Fat grafting is not new. But we are getting better at it by studying it.
There are all sorts of claims out there of ways to increase fat survival. Which of these are necessary? How much do they help? What are the issues with them? I love the analogies to gardening and new plants. If you think in this way, the whole fat transfer and graft thing makes more intuitive sense.
We are still at the beginning of our new era of fat grafting. We know some basic really low tech things:
- Time is critical. Fat cells do not last well outside of the body.
- We need to prep the recipient site to make it a more fertile bed. We know that preexpansion and volume maintenance may help with this.
- How we harvest is important. There is an ideal fat globule size- if the fat globule is bigger than this, we get increased fat loss, as it can’t get enough blood supply so it dies.
- The processing of the fat is important- what pressure are we removing the fat at? Hand held syringes seem less traumatic, but a study showed that how much you pull the syringe has an effect. So a teeny tiny 10cc syringe when pulled back to 10 cc has 600mm of pressure. (!) This is more than a liposuction machine at low or medium setting, and too much to not damage the fat cells.
We get some feedback on how we are removing the fat. The more oil we see, the more cell damage there is. When the cell wall is hurt, there is release of LPH, triglycerides, and increased enzyme activity. These all indicate damaged fat cells. Damaged fat cells don’t live.
So. Be gentle to your newly moved plants. Remove them gently, handle them with care, put them in a new fertile bed, and water them well.