I had a fat transfer to my flat cheeks about 2 weeks ago. So far, it looks nice. However, my doctor said I might want to come back for a touch up in 6 months. I have a question about her procedure. She harvested the fat with a hand syringe. But, she did not spin the fat before injecting. What are your thoughts on this? I know I should have asked her, but I did not. Thanks!
Question About Doctor's Procedure
Doctor Answers 6
Fat Transfer Requires Gentle Care
Your surgeon sounds like she knows exactly what to do! The main concern about fat transfer has been the viability of the transferred fat - keeping most of the fat alive after transfer. Gentle care in harvesting and transfer has been shown to be most effective. Straining, spinning, and washing harvested fat may subject the cells to harmful trauma and may also discard valuable stem cells that will improve the viability of the transferred fat.
Fat grafting processing
There is a wide variability in how fat graft surgeons process their fat. If your doctor gets good long term results that's the main thing. I do use hand suction and a centrifuge for a few minutes and have been happy with the results.
Similarly, some people add various solutions to the syringe before harvesting the fat (albumin, etc.). Again, I wouldn't be caught up too much in the small details of the procedure since there is no one standard method of doing it.
Technique of Fat Transfer
I've done fat transplantation for over 25 years without spinning the fat. There are many excellent techniqes used by different surgeons with excellent results. The advantage of spinning the fat is that the procedure is a little quicker.
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Dear 678Sandy, It is perfectly okay not to spin the harvested fat. The whole purpose of spinning is to separate the true fat from serum/blood/anesthetic fluid. This can be equally accomplished by putting the syringes in a vertical position to allow the fluids to gravitate to the bottom & the fat remains on top. You get excellent quality fat for the transfer. I use the FAMI technique , but stopped the spinning several years ago, with no effect whatsoever on the results. I usually hold some of the harvested fat in the freezer for "touch-ups" over the following 1 year , if needed.
Fat Transfer techniques
There has always been a great deal of controversy about the best method of processing the fat cells before transferring them into the desired area. Some surgeons spin the fat by hand; others use a centrifuge. Some bathe the fat cells in insulin/glucose/other media. There is no data that clearly shows one method to be more adventageous. Each physician becomes familiar with what he/she can acheive with their techniques, such that they can deliver predictable long term results. The goal should be one treatment, although rarely a patient might request a second procedure. Hopefully this can be anticipated ahead of time and discussed with the patient.
Regarding how to acquire the fat cells, using hand-held liposuction generates much less negative pressure, and thus theoretically is less damaging to the fat cells than traditional machine liposuction. Thus, when transferring fat to the face, I believe hand-held liposuction is most appropriate.
Yoash R. Enzer, MD