Fat Transfer: Q&A
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Fat Transfer Without Any Centrifuge?
I had an appoint with my Dr. and he proposed doing a fat transfer to help with depressed scars (which he created doing a botched DeepFX laser procedure). He was proposing to correct the scars, correct the under eye and other facial areas to help correct the fat loss and the traumatic damage done by the laser.
I asked him if he planned to add Platelet Rich Plasma to the fat (an increasingly popular protocol). He said no; that he would use the fat straight as it came out of the body. No centrifuge or anything. He felt that the less you did the better.
From the research I’ve done, centrifuging the fat is a standard approach. Introducing fat with body fluids would seem to increase inflammation and reduce effectiveness. Plus, I am concerned that the uncentrifuged fat would be difficult to apply smoothly in the undereye area without the smoothing effects of the centrifuge.
I was also worried when he said I would be very swollen for a week (i.e. he stressed I would have to stay home) with obvious swelling for at least two weeks. He stressed the difficulty of the recovery. My gut tells me to not do it, even though I could use the improvement in my scars.
Please let me know your opinion of using fat straight form the body; am I off base my reacting so negatively to this approach? I think I may need to find a new doctor since he botched a laser procedure then the there's a possibility of a botched fat transfer!
Thank you for you insights, Dave
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14 Doctor Answers |
Asked by
deepfx injury
in Chicago
+3
Just like every powerful tool, the impact comes from the craftsman, not the tool.
Hi Dave,
Trust is very important in facial cosmetic surgery. If you trust your physician to do a good job on you, then stick with him. It never hurts to get many other "second" opinions before committing to a treatment.
Management of fat for fat transfer varies among physicians. I have transferred fat both directly after straining it, as well as after centrifuging it. There are many very fine Beverly Hills surgeons who have used simple straining for fat transfer with excellent,...
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+2
Centrifuging is not all the same
Many doctors talk of their own anecdotal experiences, but what do the studies show:
1- Centrifugation at 1287G's (common to most physicians) will kill the majority of the cells.
2-Centrifugation at 50G's for no more than 2 minutes will filter the live fat from the contaminants with minimal to no trauma to the fat. The only system doing this is the Viafill System.
3- Fat is exactly like chicken soup. If you pour water on the fat, it will die and look like those oile...
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+2
Fat transfer best done without centrifuge.
Hi.
I know that centrifuging is very popular. But in New York City, we wash the fat without centrfuging it, with good results. Less trauma. Several of the best fat transfer surgeons do this.
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+2
Hold off on this treatment
As you can see from the other answers, there are many acceptable ways to do fat transfer. You should also read from your doctor's advice that this is a real surgical procedure to transfer fat to your face. This invoves real recovery, swelling and possible bruising. He is trying to set your expectations for recovery at a realistic level so you won't be disappointed that he made the process sound simpler than it turned out to be. He has already had one problem in your care and doesn't...
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+2
Consider fillers instead
From the tone as well as the words, you have lost trust, and the doctor patient relationship is strained. From what he is saying, it seems to me like he is reluctant. Think about it.
Many people do not centrifuge the fat. Adding platelets is a body fluid, and thus doesn't jive with your theory. However platelets are rich in growth factors that are thought to increase take of the fat transfer. Again, not all surgeons use it. There is a risk with giving any body fluids as it relates to...
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+2
Consider non-ablative fractional laser for scar correction
I strongly agree with Dr. Persky that you should get a second opinion.
Any scarring that has occurred due to DeepFX treatment is caused by damage to and loss of collagen in the dermis layer of your skin, not the fat. Trying to replace lost dermal collagen with a deep fat injection is unlikely to correct the problem.
The best way to correct a dermal scar is to replace dermal collagen. Filler injections can help, but they are temporary.
New non-ablative fractional laser treatments using a 1540...
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+2
Follow your instinct
There are many different protocols used for fat transfer today. Spinning the fat before the transfer is only one of them (and the one, I personally use). Other surgoens blot the fat with sterile gauze or put it through a strainer. And they do report good patient outcomes which is all that counts at the end!
Although less frequently, some plastic surgeons may find a direct transfer without further handling of the fat useful. Personally, I see a few potential issues/ disadvantages with such a...
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+1
A Centrifuge is Not Essential to Successful Fat Grafting
There are many "latest and greatest"modifications in fat grafting but to date there is no standardized approach. The reason for this is that if there was overwhelming scientific evidence of the superiority of one technique over another then this would be the standard. This is not the case. There are many variations such as use of a centrifuge, and using enriched growth cell factors (e.g.Platelet Rich Plasma) or enriched stem cells but at present I have not found this to...
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+1
Fat transfer techniques vary
Dr. Coleman and other pioneers in the field of fat transfer use a centrifuge of various types during the fat transfer process. Others have developed successful fat transfer protocols that don't use centrifugation, and have excellent results. Injection technique is probably the most important aspect of successful fat transfer procedures.
+1
Centrifuge and fat
With fat grafting the proper technique of harvesting and injection are much more important than whether you centrifuge or not
+1
Fat transfer without centrifuge
Fat transfer is a very powerful and effective technique to recontour the body and face. When we perform this technique we perform liposuction to different areas of the body and then cleaned and process this fat before transferring it to another part of face. Keep in mind that successful results of a fat transfer depend on the quality of fat that is used and the technique for cleaning and transplanting the fat. One method to clean the fat is through a centrifuge. However, this is not the...
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+1
Many things can affect your fat transfer procedure
I think that you doctor is right to some degree regarding platelet rich plasma and centrifuging the fat. Fat can be something that can improve scars. Although I think depressed scars are a little harder to correct with fat grafting. Fillers were suggested by another doctor but you better be ready to continue to pay for additional filler every year or less to keep the condition corrected.
Platelet rich plasma will only introduce more inflammation to your fat transfer and will ultimately...
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+1
Centrifugation of harvested fat for fat grafting
Fat used for fat grafting is harvested from the abdomen, thighs, hips or buttocks using specially-designed instruments and a specialized technique. Centrifugation eliminates components of the harvested material (which is not viable fat), and meticulously injected into the facial areas to be enhanced. As some of the other surgeons have pointed out, you seem to have lost confidence in your surgeon. I agree that it is best for you to take some time before proceeding with fat grafting....
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+1
Consider Fillers prior to Fat as a trial run
I would agree with all that has been said, namely:
1) management of fat varies among surgeons
2) platelet rich plasma is unproven and very costly
3) communication and the patient-doctor relationship is very important in ongoing care
However, I would add one additional piece of information. Before undergoing another surgical procedure, why don't you try a subcutaneous filler such as Perlane to see if it achieves the goals you desire. It may or may not produce the desired results in the...
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