Introducing fat grafting: macro, micro, nano fat

Fat grafting is a procedure in which fat is harvested from one part of the body, processed (treated) and transplanted (injected) into another part that lacks volume and/or elasticity. The fat is harvested via special cannulas, processed gently using the Coleman technique and decanting, i.e. letting the fat sink and separating the fat cells from the blood, oil and fluid from the local anesthetic.

Sometimes we use vibration technology to remove fat with the PAL-650 from MicroAire®machine. This is done under sedation and local anesthesia, with an anesthesia and surgical nurse.

It is assumed that you have areas on the body with excess fat and a desire to harvest from, which can be used. Typical good areas are the stomach, inner or outer thighs, inner knees, 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 have to lose. Generally speaking, it's a matter of relatively moderate amounts of fat; if too much fat is moved, the fat cells die as they need good blood circulation and tissue to survive.

Normally, the fat is well integrated (incorporated, grows) in the receiving area, but it must be assumed that the body absorbs approx. 30% of the fat in the first few months (somewhat less in the head region as it has good circulation in the receiving areas), so you fill a little more than you need to compensate for this. In addition, you will be somewhat swollen in the first few weeks, which gives the impression of more volume. Minor unevenness may therefore occur after surgery, but this can be corrected within the warranty period.

During the consultation, your wishes and needs are thoroughly assessed with regard to the overall situation and the possibility of harvesting fat. If there is an indication for other procedures, this will be considered whether it should be done at the same time or in a separate case.

In a standard fat injection, small puncture holes of approx. 1-2 mm are made to inject the fat. We close the wound with stitches that dissolve on their own, 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 at least 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 grafting based on the size of the fat particles harvested, the area of relocation and the indication for the procedure in the receiving sites:

• Macrofat Grafting: 2.5 mm parcel size or fat particles size 2.5 mm or larger cannula, (not used on the face). Used for large volume fat grafting as in breast augmentation with fat, hybrid treatment with fat and implant, and Conversion exchange implant with fat, buttock augmentation with fat/BBL or fat to calves. The fat is harvested with large cannulas of 2.5-4 mm.
• Millifat Parcel Size: or fat particle size of 1.2-2.4 mm (1.2-2.5 mm cannula)
  
  
• Microfat Grafting: less than 1.2 mm (0.5-1.2 mm cannula), fat particle volume is less than 1.2. Used for smaller volumes of fat grafting 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 Microne (needle of 27 or 30 G). Nanofat grafting takes the treatment one step further. Stem cells and growth factors are separated from the fat, with cells that can divide into new stem cells, or in this case new skin cells. Nanofat is a relatively new type of treatment with regeneration as its goal 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 passing it between two syringes to emulsify the fat, i.e. to separate the bag of fiber cells etc. that you do not want from the stem cell fluid. Nanofat treatment improves skin quality, 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 grafting does not build up volume in the face, it has regenerative properties and provides beneficial effects on the quality and appearance of the skin, adding stem cells that are in the nanofat after it has been separated from the tissue and fluid fat. Regenerative effect on the skin, i.e. on the renewal process in the skin - provides better elasticity, less pigmentation, thicker leather skin and less wrinkles. This results in a younger-looking and more resilient skin. The most common areas for Nanofat grafting and fat grafting are the face and can be combined with other facial procedures, such as facelift, eyelid surgery, forehead and eyebrow lift, lips. Can also be used for scar treatment, on the scalp for hair loss, dark circles under the eye and vaginal canal walls.
  
  
• Other types of fat grafting are Microneedling and Nanocreams, the latter being a relatively new product.