Fragmented Fat Transfer for Massive Weight Loss Gluteal Contouring.pptx

Fragmented Fat Transfer for Massive Weight Loss Gluteal Contouring.pptx

1. Fragmented Fat Transfer for Massive Weight Loss Gluteal Contouring Flavio Henrique Mendes, M.D., Ph.D. Fausto Viterbo, M.D., Ph.D. São Paulo, Brazil PRESENTER: Gerelmaa J, MD AGAPE CHRISTIAN HOSPITAL, JOURNAL CLUB 2022.04.29 Fragmented Fat Transfer for Massive Weight Loss Gluteal Contouring

2. Introduction Gluteal augmentation by fat grafting has been accepted as an effective surgical approach, but many patients face a lack of donor tissue with harvesting limitations.

3. Introduction The massive weight loss process leads to: extensive tissue deflation making liposuction less effective due to major subcutaneous laxity the limited amount of available adipose tissue. circumferential dermolipectomy is routinely performed on massive weight loss patients

4. SYRINGE LIPOASPIRATE vs FRAGMENTED FAT NO DIFFERENCE in vitro methods (histologic analysis, immunohistochemical analysis, trypan blue testing, flow cytometric analysis, and cell culturing) in vivo methods (mass, volume, and histologic analysis of xenografts in mice)

5. PURPOSE OF THE STUDY To assess the initial clinical evidence on fragmented fat transfer to restore volume and enhance deflated gluteal contour in a sample of massive weight loss patients.

6. PATIENTS AND METHODS 2019 Jan - Sep - 20 cases Selection criteria female patients who underwent circumferential body lifts and fleur-de-lis abdominoplasties body mass index no greater than 30 kg/m2 at least 18 months earlier undergone bariatric surgery weight loss stabilization / m <3% in a 3M/

7. SURGICAL TECHNIQUE Pre-OP marking Gluteal regions symmetrically divided into several zones NO PREVIOUS INJECTION 60 cc syringe 4mm cannula Fragmented fat was equally transferred Suturing.

8. FRAGMENTATION TECHNIQUE

9. RESULTS 20 post bariatric surgery patients. IV general anesthesia - 9 cases Spinal Blocks - 4 cases Combination anesthesia - 7 cases AB PROPHYLAXIS + PO AB /24hrs/ no DVT prophylaxis AVE V= 720ml /500-960ml/ Small spots dehiscence - 4 cases NO COMPLICATION

10. RESULTS

11. Discussion liposuction has long been the only possible harvesting procedure , despite its time-consuming, aggressive nature and profound limitations. in extremely deflated patients, whose buttocks really need both lifting and augmentation, liposuction alone is not likely to provide the required amount of lipograft.

12. Discussion Fat fragmentation has proved useful and effective in providing greater amounts of viable fat graft in a safe, simple, and reproducible technique without noticeable complications.

13. Discussion free of fluid injections (no saline, lidocaine, or adrenalin) the exposure of fragmented fat to air should be addressed in further studies for risk of contamination and graft take impairment. NOT ONLY FOR BUTTOCK RESHAPING

14. Conclusions Although preliminary, their clinical findings with this new technique support further studies of fragmented fat as an alternative to liposuction in gluteal fat grafting. Additional potential applications, including in wound healing and regenerative medicine, are worth exploring.

15. ACH case /PBSC- dorsum of the hand/ KEY TAKEAWAYS /easy, simple/

16. THANK YOU FOR YOUR ATTENTION AND NO QUESTION, OKAY?!