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The opinion of the majority of surgeons is fat grafting does not work. The fat cells do not survive transfer. Many have attempted the techniques only to become discouraged and abandon it. This article describes certain principles necessary for successful fat grafting: for harvesting use of a large-diameter syringe and needles, an atraumatic method of cleaning the fat cells, and an anaerobic method of storage. A method of autologous fat cell transfer including harvesting, processing, and injection of the fat is described. Long-term results are shown and limitations of the procedure are presented.

A method for measuring skin removed during rhytidectomy is presented based on analysis of 50 female patients. More skin was removed in primary rhytidectomies than in subsequent ones. Younger patients, aged 30 to 39 years, had measurably more skin removed than any other group between 40 and 69. The amounts of skin removed from the two sides of each patient's face were nearly equal in most cases. In those few cases where the skin excisions were unequal, there were still no significant differences between the two sides. The method described for measuring skin excisions is easy, rapid, and convenient.

The fluorescein test is a useful ancillary procedure for predicting the viability of breast flaps in reconstructive procedures after subcutaneous mastectomy or radial mastectomy.

Lipoplasty provides a new method of removing subcutaneous fat and contouring the neck. This author reports his experience in 50 cases. A total of 35 patients were done in conjunction with a rhytidoplasty, and 15 patients had lipoplasty as an isolated procedure. The series could be divided into halves. After 25 cases, several undesirable results were noted, including discomfort (15 of 25), nodularity (6 of 25), and contour irregularities (3 of 25). Modifications were made in the technique and postoperative treatment, including a smaller-diameter cannula, more extensive dissection with feathering, multiple incisions and cross-tunnels, and the postoperative use of massage and ultrasound and an elastic head garment. Subsequent patients had reduced morbidity and improved operative results. A detailed account of the operative procedure is discussed. Photographic documentation of results is given. This author's initial experience with lipoplasty of the neck indicates early problems, solutions, and results. The technique is viewed as a useful addition to the armamentarium of the plastic surgeon.

We report our experiences in 100 consecutive face lifts done in a well-equipped office operating room, and we believe the results answer the question about the safety of face lifts being done in this manner in a carefully screened population. With the application of our preoperative criteria for patient selection, the complication rate in these outpatients compares favorably with the reported rates in inpatient series of face lifts. Patient satisfaction has been higher, we feel.

A case report of an unsuspected inflammatory carcinoma developing in a 33-year-old woman after silicone injections is reported. Biopsy of the edematous skin is recommended as a diagnostic tool. Since this case report was submitted, three additional patients have been noted to have carcinoma of the breast following silicone injections 6 to 8 years before. One patient of Dr. Matthew Gleason, of San Diego, was 33 years of age and two patients of Dr. Edward H. Kopf, of Las Vegas, were 31 and 32 years of age.