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Page 6 of 10 Ohashi. Plast Aesthet Res 2020;7:26 I http://dx.doi.org/10.20517/2347-9264.2020.15

Table 5. Complication
Severe or moderate complication* 0 patients (0%)
Mild complication** 5 patients (1.9%)

*For example, infection and fat necrosis; **only temporary pigmentations
(inflammatory pigmentation and scars from needling)

Table 6. Volume change of fat after cryopreservation
Not centrifuged Centrifuged
Sent volume 169 mL ± 72.7 mL 143 mL ± 67.9 mL
Returned volume 59 mL ± 29.2 mL 76 mL ± 43.9 mL
% volume 34.4% ± 5.5% 51.3% ± 9.8%
Not centrifuged: only gravity; centrifuged: usually 700 ~ 1200 g, 3 min. Table 6 is used
with permission from Ohashi et al. [18] published in Plast Reconstr Surg Glob Open

A comparison of sent and returned fat volumes showed that fat volume decreased 34.4% if it was not
centrifuged before being sent, and decreased 51.3% if centrifuged before sending [Table 6].

5
5
SVF in fresh fat was 7.1 × 10 /mL (before sending) and 14.8 × 10 /mL in thawed cryopreserved fat (returned
fat) (n = 5). These amounts reflect the amounts of SVF/mL that were concentrated from cryopreserved fat
as compared to fresh fat.

We show some cases below
Case 1: facial rejuvenation using cryopreserved fat [Figure 4]
A 46 y.o. patient disliked her bony face and wanted to look younger. She did not want to undergo painful
harvesting many times. Therefore, we planned serial injections after one harvesting session followed by the
cryopreservation of her fat. She received facial rejuvenation surgery (first operation) involving fat grafting
to her forehead (20.0 mL), cheeks (8.0 mL each), and lips (1.5 mL each) with thread lift (Silhouette Soft;
Sinclair Pharma, London, UK) using the bidirectional floating method for her sagging cheeks, and her
residual fat was sent for cryopreservation. After her first operation, she received two more fat grafting
procedures using her cryopreserved fat within one year (three and six months after her first operation). She
looked younger and healthy after these operations.

Case 2: facial rejuvenation using cryopreserved fat [Figure 5]
A 47 y.o. patient hated her bony forehead and complained of looking older than her real age. Her first
operation involved facial fat grafting to her forehead (22.0 mL), malar area (3.0 mL each), cheeks (5 mL
each), upper and lower eyelids (1.0 mL each, and 1.5 mL each, respectively) and chin (2.3 mL) with lower
orbital fat removal. After her first operation, she received fat grafting using her cryopreserved fat two more
times within two years (6 and 18 months after first operation). Postoperative photographs [Figure 5] are
one year after her last fat grafting procedure using cryopreserved fat (3.5 years after her first injection),
where she appears more youthful than she did prior to her first operation.

Case 3: repeat rigottomy (needling) using cryopreserved fat [Figure 6]
A 41 y.o. patient had undergone breast implant removal and simultaneous fat grafting (SIEF) [19,20] . However,
three months after the operation, her right breast became deformed due to capsule contracture. Therefore,
we performed a rigottomy (percutaneous aponeurotomy) with fat grafting using fresh fat followed by serial
injections using cryopreserved residual fat. After receiving five total rigottomies with fat grafting (two with
fresh fat, three with cryopreserved fat), her breasts developed a nearly natural appearance.