Fat cells are transfer from donor area most commonly lower abdomen, thigh or buttock to the recipient area like face, scalp and other area. Parcels of adipose tissue has autologous stem cells popularly known as adipose derived stem cells (ADSC) or also known as stromal vascular fraction (SVF).The SVF and ADSC are heterogenous populations of multipotent mesenchymal stem cells. these are used to treat lipoatrophy of face, to decrease inflammation and pain associated with osteoarthritis and even to treat scleroderma. Now days fat cells transfer is used for hair growth and aesthetic refinement of face.
In 1893, for the first time in the history of plastic surgery, the German surgeon Gustav Neuber (1850- 1932) transferred parcels of adipose tissue from the arm to the lower orbital margin to correct adherent scars resulting from osteomyelitis; this produced a pleasing aesthetic outcome.
Systemization of The Fat Injection Procedure
In the 1990s Sydney R. Coleman, with his vast experience with autologous fat transfer, reemphasized the importance of the most atraumatic technique for fat harvesting and placement to preserve fragile adipocytes.
Coleman Fat Grafting Technique
⦁ Harvesting. The goal is to collect small parcels of adipose tissue or cell clusters without interfering with cell visibility. A syringe is considered a better option with respect to lipoharvesting instrumentation.
⦁ Processing. The aim is to create the purest graft possibility by removing blood, cell debris and fatty acids. Apparently, these components stimulate an inflammatory response, which may result in graft degradation. Current methods of processing include centrifugation, decanting, filtration, straining. Centrifugation is the most common procedure. Damage to adipocytes is reported by exposure to open air and cell lysis. Tissue filtration has numerous proponents, because a closed system within a sterile field used.
⦁ Placement. Choice of the appropriate type of cannula is of paramount importance. For facial fat grafting an 18- or 22-gauge blunt cannula should be used for placement. Delivery includes the deposition of small threads of fat in a retrograde way and in multiple tunnels. To enhance the contact between the graft and the surrounding tissue only minimal aliquots should be transferred avoiding bolus.