Fragmented fat transfer is an effective technique for gluteal augmentation in massive weight loss patients with limited donor tissue. 20 female patients who underwent body lifts more than 18 months after bariatric surgery received gluteal injections of fragmented fat harvested without fluid or chemicals. Each buttock received around 720ml of fat on average. There were a few minor dehiscences but no other complications. Fragmented fat transfer provides a safe and reproducible method for harvesting more viable fat compared to traditional liposuction, making it a promising option for contouring deflated areas in post-bariatric surgery patients. Further studies are still needed to optimize techniques and evaluate additional applications.

1. Fragmented Fat Transfer for Massive Weight
Loss Gluteal Contouring
Flavio Henrique Mendes, M.D.,
Ph.D.
Fausto Viterbo, M.D., Ph.D.
São Paulo, Brazil
PRESENTER: Gerelmaa J, MD
AGAPE CHRISTIAN HOSPITAL, JOURNAL CLUB
2022.04.29
Fragmented Fat Transfer for Massive
Weight Loss Gluteal Contouring

2. Introduction
Gluteal augmentation by fat grafting has been
accepted as an effective surgical approach,
but
many patients face a lack of donor tissue
with harvesting limitations.

3. Introduction
The massive weight loss
process leads to:
● extensive tissue deflation
● making liposuction less effective due to major subcutaneous
laxity
● the limited amount of available adipose tissue.
● circumferential dermolipectomy is routinely performed on
massive weight loss patients

4. SYRINGE LIPOASPIRATE vs FRAGMENTED FAT
• NO DIFFERENCE
in vitro methods (histologic analysis, immunohistochemical analysis, trypan blue testing, flow
cytometric analysis, and cell culturing)
in vivo methods (mass, volume, and histologic analysis of xenografts in mice)

5. PURPOSE OF THE STUDY
To assess the initial clinical evidence on
fragmented fat transfer to restore volume and
enhance deflated gluteal contour in a sample of
massive weight loss patients.

6. PATIENTS AND METHODS
- 2019 Jan - Sep - 20 cases
- Selection criteria
● female patients who underwent circumferential body lifts
and fleur-de-lis abdominoplasties
● body mass index no greater than 30 kg/m2
● at least 18 months earlier undergone bariatric surgery
● weight loss stabilization / m <3% in a 3M/

7. SURGICAL TECHNIQUE
● Pre-OP marking
1. Gluteal regions symmetrically divided into several zones
2. NO PREVIOUS INJECTION
3. 60 cc syringe
4. 4mm cannula
5. Fragmented fat was equally transferred
6. Suturing.

8. FRAGMENTATION TECHNIQUE

9. RESULTS
● 20 post bariatric surgery patients.
● IV general anesthesia - 9 cases
● Spinal Blocks - 4 cases
● Combination anesthesia - 7 cases
● AB PROPHYLAXIS + PO AB /24hrs/
● no DVT prophylaxis
● AVE V= 720ml /500-960ml/
● Small spots dehiscence - 4 cases
● NO COMPLICATION

10. RESULTS

11. Discussion
- liposuction has long been the only possible harvesting
procedure, despite its time-consuming, aggressive nature and
profound limitations.
- in extremely deflated patients, whose buttocks really need both
lifting and augmentation, liposuction alone is not likely to provide
the required amount of lipograft.

12. Discussion
- Fat fragmentation has proved useful and effective in
providing greater amounts of viable fat graft in a
safe, simple, and reproducible technique without
noticeable complications.

13. Discussion
- free of fluid injections (no saline, lidocaine,
or adrenalin)
- the exposure of fragmented fat to air should be
addressed in further studies for risk of contamination
and graft take impairment.
- NOT ONLY FOR BUTTOCK RESHAPING

14. Conclusions
- Although preliminary, their clinical findings
with this new technique support further studies of
fragmented fat as an alternative to liposuction in
gluteal fat grafting.
- Additional potential applications,
including in wound healing and regenerative
medicine, are worth exploring.

15. 1.ACH case /PBSC- dorsum of the hand/
2.KEY TAKEAWAYS /easy, simple/

16. THANK YOU
FOR YOUR
ATTENTION
AND
NO
QUESTION,
OKAY?!