Research Article| Volume 65, ISSUE 12, P1692-1699, December 2012

Development of micro-injection as an innovative autologous fat graft technique: The use of adipose tissue as dermal filler



      Autologous fat graft, by virtue of its volumetric qualities and its action on skin trophicity, can be considered as a gold standard implant. Current techniques do not allow very superficial or subdermal injections of adipose tissue. The authors report technical modifications that enable fat transfer through a 25-gauge cannula. The viability of grafted fat was assessed after subcutaneous injection on a murine model.


      Micro-fat grafting consists of harvesting fat tissue using a multiperforated cannula with holes of 1 mm. Fat tissue is refined as described by SR Coleman and transferred through a micro-cannula. Initially, human fat was first harvested using two different procedures: Coleman's technique and the modified harvesting technique. Preliminary comparative histologic analyses were performed. Sixteen nude mice received human fat tissue: one side was filled with 0.7 cc through a 17-G cannula using Coleman's technique, and the opposite side was grafted using smaller cannulae (20G, 23G and 25G) following the modified harvesting technique. Mice were euthanised at 12 weeks and skin biopsies were performed.


      Experimental fat grafts on mice were observed and analysed: macroscopically, the fat tissue of each side showed the same healthy aspect. Haematoxylin–eosin–saffron staining revealed intact adipocytes and anti-CD31 antibody immunohistochemical staining highlighted an abundant neo-vessel network.


      Fat graft obtained by the modified technique maintains a normal histologic structure. Fat injection with micro-cannulae extends the application of lipostructure to the superficial layers of the skin.


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        • Neuber G.
        Verh Dstch Ges Chir. 1893; 22: 66
        • Peer L.A.
        Loss of weight and volume in human fat grafts.
        Plast Reconstr Surg. 1950; 5: 217
        • Mojallal A.
        • Foyatier J.L.
        Historical review of the use adipose tissue transfer in plastic and reconstructive surgery.
        Ann Chir Plast Esthet. 2004; 49: 419-425
        • Coleman S.R.
        Long-term survival of fat transplants: controlled demonstrations.
        Aesthetic Plast Surg. 1995; 19: 421
        • Coleman S.R.
        Facial recontouring with lipostructure.
        Clin Plast Surg. 1997; 24: 347-547
        • Coleman S.R.
        Structural fat grafts: the ideal filler?.
        Clin Plast Surg. 2001; 28: 11-119
        • Coleman S.R.
        Structural fat grafting: more than a permanent filler.
        Plast Reconstr Surg. 2006; 118: 108 S-120 S
        • Sultan S.M.
        • Barr J.S.
        • Butala P.
        • et al.
        Fat grafting accelerates revascularisation and decreases fibrosis following thermal injury.
        J Plast Reconstr Aesthet Surg. 2012 Feb; 65: 219-227
        • Coleman S.R.
        • Mazzola R.F.
        Fat injection from filling to regeneration.
        Quality Medical Publishing, St Louis2009
        • Zheng D.N.
        • Li Q.F.
        • Lei H.
        • et al.
        Autologous fat grafting to the breast for cosmetic enhancement: experience in 66 patients with long-term follow up.
        J Plast Reconstr Aesthet Surg. 2008 Jul; 61: 792-798
        • Kishi K.
        • Imanishi N.
        • Ohara H.
        • et al.
        Distribution of adipose-derived stem cells in adipose tissues from human cadavers.
        J Plast Reconstr Aesthet Surg. 2010 Oct; 63: 1717-1722
        • Herold C.
        • Utz P.
        • Pflaum M.
        • Wilhelmi M.
        • Vogt P.M.
        • Rennekampff H.O.
        Negative pressure of manual liposuction with Coleman technique is highly dependant on the position of plunger of the syringe.
        J Plast Reconstr Aesthet Surg. 2012 Jan 18;
        • Xie Y.
        • Zheng D.
        • Li Q.
        • Chen Y.
        • Lei H.
        • Pu L.L.Q.
        The effect of centrifugation on viability of fat grafts: an evaluation with the glucose transport test.
        J Plast Reconstr Aesthet Surg. 2010; 63: 482-487
        • Smith P.
        • Adams W.P.
        • Lipschitz A.H.
        • et al.
        Autologous human fat grafting: effect of harvesting and preparation techniques on adipocyte graft survival.
        Plast Reconstr Surg. 2006; 117: 1836-1844
        • Zografou A.
        • Tsigris C.
        • Papadopoulos O.
        • et al.
        Improvement of skin-graft survival after autologous transplantation of adipose-derived stem cells in rats.
        J Plast Reconstr Aesthet Surg. 2011 Dec; 64: 1647-1656
        • Junk M.K.
        • Song S.B.
        • Cheon S.Y.
        • et al.
        Botulinum toxin enhances the implantation effect of adipocytes in C57/BL6 mice.
        Aesthetic Plast Surg. 2009; 33: 722-729
        • Thanik V.D.
        • Chang C.C.
        • Lerman O.Z.
        • et al.
        A murine model for studying diffusely injected human fat.
        Plast Reconstr Surg. 2009; 124: 74-81
        • Torio-Padron N.
        • Paul D.
        • von Elverfeldt D.
        • Stark G.B.
        • Huotari A.M.
        Resorption rate assessment of adipose tissue-engineered constructs by intravital magnetic resonance imaging.
        J Plast Reconstr Aesthet Surg. 2011 Jan; 64: 117-122
        • Jauffret J.L.
        • Champsaur P.
        • Robaglia-Schlupp A.
        • Andrac-Meyer M.
        • Magalon G.
        Arguments in favor of adipocyte grafts with the S.R. Coleman technique.
        Ann Chir Plast Esthet. 2001; 46: 31-38
        • Pu L.L.Q.
        • Coleman S.R.
        • Ferguson R.E.H.
        • Cui X.D.
        • Vasconez H.C.
        Autologous fat grafts harvested and refined by the Coleman technique: a comparative study.
        Plast Reconstr Surg. 2008; 122: 932-937
        • Pu L.L.Q.
        • Cui X.D.
        • Fink B.F.
        • et al.
        The viability of fatty tissues within adipose after conventional liposuction: a comprehensive study.
        Ann Past Surg. 2005; 54: 288-292
        • Suga H.
        • Matsumoto D.
        • Inoue K.
        • et al.
        Numerical measurement of viable and nonviable adipocytes and other cellular components in aspirated fat tissue.
        Plast Reconstr Surg. 2008; 122: 103-114
        • Mojallal A.
        • Lequeux C.
        • Shipkov C.
        • et al.
        Improvement of skin quality after fat grafting: clinical observation and an animal study.
        Plast Reconstr Surg. 2009; 124: 765-774
        • Hong S.J.
        • Lee J.H.
        • Hong S.M.
        • Park C.H.
        Enhancing the viability of fat grafts using new transfer medium containing insulin and beta-fibroblast growth factor in autologous fat transplantation.
        J Plast Reconstr Aesthet Surg. 2010 Jul; 63: 1202-1208
        • Pu L.L.
        Towards more rationalized approach to autologous fat grafting.
        J Plast Reconstr Aesthet Surg. 2012 Apr; 65: 413-419
        • Pallua N.
        • Pulsfort A.K.
        • Suschek C.
        • Wolter T.P.
        Content of the growth factors bFGF, IGF1, VEGF and PDGF-BB in freshly harvested lipoaspirate after centrifugation and incubation.
        Plast Reconstr Surg. 2009; 123: 826-833
        • Kaufman M.R.
        • Bradley J.P.
        • Dickinson B.
        • et al.
        Autologous fat transfer national consensus survey: trends in techniques for harvest, preparation, and application, and perception of short- and long-term results.
        Plast Reconstr Surg. 2007; 119: 323-331
        • Trepsat F.
        Periorbital rejuvenation combining fat grafting and blepharoplaties.
        Aesthethic Plast Surg. 2003; 27: 243-253
        • Trepsat F.
        Midface reshaping with micro-fat grafting.
        Ann Chir Plast Esthet. 2009; 54: 435-443
        • Tsai F.C.
        • Liao C.K.
        Clinical outcomes of patients with prominent nasolabial folds corrected by the technique: dermo-fascial detachment and fat grafting.
        J Plast Reconstr Aesthet Surg. 2011 Mar; 64: 307-312
        • Zuk P.A.
        • Zhu M.
        • Hedrick M.H.
        Human adipose tissue is a source of multipotent stem cells.
        Mol Biol Cell. 2002; 13: 4279-4295
        • Casteilla L.
        • Dani C.
        Adipose tissue-derived cells: from physiology to regenerative medicine.
        Diabetes Metab. 2006; 32: 393-401
        • Rigotti G.
        • Marchi A.
        • Sbarbati A.
        Adipose-derived mesenchymal stem cells: past, present and future.
        Aesthetic Plast Surg. 2009; 33: 271-273
        • Itoi Y.
        • Takatori M.
        • Hyakusoku H.
        • Mizuno H.
        Comparison of readily available scaffolds for adipose tissue engineering using adipose-derived stem cells.
        J Plast Reconstr Aesthet Surg. 2010 May; 63: 858-864
        • di Summa P.G.
        • Kingham P.J.
        • Raffoul W.
        • Wiberg M.
        • Terenghi G.
        • Kalbermatten D.F.
        Adipose-derived stem cells enhance peripheral nerve regeneration.
        J Plast Reconstr Aesthet Surg. 2010 Sep; 63: 1544-1552
        • Sterodimas A.
        • de Faria J.
        • Nicaretta B.
        • Pitanguy I.
        Tissue engineering with adipose-derived stem cells (ADSCs): current and future applications.
        J Plast Reconstr Aesthet Surg. 2010 Nov; 63 ([Review]): 1886-1892
        • Erba P.
        • Mantovani C.
        • Kalbermatten D.F.
        • Pierer G.
        • Terenghi G.
        • Kingham P.J.
        Regeneration potential and survival of transplanted undifferentiated adipose tissue-derived stem cells in peripheral nerve conduits.
        J Plast Reconstr Aesthet Surg. 2010 Dec; 63: e811-e817
        • Orbay H.
        • Uysal A.C.
        • Hyakusoku H.
        • Mizuno H.
        Differentiated and undifferentiated adipose-derived stem cells improve function in rats with peripheral nerve gaps.
        J Plast Reconstr Aesthet Surg. 2011; 65: 657-664
        • Rigotti G.
        • Marchi A.
        • Gali M.
        • et al.
        Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose derived adult stem cells.
        Plast Reconstr Surg. 2007; 119: 1409-1424
        • Sarfati I.
        • Ihrai T.
        • Kaufman G.
        • Nos C.
        • Clough K.B.
        Adipose-tissue grafting to the post-mastectomy irradiated chest wall: preparing the ground for implant reconstruction.
        J Plast Reconstr Aesthet Surg. 2011 Sep; 64: 1161-1166
        • Park T.H.
        • Seo S.W.
        • Kim J.K.
        • Chang C.H.
        Clinical experience with hyaluronic acid-filler complications.
        J Plast Reconstr Aesthet Surg. 2011 Jul; 64: 892-896