Fat grafting involves harvesting fat from areas like the abdomen through liposuction and refining it to separate viable fat cells from other components. The purified fat is then reinjected into areas like the face and breasts through microdroplet injections between skin layers to augment volume. Potential complications include irregular contours, necrosis of grafted fat, and infection. However, stem cells found in fat tissue are also being researched for uses like wound healing, skin engineering, and repairing various organs. Fat grafting is a popular aesthetic procedure that has been improved through techniques preserving high viability of transplanted fat cells.

2. Fat Grafting
DR. MUJTUBA PERVEZ KHAN
PLASTIC AND RECONSTRUCTIVE SURGERY
DUHS-CHK

3. Biology of Fatty Tissue
• Connective tissue composed of
adipocytes along with stromal cells,
adipose-derived stem cells (ADSC),
mesenchymal stem cells etc.
• Contributes in energy storage,
thermoregulation and cushioning
• White and BrownAdipose tissue
• Subcutaneous adipose tissue is the
largest known reservoir of adult stem
cells

4. History
• The first report of fat grafting was in
1893 by German surgeon Neuber
• Fat grafting was considered difficult,
time consuming and unpredictable
• Dr Coleman in 1990’s documented
stability in fat grafting with his
technique

6. Indications
• Aging (most common)

7. Indications
• Aging (most common)
• Breast Augmentation
• Post Mastectomy breast
reconstruction
• Hand Augmentation
• ButtockAugmentation
• Hemifacial Microsomia
• Treacher Collins syndrome
• Filling of depressed areas
resulting from trauma/injury
• Liposuction deformities

8. Fat Harvest
• Common sites of harvest
• Layers of fat
• For small volume
0.5% lidocaine with 1 : 200 000
epinephrine
• For large volume
0.2% lidocaine with 1 : 400 000
epinephrine

9. Fat Harvest
• Harvesting cannulas
• Dry,Wet and Super wet
(tumescent) technique of fat
harvesting

11. Fat Refinement
• To separate non viable
components (blood, oil and
local anesthetic)
• Gravity sedimentation, telfa
pads or centrifugation
• Centrifuge at 1286 g for 2 min
minutes for smaller volumes
• yields relatively pure fat for
grafting and a more predictable
volume

12. Fat Placement
• Mapping technique, Reverse
Liposuction technique
• Grafting below the dermis
improves quality of skin,
reduces wrinkles and scarring
• Grafting above the periosteum
changes the shape of the
face/body
• Transfer of large globules can
result in central necrosis with
resorption and loss of volume

14. Complications
• Aesthetic (commonest)
• Fat necrosis
• Contour irregularities due to
over grafting
• Intravascular embolization
• Weight gain can change the
size of the are grafted
• Infection

18. Future
• Adipose derived stem cells for:
1. Wound healing
2. Skin re-engineering
3. Skeletal reconstruction
4. Liver regeneration
5. CNS repair and regeneration
1. Diabetic retinopathy
2. Bladder regeneration

19. THANK YOU