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Original Article Plastic and Aesthetic Research

Differential fat harvesting

1
Sebastian Torres Farr , Angelo Trivisonno 2
1 Department of Cranio Maxillofacial and Aesthetic Surgery, Clinica Santa Rita, 95124 Catania, Italy.
2 Department of Plastic Surgery, Sapienza University, 00185 Rome, Italy.
Address for correspondence: Dr. Sebastian Torres Farr, Via Monti Peloritani 2 C, 95030 Catania, Italy. E-mail: info@sebastiantorresmd.com

ABSTRACT
Aim: Volume replacement with fi llers is regularly performed with the use of diverse volumetric materials
to correct different structures around the face, depending on the volume enhancement required and
the thickness of the soft tissue envelope. Differential fat harvesting and posterior grafting is performed
to place the correct fat parcel size for each target area, expanding the potential applications of fat.
Methods: Sixty patients consecutively recruited on a fi rst come basis undergone a facial fat grafting
procedure, in private practice setting between March 2012 and October 2013. Fat grafting quantity and
quality was predicted for each case. Differential harvesting was performed, with 2 fat parcels size.
Processing was performed through washing. Fat infi ltration was carried out through small cannulas
or needles depending on the treated area. Outcomes were analysed both by the physicians and the
patients at 7 days, 1 month, 3 months and 6 months through a perceived satisfaction questionnaire.
Parameters considered were downtime or discomfort, skin benefi ts, volume restoration, reabsorption
rate estimated and overall improvement. Results: Full facial differential fat grafting procedure lasted
an average of 1.5–2.5 h. Average downtime was 3–4 days. Follow-up was performed to a minimum
of 6 months. Both patient and physician overall satisfaction rates were mostly excellent. Adverse
events like lumps or irregularities were not encountered. Conclusion: Differential fat harvesting and
posterior grafting is a valid alternative, to expand the repertoire of fat use, allow a more homogeneous
effect, reduce the potential complications, speed up the process, improve graft survival, and to enhance
overall aesthetic outcome.

Key words:
Adipose stem cells, differential harvesting/grafting, facial fat grafting, mesofat, sharp needle intradermic
fat grafting

INTRODUCTION The former technique presents several limitations and
complications especially in the lower eyelid region. In this
[2]
Volume replacement with fillers is regularly performed area, the gross fat parcels cannot be hidden by a thin soft
with the use of diverse volumetric materials to correct tissue envelope without risking overcorrection or lumps.
different areas around the face, depending on the volume Micro fat grafting has been proposed as an option
enhancement required and the thickness of the soft tissue to bypass the former problems, and to extend the
envelope that allows concealing the product.
application of lipostructure to the sup erficial layers of the
Fat grafting, according to Coleman, has been traditionally skin. However, this is time consuming and inefficient in
[3]
[1]
done with tissue harvested with 2 mm port cannulas volume restoration. Moreover, harvesting through small
which only allows a gross correction of volume. hole cannulas can affect the integrity of adipocytes. [4,5]
Fat processing is another key factor in fat grafting, which
Access this article online allow us to get rid of all the toxic and inflammatory agents
Quick Response Code: that may affect graft retention. Centrifuging, washing
Website: and decanting have been proposed as valid alternatives.
www.parjournal.net
Nevertheless, recent data suggest that strong centrifugation
can damage adipose graft integrity and decanting is not
DOI: able to get rid of the oil vacuoles present within the graft.
10.4103/2347-9264.143556 Washing, therefore, remains as the single most important
phase in fat processing. The same authors have proposed
[6]
Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014 103