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Lipofilling: an emerging field of new application


Hilkka Peltoniemi, MD, Klinikka 22, Finland


Yves Surlemont, MD, Clinique Saint Antoine, France


Inge Matthiesen, PhD, discusses the potential of lipofilling procedures with Hilkka Peltoniemi and Yves Surlemont.


tissue is now considered an ideal filler for soft-tissue augmentation because it is biocompatible, versatile, natural-looking, readily available, and can be harvested and re-injected easily and repeatedly by water-jet assisted fat transfer, with minimal trauma.


L


What kind of indications do you treat with water-jet assisted autologous fat transfer? HP There are a variety of applications. I do fat grafting for breast augmentation, and for the treatment of breast asymmetries, breast anomalies, and reconstruction after mastectomy. I also use autologous fat transplantation as a salvage procedure during implant


I P OFILLING holds much promise in plastic and reconstructive sur ger y . Autologous fat


removal after problems with encapsulated or ruptured implants. Autologous fat from water-jet assisted liposuction is well suited for the correction of surgical soft tissue defects and scars, rejuvenation of the face and hands, and augmentation of buttocks and calfs. I have also treated patients with scoliosis deformities and general soft tissue defects. YS I do fat grafting when there is a lack of volume — reconstructive (breast malformations, thoracic breast deformities, breast reconstruction) or aesthetic (augmentation), or in complications after breast implants. Of course, there must be enough fat to be harvested, the BMI should be 20 at least, or rather, over 22. Autologous fat is biological and long-lasting. In contrast to the use of implants, there is a low rate of complications, and it is a precise material, which you can graft exactly where needed. This also applies to the rest of the body, and especially the face. And don’t forget that fat increases skin quality, which is not the case with implants or hyaluronic acid.


From which areas do you harvest fat tissue for autologous transplantation? HP The fat is taken from a number of areas, such as lateral and medial thighs, waist, axillary rolls and then transferred to the breasts, face and hands. In many cases, the patients had other liposuction or lipolysis treatments before, with uneven results, which I have corrected with a combination of liposuction and transplantation.


How many patients have you treated? HP I have treated approximately 130–140 patients, representing 160–170 procedures. Patients are coming back for another transfer whenever they have extra fat — now they know what to do with it. I have carried out around 500 liposuction procedures. YS I have been treating patients with fat grafting since 1999 and I’m doing a lot of procedures with either fat grafting alone or combined with other procedures for the breast, face, buttocks or other indications, with an average of five fat grafting procedures per week.


Why did you choose water-jet assisted fat transfer with the body-jet® and the LipoCollector? HP I use water-jet assisted fat transfer because this method is efficient, atraumatic, safe, and simple. I appreciate its good fat quality and cell vialbility, and that there is no need for processing like centrifugation. The body-jet® system offers good possibilities for body contouring — not just for the collection of fat. Besides, it is an efficient tool for a woman who does not have masculine muscles. YS For small volumes I use the Coleman technique, but as soon as I need more than 20–40 cc I use the water-jet technique because: ■ It goes faster. I need an average time of 5 minutes to get 100 ml of fat + solution under general anaesthesic, and 15 minutes under local anaesthetic with sedation


■ It is a closed system and there are very few manipulations of the fat before grafting


■ The fat is liquid and very easy to graft precisely


■ As shown in the MRI volumetry study1


, you may be able to


predict the result for breast augmentation


■ There is less pain and less haematoma on the donor sites, so the patient will come back without any fear if a second procedure is needed.


Are you planning any new clinical studies on water-jet assisted fat grafting? HP A retrospective clinical trial on the de novo breast reconstruction with autologous fat grafting in post-mastectomy patients has just been completed. Three European centres participated in this study, with Dr Ueberreiter in Germany, Dr Surlemont in France, and our centre in Helsinki. Autologous fat grafting was carried out using water-jet assisted fat transfer according to the standardised protocol of the BEAULI Method. The study will be published this year.


Reference


1. Ueberreiter K, von Finckenstein JG, Cromme F, Herold C, Tanzella U, Vogt PM. [BEAULI ® a new and easy method for large-volume fat grafts.] Handchir Mikrochir Plast Chir 2010; 42(6): 379–85


prime-journal.com | July/August 2012 ❚


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