SMALL-VOLUME FAT TRANSFER

BACKGROUND. The use of autologous fat has been advocated for tissue au gmentation for over a century. However, this technique remains controv ersial and many investigators have made suggestions to increase its po tential. OBJECTIVES. TO develop a less traumatic method to collect, pu rify, and reinject fat to obtain more dramatic augmentations for the c osmetic improvement of contours and tissue defects. METHODS. Fat was c ollected from the donor site following tumescent infiltration of tissu e. A ''vented'' syringe with an atraumatic Mercedes tip was used to co llect the fat and, after washing with lactated Ringers or saline, the fat was transferred to small syringes for controlled injections. Small filaments of fat were placed in multi-layers throughout the area of t he defect or area of desired contour change. The unused fat was frozen for a second or third injection session. RESULTS. The fat transfer me thod yielded augmentations of 40%-120% of injected volume in the 339 a reas treated. After 45-60 days, the implant was stabilized and remaine d for the length of our study (up to 10 years). In several cases exces sive fat had toe removed. ther than slight bruising, occasional divots at the donor site, and three cases of bacterial infection, the autolo gous tissue transfer was an uncomplicated event. CONCLUSION. Fat graft ing has proven to be a safe and effective procedure for correcting and enhancing tissue defects and contour deficiencies. (C) 1998 by the Am erican Society for Dermatologic Surgery, Inc. Dermatol Surg 1998;24:85 7-865.