LIPOFILLING TECHNIQUE – dentrocasa magazine, October 2013

The idea of ​​using body fat as a tissue to be taken and grafted into other anatomical areas to increase its volume is rather old and first came about at the end of the nineteenth century. In the middle of the twentieth century, the first works were published on the subject that remained in the dark until the eighties when Fournier, the father of modern lipofilling, codified the technique. A further substantial contribution comes from Coleman in the 90s who proposed the centrifuge of the fat destined for the implant.
With the help of small cannulas, the body fat is extracted from an area identified as a donor, the fat is then left to settle or centrifuged and then injected into the area to be treated. From the biological point of view, there is an interruption of the vascular nourishment of the collected fat which is not immediately restored and the newly implanted tissue can survive only through the imbibition mechanism while waiting for a new and definitive supporting vascular network to be organised. This phase is extremely delicate and that portion of tissue that does not find adequate nourishment is eliminated. The percentage of engraftment is variable and this element is the main limitation of lipofilling. The factors that most influence the success of this technique are the areas of ​​collection and grafting, the speed of execution, the quantity and its distribution and the age of the patient.
The indications of lipofilling are manifold. It is possible to add volume to midface or lips with your own fat and, in very thin patients, the fat is used to fill the temporal region. Excellent results are obtained in the hands when a reduction of the skeletonization that gradually develops with skin aeging is desired.
In body surgery, lipofilling is used to compensate for any depressions near scars or areas that have been subject to trauma. In limited quantities, it is suitable to improve symmetry in patients undergoing quadrantectomy or in limb trauma outcomes. In cosmetic surgery, there is a growing demand for the filling of breasts and buttocks with satisfactory results when demands from the point of view of volume are limited.
It is performed under local anaesthesia or with the support of sedation in emotional patients or when the areas to be treated are particularly extensive. It is a rather simple procedure that does not provide a demanding post-operative course.
Side effects are minimal. Swelling, bruising and some irregularities in the settling phase can be expected.