Introduction of fat grafting: macro, micro, nano fat

Fat grafting is a procedure where fat is harvested from one part of the body, processed (processed) and transplanted (injected) into another area where it lacks volume and/or elasticity. The fat is harvested via special cannulas, gently processed using the Coleman's technique and decanting, i.e. allowing the fat to sink and separating the fat cells from blood, oil and fluid from the local anesthetic.

Sometimes we use vibration technique 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 your 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. For the most part, relatively moderate amounts of fat are involved; if too much fat is removed, the fat cells die as they need good blood circulation and tissue to survive.

Usually the fat integrates (incorporates, grows) well in the receiving area, but you should expect the body to absorb about 30% of the fat in the first few months (somewhat less in the head region as it has good circulation in the receiving sites), so you fill up 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 picture and the possibility of harvesting fat. If there is an indication for other procedures, we will assess whether they should be performed at the same time or separately.

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 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 injection 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 to which you are moving and also the indication for the procedure in recipient sites:

• Macrofat Grafting: 2.5 mm parcel size or fat particle size 2.5 mm or larger cannula, (not used in 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 external 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. It separates the stem cells and growth factors 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 that aims to regenerate rather than fill volume. The fat cells have a particle size of 800 microns, and the fat is harvested with small cannulas of less than 1mm and smaller. The fat is then processed by passing between two syringes for emulsification of 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 transplantation 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 the 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 fewer wrinkles. This results in a younger-looking and more resilient skin. The most common areas for Nanofat transplantation and fat grafting are the face and can be combined with other facial procedures, such as facelift, eyelid plastic surgery, forehead lift and eyebrow lift, lips. Can also be used for scar treatment, 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.