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According to Eto et al., micro fat lobules are easy to its popularity and interest in the medical community. It
[10]
inject, have a greater three-dimensinal cellular interaction has also created greater confusion widening the possible
and generate less nodules or bumps incidence. Moreover range of variables regarding fat grafting. This has been
they have greater versatility of use, being placed reflected in recent publications that try to obtain a recipe
using cannulas or needles and in different anatomical for the correct technique. [12]
planes (subcutaneous or intradermal). Recently, it has
been proposed that greater tissue disruption obtained The goals of a fat grafting treatment are: volume
with smaller cannulas has been associated with higher restoration and skin regeneration. Volume is determined
amount of ASC in the lipoaspirate, especially of the mainly by the adipocytes, and the process known as
superficial layers of fat. [11] primary adipocyte integration should be considered a
primary goal within the treatment.
Indications for thin fat parcels harvesting include: the
treatment of facial critical areas of delicate skin with Cellular regeneration, is principally explained by the
thin soft tissue envelope (like periorbital, temporal and presence of ASC in the lipoaspirate. It is an important
perioral regions), the delivery of fat through needles (SNIF event, but it is not the only factor involved.
or Mesofat techniques), [7,8] main treatment goal to be skin Cannulas port size affects directly the adipocytes. The
regeneration, and the use of fat for ASC enhancement larger the aspiration cannula, the greater the viscosity,
through filters. retention and quality of the graft. [4,5]
Nevertheless their extraction is much slower than On the other hand the smaller the cannula size, the lesser
traditional harvesting. Furthermore, reduced diameter or the viscosity, and higher tissue disruption, oil content
ports from harvesting cannulas generate greater adipose and amount of ASC within the graft [Figure 7]. A fluid
cells stress, cellular breakdown and oil content in the grafts allows needle or fine cannula placement and avoids
harvested tissue, resulting in less viable adipose cells, irregularities in critical areas.
with greater necessity of fat processing (washing or
centrifugation) [Figure 6]. [4,5] In this context, the concept of differential harvesting is
raised.
All above, has put micro lipofilling into fashion, increasing
The term differential fat harvesting stands for fat
harvesting through different cannulas (port sizes or

Figure 3: Clinical case 2. Patient before, intra operatory design, and
6 months postoperative
Figure 4: Clinical case 3. Patient before and 12 months postoperative

Figure 5: Global patient scores graph on satisfaction questionnaire and Figure 6: Different cannula port sizes and time needed for harvesting
trend line and amount of fat and oil extracted
106 Plast Aesthet Res || Vol 1 || Issue 3 || Dec 2014