Fat Autografting Muscle Injection: Autologous Fat Grafting

In autologous fat grafting (synonyms: Fat Autografting Muscle Injection/Facial Autograft Muscle Injection (FAMI), Autologous Fat Grafting) is a plastic or cosmetic surgery procedure in which fat tissue is removed from one area of the body and transplanted to another area of the body. Due to the multiple body parts on which autologous fat transplantation can be performed, the possible applications of the transplantation procedure are almost unlimited. Furthermore, it should be noted that in autologous fat transplantation, on the one hand, vital (directly removed) fat tissue can be used, on the other hand, frozen preserved tissue can be used. The use of the frozen autologous (body’s own) fat tissue causes an inflammatory reaction in the surrounding tissue, so that a reduced rejection of the used autologous fat in the adjacent tissue occurs. Historically, the first fat tissue transplants were performed as early as the end of the 19th century. However, the use of the procedure as practiced today is largely based on the physicians Dr. Pierre Fournier and Dr. Sydney Coleman, who helped make autologous fat grafting widely known.

Indications (areas of application)

Autologous fat grafting can be performed in the following body regions:

  • Face: cheek area, cheekbone area, lip and chin area.
  • Body trunk: chest and buttocks area
  • Extremities: Hands and muscle contours

Contraindications

  • Inflammation in the injection area
  • Lactation
  • Pregnancy
  • Anticoagulation (blood thinning medications associated with an increased tendency to bleed).
  • Lack of compliance (lack of cooperation from the patient).

The surgical procedure

The principle of autologous fat grafting is the redistribution of fat tissue through autologous transplantation(donor and recipient are the same person). A periumbilical (located next to the belly button) region rich in adipose tissue is often used for fat harvesting. The following is the description of adipose tissue harvesting:

  • Before the actual procedure, local anesthesia is performed (local anesthesia). In this case, an application of tumescent local anesthesia(TLA – procedure whose principle of action is based on the use of a large-volume administration of a solvent, which is mixed with the local anesthetic and injected into the subcutaneous fat tissue) is indicated. Moreover, the use of tumescent anesthesia leads to a decrease in the firmness of the tissue (tumescere: Engl. swelling).
  • Following local anesthesia, the fat tissue is removed by manual aspiration (suction) through a syringe holding between 10 to 20 ml. After injection of the TLA, the fatty tissue is removed through narrow cannulas as a result of the softening effect. This form of extraction is called microlipoextraction in plastic surgery. As a salient feature of microlipoextraction is the low proportion of unwanted connective tissue during fat removal.
  • Aftertissue removal, the preparation of the material to be used for transplantation can be done by two different mechanisms. Closed fat harvesting is considered the preferred method. In this method, the fat can be freed from possible blood contamination. There is the possibility of purification via the addition of saline or Ringer’s solution (aqueous infusion solution).
  • Durchdas Umfüllen of the removed own fat via Luer-to-Luer connectors (the Luer-Lock system is a standardized connection system for cannulae, syringes and infusion tubing) in small syringes, the transplantation process takes place without further processing of the removed fat tissue.
  • Furthermore, there is the possibility of using the open fat extraction.In this method, the previous fat tissue removal by means of larger cannulas, more connective tissue is removed from the body. Due to this, it is necessary to perform filtration. The purified fat can now be decanted into small syringe and returned to the body tissue inTransplantation.

Below is the description of autologous fat transplantation:

  • If the fat tissue is frozen material, it can be thawed or used in the frozen state.After determining the puncture points can be injected into the subcutis (superficial layer of the skin).
  • About additional cooling of the surrounding tissue, the effect of the anesthetic can be enhanced.
  • If there are uneven skin dimples, they can be compensated by different injection depths.

After the fat grafting is done, a tissue massage follows to promote blood circulation and to ensure an even distribution of fat. If the fat is to be removed only in the context of liposuction (“liposuction”), this is not achieved using syringes, but by special vacuum pumps. Moreover, by using the grafting method, correction of troublesome scars can be achieved.

Possible complications

  • Redness and swelling in the injection areas.
  • Sensory disturbances in the graft area
  • Erysipelas (acute skin infection often accompanied by fever and chills).

Benefits

Autologous fat grafting is a recognized and virtually complication-free method of redistributing fat tissue. In long-term studies, the effect has been demonstrated by sonography (ultrasound) even decades after the procedure was performed. As a result of the easy-to-perform therapy, the quality level of the procedure is considered high. According to new studies, successful application in skin treatment of irradiated patients (condition after radiotherapy/radiotherapy) is also possible.