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Page 8 of 10 Ohashi. Plast Aesthet Res 2020;7:26 I http://dx.doi.org/10.20517/2347-9264.2020.15

Figure 6. Csae 3: repeat rigottomy (needling) using cryopreserved fat. (left) after 3 months postoperative follow-up. Her right side
residual capsule was greatly shrunken; (middle) her appearance when she holds up her right arm; (right) after receiving a total of five
rigottomies with fat grafting (two with fresh fat, three with cryopreserved fat). This figure is used with permission from Ohashi et al. [18]
published in Plast Reconstr Surg Glob Open

Figure 7. Case 4: hand rejuvenation using residual fat. (left) Before operation. (right) After injection of cryopreserved fat, veins covered
with fat and unremarkable. This figure is used with permission from Ohashi et al. [18] published in Plast Reconstr Surg Glob Open

Case 4: hand rejuvenation using residual fat [Figure 7]
A 65 y.o. woman received fat grafting for breast augmentation and requested her cryopreserved residual fat
be used as well. Four months after the first operation, she received fat grafting in her hands (16.0 mL for
each hand) for hand rejuvenation without any additional harvesting needed.

DISCUSSION
Fat grafting is a major procedure for volume augmentation of areas such as the breasts, buttocks, and face.
It has become clear that there are other merits of fat grafting including but not limited to skin rejuvenation,
improve of fibrous scars, burn relief, alleviation of scleroderma symptoms, and healing of radiation damage.
This is due to the revitalization/fertilization and regenerative effects of fat [4,7,21,22] .

However, one of the biggest demerits of fat grafting is the unpredictable nature of results involving varying
maintenance rates for volume augmentation and the unpredictable degree of revitalization/fertilization and
regeneration effects.

Due to varying effects, we often administer repeat injections to achieve satisfactory results. But repeat
harvesting of fresh fat has detrimental impacts on patients with regard to pain and high costs. Therefore, it
is in the interest to both aesthetic/plastic surgeons and patients to be able to preserve and use cryopreserved
fat.

There are concerns regarding the viability of cryopreserved fat [23,24] . Many authors have recently suggested
that slow cooling and fast thawing with cryoprotective agents may improve the viability of stored fat to a
degree comparable to that of fresh fat [25-27] .