skill. This makes the procedure highly feasible as it has so many advantages over artificial fillers like silicon.
Up to 100ml of pure fat cells are grafted under general anesthesia. Each 50ml full syringe of tumescent liposuctioned fat can yield 25 ~ 40ml of pure fat cells by centrifuging at 3200 ~ 3500 rpm for 5 –10 minutes. 1 cc Coleman syringes are filled with the pure fat cells for injection.
Synthetic fillers like hyaluronic acid cost about US$300 ~ 400 per ml. Besides being costly if more than the usual 10ml only being used, larger quantities injected give more side effects such as foreign body reaction, infection, permanent redness, local hard mass, tough skin, etc.
In contrast, up to 100ml of highly concentrated fat cells can be successfully injected for full facial filling [less for partial] with no side effects, as we are using your own fat. The surviving grafted fat ages along at the same rate as does your other fat cells in the treated area.
A full facial filling with pure fat cells takes about 3 hours. As it is done under sleep anesthesia, there is no pain during the procedure. After that, some discomfort may be felt but this usually goes away after a few hours. Rest for 3 ~ 5 days at home is recommended.
Depressed upper buttocks can be enhanced with 200 ~ 250ml of fat cells to each, using the 50ml syringes and 1ml Coleman syringes complementarily to help ensure evenness and symmetry. The procedure takes about 2 hours.
Due to the large amounts used, the fat survival rate is more variable, at 40 ~ 80 % (usually 60~70%) and the re-absorption rates are about 30 ~ 40 % - similar to that for breast augmentation. If the re-absorption rate is fast in your case, a 2nd surgery 6 months to a year later is recommended.
One should not put pressure on the grafted areas for 1 ~ 2 weeks and not sleep on hard bed for 2 months.
This technique gives good results in breast augmentation and does away with the dangers of silicon implants or injections. Further, spreading the grafted fat evenly and approaching from the anterior axillary fold helps to give a natural feel and look to the augmented breasts
Fine needles are avoided as they cause bleeding when passed into the mammary tissue. 10ml syringes with slightly larger needles are used instead – to graft the 50 ~ 100ml of pure fat for each breast.
14 months after
The labia majora [outer lips of the female external genital organs] can also be easily restored to size by FT - with or without trimming the labia minora [inner lips] at the same time.
In a reported series of 2,000 cases of facial filling, >250 cases of breast augmentation and >15 cases of buttock augmentation over a 5 year period, there was 99 % success rates and under 1 % complication rates.
The complications were 2 cases of localized infection and 10-12 cases of oil cyst necrosis. The latter was easily solved with aspiration by Coleman needle. No calcification cases have occurred [but a longer observation time is required]. Usually, it is expected that these happen only if inflammations or oil cysts are allowed to persist for a long time. Should calcifications occur, they are usually of little consequence as they can be easily distinguished from original breast tissue. If needs be, a TRAM flap with abdominal adipose tissue can be performed.
It is expected, with the knowledge that pure concentrated fat without free oils and contaminants give good results, that various and improved techniques for autologous FT will be developed.
Artificial fillers will be of no use any longer and, since large quantities can be safely grafted at one surgery, artistry and completeness in cosmetic surgery will also be greatly improved.
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Your consultation will be personal and private. We look forward to meeting you.
DR ALEX K H OOI
MBBS, MMED [O&G], FRCOG, FAMS, FICS, MBA.
Gynecologic Minimal Access Surgeon
3 Mount Elizabeth, #11-07
Mount Elizabeth Medical Centre
T +65-67388331 F +65-67348896
[View TLS & FT photo-illustrations at www.liposuction.com and www.obgyndr.org]