Is Puregraft better than regular fat graft?

Question

I am thinking about getting fat graft as a filler for some areas of my face. My doctor has told me that Puregraft is better and longer lasting than regular fat graft. Can you confirm this is true? Thank you!

Terence Goh, MBBS, MRCS(Ed), FAMS (Plast Surg) · Answer

As some of the doctors have mentioned, the key to successful fat grafting and graft survival is technique ie. surgeon dependent  and not dependent on equipment. I have used traditional methods such as the Coleman technique, as well as PuregrafTMand the Revolve system. (In Singapore, Revolve is no longer available now.) Notably, these systems only affect the post-harvest processing part of fat grafting. 
What is PuregraftTM?There are 3 critical steps for fat grafting - Fat Harvest, Fat Preparation and Fat Injection. Puregraft helps with the Fat Preparation stage only. After fat harvest, there is a need to process the fat and remove the unwanted parts eg. red blood cells, oil and the infiltration fluid before the fat can be injected. Puregraft is a fat processing device that allows the preparation of the fat grafts after fat harvest. The Puregraf is a close filtration system that allows sedimentation and washing. You can obtain fat ready for grafting subjecting the fats to a centrifuge.
The Puregraft system consists of filters that enable you to wash the fat and remove up to 97% of the impurities within a close system.
Why do I prefer PuregraftTM?
Personally, I like the PuregraftTM system very much because it saves time during the fat processing, typically 30 to 45 minutes per surgery and that to me is the largest advantage of this system. It reduces the anaesthesia time, which translates to a quicker recovery for the patient and also cheaper facility costs. This is significant considering it takes about 2-3 hours using Puregraft vs. 3-4 hours using traditional methods. That’s about a 25% reduction in time. Moreover, the system is sterile and also a closed system hence ensuring higher viability of the grafts. However, the system is single use system and it does add to the costs of the surgery and this is may be a limitation for some patients or surgeons to adopt this device. I do maximise the use of each bag (reusing it up to 3 times during the same surgery) and found no problems. 
Some studies have shown that the method with the highest survival rate of fat graft is the filtration method using gauze. However, that method is time consuming and not practical for preparation for large grafts amounts e.g. for breast augmentation. The Puregraft system using a series of sieves allows filtration of up to 97%  of the contaminants from the collected fat in preparation for fat grafting. In my experience with this system, I have experienced lower incidence of cysts and a 60-70% fat survival consistent with most studies.
Hope this short answer explains the difference between PuregraftTM and other traditional methods.Have a great weekend!Dr. Terence GohAZATACA Plastic Surgery

Jason Emer, MD · Answer

Hi Isa. Fat transfer results are permanent, but not all fat will survive. Harvesting is the key to fat transfer. We extract the cleanest, most viable fat possible from our patient’s body, purify it through Puregraft microfiltration (removing any contaminants, oil, debris and blood) and enrich the fat with stem cells, A-cell, growth factors, and platelet-rich plasma (PRP) derived from the patient’s blood. This can be combined with Sculptra, depending on the treated area, to improve outcomes. I recommend getting a formal evaluation with a fat grafting expert. Best, Dr. Emer

John Reilly, MD, FACS · Answer

Fat transfer to the face is a very satisfying procedure for patient and surgeon when done correctly. Purgraf is a brand name for the equipment used to process the fat after it is removed from your body. It is used for larger volume fat transfers. Since the face does not require a large amount of fat it is only going to add to the cost of the procedure. I perform fat grafting to the face in my office with local anesthesia. Good luck.

Guy Cappuccino, MD · Answer

I use both Purgraf as well as other techniques for facial fat transfer. I agree with other posters that the post harvest processing method is only one factor involved with the ultimate fat survival .  I do like purgraf very much and think it does a great job of purifying the fat, but for smaller volume cases I often use manual fat processing and transfer to save the patient money.  In my experience the results are just as good and my results are consistent with many studies which show approximately 65-70% fat survival.

Alexander Aslani, MD · Answer

Puregraft is a heavily marketed fat filter system.There is no whatsoever evidence that it works better than comparable techniques, there is only evidence that it costs a lot of money.

Curtis Perry, MD · Answer

Proper technique is the key to graft survival and not the equipment brand. As long as the instrumentation allow for gentle handling of tissue its fine.

Robert T. Buchanan, MD (retired) · Answer

Puregraft is a method of collecting and processing the fat once aspirated. It does provide good fat for transfer. However, when the far suction and processing is done correctly, it is absolutely no better. Its main advantage is when you are transferring a large amount of fat such as into the buttock or breast. In the face, you do not need a large amount of fat. Puregraft is used with a mechanical suction machine. Unless you turn the suction power down, you injure the fat cells and It does not matter how you collect the fat or process it. For the face, I prefer to use a syringe technique with minimal suction pressure and simply wash the fat. With it I get excellent take of the grafted fat.

Is Puregraft better than regular fat graft?

Answers (7)

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