Autologous Fat Transfer, breast Augmentation, Buttock Augmentation, Cheek Augmentation, facial Rejuvenation, Acne Scarring,body contouring

1. Dr. Sumita Shankar
Plastic, Cosmetic and Microsurgeon
MD Amaze MedSpa
Consultant: Consultant:
Abu Dhabi: Medeor 24x7 Hospital
Hyderabad: Apollo Hospital , Jubilee Hills
Vijayawada: Liberty Hosp., MJNaidu Hosp.
Guntur: Sai Bhaskar Hospital
Autologous Fat
Transfer

2. • Plastic and Reconstructive Surgery
• Role of Autologous Fat Transfer to the
Superficial Fat Compartments for Perioral
Rejuvenation
• Ronnie A. Pezeshk, M.D.; Ran Y. Stark, M.D.;
Kevin H. Small, M.D.; Jacob G. Unger, M.D.;
Rod J. Rohrich, M.D.
• Disclosures
• Plast Reconstr Surg. 2015;136(3):301e-309e.

3. • One limitation of autologous fat transfer in the
perioral region is the white roll; we and other
authors avoid fat transfer in the white roll
because of asymmetric and unpredictable take
secondary to increased movement.[29]
Bioengineered fillers should be first line for rejuvenating the white
roll, and autologous fat can be reserved for volumizing the deeper
perioral region.

4. Future of Medicine
Autologous Fat Transfer ‘AFT’
Anti-aging and Regenerative Medicine

5. Two Dominant Properties Of Fat
Grafts.
• Lipo- Structure: ‘Good Filler’
To Fill A Defect: Breast , Buttocks, Face
Contour deformities, Depressed Scars
• Fat Graft Rehydrates Facial Skin And Improves
The Patients Skin Quality : Regenerative effect
due to ? Stem Cells

6. ‘As Stem Cells’
ADSC’s (Adipose
derived Stem Cells)
are considered a
powerful source of
skin regeneration
because of their
capability to provide
cellular elements and
cytokines.

7. Adipose tissue (fat cells) is one of the richest
sources of MSCs. When compared to bone
marrow, there are more than 500 times more
stem cells in 1 gram of fat when compared to 1
gram of aspirated bone marrow

12. • It is observed that transplanted fat not only
adjusts facial and body proportion but also
improves surrounding tissues into which the
fat is placed.
• It not only the improves the quality of aging
skin and scars but also a remarkable
improvement in conditions such as radiation
damage, chronic ulceration, breast capsular
contracture, and damaged vocal cords is seen

13. Lipotransfer – Helpful for
• Aging and Wrinkles
• Acne Scarring
• Damaged Skin
• Scleroderma
• Facial Deformities
• Facial Reconstruction
• Body Contouring
• Augmentation
(Breast, Buttocks, Nose, Face)

14. Evolution of Fat Grafting
• 1893 German Surgeon (Adolf Neuber)
• 1983 Illouz’s Suction Lipectomy Introduced
Drawbacks: Resorption & Unpredictable results
• 1986 Ellenbogen reported the use of free pearl fat autografts
in a variety of atrophic and posttraumatic facial deficits
• Coleman Technique- Structural Fat transfer
• Present Studies –from Structural Fat Grafting

A Regenerative Procedure
(Stem Cells, Platelet Derivatives & Other Additives To Fat
Grafts)

15. Surgical Technique
• Fat Harvesting
• Fat Processing
• Fat Transfer

16. Fat Harvesting

17. Fat grafting Kit

18. Procedure
• Informed Consent
• Photography
• Marking of the Recipient
• Marking of the Donor area

19. Donor Areas: Selection
• Both Thighs
• Tummy
• Buttocks
Important Considerations
Symmetrical
Accessible
Unwanted Places

20. Tumescent Anaesthesia

21. Tumescent Anaesthesia
• Dr. Jeffrey Klein, a dermatologic surgeon, is
credited as the originator of the tumescent
technique, which has allowed liposuction to
be performed with the patient under local
anesthesia while minimizing blood loss and
the risks of GA

22. Composition Of Tumescent
Anaesthesia
• 0.1% lidocaine with 1:1,000,000 epinephrine,
into the subcutaneous tissues of a max.
concentration of 35 mg/kg
• The maximum plasma level that was reached
at 11-15 hours postoperatively was 0.8-2.7
mcg/mL, well below the toxic level of 5
mcg/ml

23. Harvesting

24. Processing: Centrifuging +
Decanting

25. Preparation of Fat for Transfer
• Centrifuging 3000rpm /1,200 g
• For 2 min
• Decanting the fluid and removal of
supernatant oil
• Transferring in to required syringes

26. Removing Oil & Fluid

27. Indications
• Rejuvenation And Soft Tissue Augmentation
Face: Nasolabial folds, Tear toughs, Chin,
Malar, Forehead
Hand: Dorsum
• Fat injection to the Nose, Face, Breast, Body
• Contour irregularities
• Acne and Depressed scars

28. Facial Asymmetry:
Scleroderma

29. Facial Asymmetry:
Scleroderma

30. Facial Asymmetry:
Congenital

31. Cheek Augmentation

32. Cheek Augmentation

33. Lip Augmentation

34. Fat Aspirate for Breast
Augmentation

35. Breast Augmentation

36. Breast Augmentation

37. Buttock Augmentation

39. Scars

40. Fractional CO2 Laser treatmet V/S Scar
Subcision & Autologous Fat Transfer in
Treatment Of Acne
Atrophic Hypertrophic
Rolling Boxcar
Icepick

41. Icepick Scars: Fractional C02 Laser
VS Subcision and Autologous Fat
Transfer
Conclusion:
Subcision with Autologous Fat transfer and
Fractional C02 laser were proved to be effective
in the treatment of acne scars. But the first was
more effective than the second particularly in
the treatment of icepick scars

42. Is Fat an Ideal Filler?
• Auotologous
• Completely Biocompatible
• Easily Accessible
• Regenerative Properties
• Available in Sufficient Quantities
• Potentially Permanent
• Naturally Integrated into host tissues
• Removable if necessary

43. Advantages for the Procedure
• A Simple Procedure
• Short Learning curve
• Dual Benefits (Removal from Unwanted Places
and addition to wanted Places)
• Out patient / Day Care
• As an Adjunct Procedure
• Minimum Adverse Effects
• Painless, Scarless

44. Complications
• Accumulation of Fat particles and visible
lumps
• Resorption and Relapse
• Facial asymmetry
• Fat Emboli?
• Donor site complications

45. Conclusion
• Conventionally Fat as a filler has become the
gold Standard for variety of applications
• Fat as a regenerator seems promising with
additional scope of applications
• Most importantly the ease of usage and
reproducibility and abundance availability is
going to increase its popularity

46. Dare to Dream…