I love fat grafting, as many of you know. The recent October 2014 issue of Plastic and Reconstructive Surgery Journal had an article on “Comparative Analysis of Processing Methods in Fat Grafting.” It was a study out of Boston.
What was it trying to find out?
When we do fat grafting for fat transfer, we harvest the fat with liposuction. Then most of us process the fat using a filter or centrifuge to help concentrate the fat and remove any things we don’t like (like oil, damaged fat cells, blood, etc). So this study is trying to add some science to figure out what is the best way to process the fat.
Ways to process fat include:
- Centrifuge (34% use this method. You put the liposuctioned fat into syringes. Then you centrifuge, wick off the liquid and oil, and transfer into smaller syringes)
- Mesh filtering (place the liposuctioned fat over pourous mesh, rinse, and drain the liquid part using gravity. Then you transfer into syringes for transfer.)
- Telfa (you roll the fat over Telfa gauze, which absorbs the liquid)
Their study looked at a few key points:
- Does the centrifuge speed affect things?
- Is the centrifuge better than the mesh technique?
- How is it making fat grafting better?
Technique They looked at liposuctioned fat from 9 women. Each experiment was done with fat from an individual patient, so the control group was from that person. The harvesting was done with a 4mm cannula at 1 atm of suction pressure. They then did their tests and looked at histology.
Findings:
- Centrifuge is better than gravity separation because it concentrates the fat. When compared with a filter or Tefla, there is no evidence is is better.
- When looking at different centrifuge speeds there was no improvement in concentration over a speed of 5000g
- Prior stuies showed a linear increase in graft take as the speed was increased up to 10,000g
- Another study whoed graft take was higher graft survival at 4200 g than 1200 g but then went on to conclude 1200g was optimal.
- They added back things into the fat sample, to compare fat alone vs. fat mixed with fluid/cell pellets/oil. There was no single spinoff component which affected the graft yield more than others. FAT CONCENTRATION was the most important determinant of graft take.
- Stem cell analysis showed similar numbers between centrifuged and mesh groups.