Fat Transfer Using Inner Knee?

In my practice I have found very good success with fat harvested from the inner knee.  In my extensive experience with fat grafting, I have found that harvest technique and harvest equipment make much more of a difference regarding fat graft survival than harvest site.  Atraumatic harvest and injection of fat cells with little exposure to air are the keys to cell survival at the graft sites.  While the inner knee is not my first choice for harvest it provides a convenient option when small volumes of fat are needed for primary or touch up cases.

Generally, the best areas to take fat from are the inner and outer thigh and abdomen.  The survival is dependent on technique both removal of the grafts and subsequent injections.   Knee fat is good as well.  Basically, the less fibrous the source the better.  Sometimes, it is a matter of where you have the most easily accessible fat.  I usually, engage my patient in the decision making process. 

I hope this helps,

Dr. Amir Karam 

Fat injection remains controversial relative to technique and outcome.  Studies are now underway to answer some of the fundamental questions about the biology of fat injections (even though we have been injecting fat for years).  The inner thigh has been touted as a good area from which to harvest fat but I have seen no scientific evidence that it is any better than other areas.

 

Typically areas that have the softest and healthiest fat are the easiest to harvest from and thus the fat graft stays healthier.  Conversely areas where the fat is firm and there is a great deal of fibrous tissue require more aggressive techniques to remove the fat and the survival is compromised.

The fat along the inner thigh and knee is a good source for fat grafts. I don't think anyone has conclusively demonstrated improved survival of fat grafts taken from one region vs. another. Certainly fat that is relatively more difficult to harvest (back fat, for example) because of it fibrous character, is probably traumatized more during the harvesting process. 

It really depends on the change in volume that occurs with weight gain or loss. I am not aware of any study that states that knee fat is superior to abdominal fat. It also depends on the technique of harvest (damage to fat cells while performing the liposuction), the method of processing the fat and technique and location of the injections as well persons health and smoking status.

Fat Graft survival depends on;

1-Location - a new study by Dr. Puckett suggests that fat is most viable when harvested from the upper hip. Inner knees was not checked.

2-Harvest Technique - minimize air exposure, harsh centrifugation, liposuction machine pressures and damaged reusable cannulas. The Viafill System from Lipose Corp. eliminates all these issues that damage the tissue. A new study shows that Viafill provides 20.8 million live cells per ml versus other systems that provide less than 4.1 million live cells per ml for injection.

3- Injection technique - small microdroplets of fat is better than large chunks. Microdroplets is also better aesthetically.

Fat can be harvested from many areas.  Harvesting techniques and technologies continue to evolve to help us get the best survival.  If you have knobby knees and don' t need a lot of graft, the knee would be an excellent source of fat and relatively easy to harvest.  The key to remember is it is likely the fat will continue to act as fat from where it was harvested rather than where it is placed.  So if you use tummy fat and gain weight, its plausible you will gain plumpness where your grafts are placed.

The future for fat grafting is exciting and has clinically been shown to do wonders for breast reconstructions and scars as well.  It certainly is a better choice than dermal fillers when considering filling facial concavities and sunken eyelids.

although it is possible to use fat from the inner knee during a fat transfer, there may not be enough fat to obtain enough good tissue for an adequate fat grafting procedure. Keep in mind that when we perform liposuction before a fat transfer, we collect this tissue and clean and process it. After this, we only have 1/2 to 1/3 of the volume that we started with. Also remember that once we inject fat into an area, approximately 20% of it will melt away. Therefore although it is possible to perform like such into the inner knees and help collect his fat for a fat graft, that may not be sufficient to correct the area you are looking for.
 

 Small studies suggested that fat from different body sites may have a different survival pattern.  I do not think we know enough to make a substantial claim.  I like the inner knees as donor site; most women like the contouring effect.