Autologous fat graft survival depends on gentle handling

The popularity of body contouring with fat grafts is growing in direct proportion to the variety of systems and techniques employed to accomplish it. Whether autologous fat transfer (AFT) is used to repair dents or dimples resulting from liposuction or traumatic injuries that leave a patient's physique less proportional than nature originally granted — or to pump up the volume on small or ptotic breasts — all fat grafting relies on a three-step process of harvesting fat, processing fat and injecting fat. The distinction — and the outcome — primarily lies in how the fat is processed.

Mark Berman, M.D., a fat grafting proponent and private practice cosmetic surgeon in Los Angeles, says any fat graft will work — at least temporarily — but how well it works depends on the technique used.

"The more stem cells that are included in the injection, the better and longer-lasting the results," Dr. Berman says. He uses the Korean developed Lipokit system (Medi-Khan), which he says enables him to maximize his fat-grafting outcomes. The system uses a syringe harvest technique that concentrates the healthiest fat and stem cells while it removes most impurities from the harvested fat, and this, he points out, provides an 80 to 90 percent survival rate of the transplanted fat grafts.

"I like to use fat injections mostly in the face, but it can be used effectively anywhere in the body," Dr. Berman says. "For example, if someone had a defect in their thigh from liposuction, you can put fat back into it to correct that. If they have a defect in their buttock from an injection of a steroid that caused a lot of fat atrophy, you can inject fat back into it and fix it, and likewise, if somebody had a traumatic injury and lost fat because of it, you can inject fat back into it to fix it."