Introduction of fat grafting: Macro- Micro- and Nano fat

Fat transplantation is an intervention where fat is harvested from one place on the body, processed (processed) and transplanted (injected) into another place where it lacks volume and/or elasticity. The fat is harvested via special cannulas, treated gently with the Colemans technique and decantation, i.e. let the fat sink and separate the fat cells from blood, oil and fluid from the local anesthetic.

Sometimes we use vibration technology to remove fat with the machine PAL-650 from MicroAire®. This takes place under sedative medication (sedation) and local anesthetic, with anesthesia and surgery nurses.

It is assumed that there are areas on the body with excess fat and a desire to harvest from, which can be used. Typical good areas are stomach, inside or outside thigh, inside knee, back and hips.

The amount and type of fat that is moved depends on both the desired volume in the area you want to correct, and how much you must remove. Mostly it is about relatively moderate amounts of fat, if too much fat is moved the fat cells die as they must have good blood circulation and tissue to survive.

Usually the fat integrates (incorporates, grows) well in the receiving area, but you must expect that the body absorbs approx. 30% of the amount of fat in the first months (somewhat less in the head region as it has good circulation in the receiving areas), therefore you fill a little more than you need to compensate for this. In addition, you will be somewhat swollen in the first weeks, which gives the impression of more volume. Smaller irregularities may therefore occur after surgery, but this can be corrected within the warranty period.

During the consultation, your wishes and needs are thoroughly assessed regarding the whole and the possibility of harvesting fat. If there is an indication for other interventions, this is assessed as to whether it should be done at the same time or in a separate case.

With a standard fat injection, small insertion holes of approx. 1-2 mm to inject the fat. We close the wound with stitches that dissolve by themselves, except for transplants to the face where we do not sew, and only close with tape. It is important not to expose these puncture wounds to the sun for a minimum of 12 months after surgery to avoid scarring and pigment changes. Cover with either tape and or high factor (Sun Block min SP30).

There are 3 main types of fat transplantation based on the size of the fat particles that are harvested, the area that is moved to and, in addition, the indication for the intervention in the recipient sites:

• Macro fat Grafting: 2.5 mm parcel size or fat particles size 2.5 mm or larger needle, (not used on the face). Used for large volume fat transplantation such as breast augmentation with fat, hybrid treatment with fat and implant, and Conversion to exchange implant with fat, buttock augmentation with fat / BBL or fat to legs. The fat is harvested with large needles of 2.5-4 mm.

• Millifat Parcel Size: or fat particle size of 1.2-2.4 mm (1.2-2.5 mm needle)

• Micro fat Grafting: less than 1.2 mm (0.5-1.2 mm needle), fat particle volume is less than 1.2. Used for smaller volumes of fat transplantation such as for the face, small defects in the body, vaginal canal and outer labia, as well as for scar treatment.

• Nanofat Grafting: less than 800 Micron (needle of 27 or 30 G). Nanofat transplantation takes the treatment one step further. The stem cells and growth factors are then separated from the fat, with cells that can divide into new stem cells, or in this case new skin cells. Nano fat is a relatively new type of treatment with regeneration as the objective and not to fill volume.

The fat cells have a particle size of 800 microns and the fat is harvested with small needles of less than 1 mm and smaller. The fat is then processed by being passed between two syringes for an emulsification of the fat, i.e. to separate the bag with fiber cells etc that you don’t want from the stem cell liquid. When treating Nanofat, you improve the quality of the skin, it can help to smooth out fine lines and small wrinkles, fine lines around the mouth and so-called crow’s feet next to the eyes, as well as the tear trough. Although nanofat transplantation does not build up volume in the face, it has regenerative properties and provides a beneficial effect on the quality and appearance of the skin and adds stem cells that are in the Nanofat after it has been separated from the tissue and liquid fat.

Regenerative effect on the skin, i.e. on the renewal process in the skin – provides better elasticity, less pigmentation, thicker leather skin and fewer wrinkles. This gives a younger appearance and better resistant skin. The most common areas for Nanofat transplantation and fat transplantation are the face and can be combined with other facial procedures, such as facelift, eyelid surgery, forehead lift and eyebrow lift, lips. Can also be used for scar treatment, in the scalp for hair loss, dark circles under the eyes and the walls of the vaginal canal.

• Other types of fat transplantation are Microneedling and Nano creams, the latter being a relatively new product.