Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report

Vibration-Assisted Volume Optimization Mammaplasty: An Alternative Approach for Large-Volume Fat Grafting to the Breast

SUMMARY

Fat grafting has become an integral part of aesthetic and reconstructive breast surgery. However, the ideal method for harvesting and injecting the fat remains unclear. The authors describe an alternative approach for large-volume fat grafting in the breast, vibration-assisted volume optimization mammaplasty, that builds on the experience of other authors with using the power-assisted liposuction machine for fat injection. The authors implemented this approach in 138 breasts over 2 years and found low rates of complications (4%). This new approach substantially reduces the time required to inject the fat graft and is simpler and faster to set up than previously described techniques. The authors believe vibration-assisted volume optimization mammaplasty can be used to perform large-volume fat grafting safely and efficiently in the breast with an acceptable rate of complications.

Personal Strategy to Avoid Fat Embolism During Fat Grafting: Brisk Withdrawal of Cannula While Injection

INTRODUCTION

Complications of fat grafting by means of injection may lead to unwanted passage of substrate into vessel lumens resulting in catastrophic complications. Likewise, a similar trend of complications is observed with non-autologous fillers regardless of an almost generalized use of blunt cannulas, the latter being implicated in the majority of serious vascular complications of hyaluronic acid injection. This report is the product of investigation to review all cases that underwent an original technique of fat injection: "The smart fat injection" during the cannula's brisk withdrawal technique. The aim of this research was to document the safety of this technique by searching if fat embolism had occurred and if yes, its incidence in this group of fat injection surgeries.

METHOD

This retrospective review included 3039 patients who underwent the smart fat injection at the facial or corporeal level between 2001 and 2019. The study focused on the search for complications linked to fat yet also cruorical embolism, as the latter may resemble the clinical symptoms of fat embolism.

RESULTS

The assessment of the 3039 patients who underwent the smart fat injection during cannula's brisk withdrawal, resulted in none presenting clinically detectable fat or a cruorical embolism.

CONCLUSION

This report documents the safety of the smart fat injection developed over a period of 22 years. It further explains the rationale of the technique for avoiding fat embolism while simultaneously enhancing fat take. This technique should not be implemented without appropriate in vitro training.

LEVEL OF EVIDENCE V

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