Four Techniques to Avoid Implant Puncture While Fat Grafting

Multiple polyurethane implant punctures during fat grafting: case report and review of the literature

“…The literature on the possible implant injury during FG is scarce [31][32][33][34][35]. The authors mainly discuss the advantages of FG and usual complications as nonpredictable graft take, irregularities, infection, cysts, fat necrosis [30,[36][37][38].…”

“…The more slowly the surgeon moves the cannula the more force he or she needs to rupture the implant [34]. Some authors recommend the 'sweep technique' which means that the cannula does not move freely from left to right being in subcutaneous tissues (as opposed to the implant pocket) [35]. However, if the implant is already punctured by the cannula the movements of the cannula from left to right will be also constrained.…”

“…FG and implant placement can be done simultaneously or in several stages. In case of simultaneous surgery, the surgeon can perform FG on the old implant or using a sizer, introducing the implant after FG or protecting the implant and visualizing its integrity before the wound closure if FG is performed after implant placement [ 6 , 35 , 39 ]. Grafting after the implant placement has the advantage of precise shaping and volume control [ 40 , 41 ].…”

“…FG should be performed subcutaneously [ 6 ]. We recommend to use multiple injection points and multiple passes not only to distribute the fat evenly but also to reach recipient areas easier which may contradict the experience of other surgeons who advise to avoid multiple passes in areas with less protection [ 35 ]. Longitudinal injection technique also may help to avoid deep injection [ 33 ].…”