Soft tissue augmentation with autologous fat graft: The dissected pouch technique

Abstract

Background:Soft tissue augmentation with autologous fat graft has been increasingly used by plastic surgeons despite unpredictable results. Several techniques have been described to prevent the main setback of this technique, fat graft resorption. However, there is no ideal technique described for this purpose.Materials and Methods:Twenty patients with subcutaneous tissue loss, atrophy or hypoplasia were treated with lipofilling. A subcutaneous pouch is dissected at the deformed area and later it is filled with autologous fat graft.Results:Graft maintenance during the postoperative period was satisfactory. Overcorrection was not performed except for the first three cases. Patient, surgeon and layman satisfaction was surveyed. Satisfaction was rated between 0 and 10. The mean score was 7.67 ± 1.22.Conclusion:The authors describe a technique for soft tissue augmentation which effectively corrects contour deformities, provides a low resorption rate and a relatively non-visible scar without causing irregularities.

Selective Augmentation of Stem Cell Populations in Structural Fat Grafts for Maxillofacial Surgery

“…Fat grafts can be placed in such a manner that these grafts are long-lasting, completely integrated, and natural looking. The transfer technique is also known as structural fat grafting (SFG), or lipostructure, and requires the centrifugation of fat and its implantation into a specific site to be restored [29] , [30] . Currently, no attention has been given to the stemness properties of the cells that are injected into the patient.…”

Surgical Management of Progressive Hemifacial Atrophy With De-Epithelialized Profunda Artery Perforator Flap: A Case Report

“…The results can be improved or maintained with the use of tissue-derived stem cells and proper centrifugation technique, but fat injection and en bloc technique also provide a low absorption rate with a relatively non-visible scar. 13,14 The body type of the patient can also be a problem, as it is very hard to harvest fat tissue from skinny patients.…”

Fragmented Adipose Tissue Transplanted to Craniofacial Deformities Induces Bone Repair Associated with Immunoexpression of Adiponectin and Parathyroid Hormone 1-Receptor

“…From a clinical perspective, unlike the centrifugation or decantation approaches in obtaining adipose tissue and its stem cells, the manipulation of adipose tissue by fragmentation may help to remove the aqueous and oily components, thus decreasing reabsorption and dehiscence formation during the wound-healing process (Khater, 2009; Livaoğlu and Yavuz, 2009). According to Gomes et al (2012), the fragmented white subcutaneous adipose tissue (WSAT) maintains the presence of CD34+ stem cells, which are the principal progenitor cells responsible for angiogenesis and in differentiation into osteoblast and adipocytes, as well as for maintaining the presence of adipose cells, which synthesize adipocytokines, and collagenous septa, which act as a scaffold for osteoprogenitor cell adhesion.…”