Principles of Autologous Fat Transplantation

Autologous fat grafting has been a controversial subject for a long time. A century after it was first performed and 25 years after the first injection of fat obtained from liposuction, it seems that the technique is finally being accepted by the plastic surgery community. Fat grafting has strong advocates as well as strong critics. It has always been clear that fat should be the best substitute for soft tissue loss, but the initial attempts to transplant fat were considered a failure, because of the partial loss of the original graft. It was the pessimistic way to look at the technique; instead of seeing the cup half full they were seeing it half empty. Once a 50% survival of a fat graft was acceptable, we started improving the technique and getting better results. With the development of liposuction, the process of harvesting fat became an outpatient procedure. The difficulty was to establish the technique’s uniform parameters. Since our first cases, we have been developing a system to harvest, treat, and inject the fat without damaging the cells to obtain a safe and reliable result. There are three different phases of the technique. They are all important and should be performed with care. Recently the development of adipose stem cell techniques promises great improvement and the possibility of harvesting, growing, and injecting fat. The technique is relatively new and needs further studies to guarantee its safety.