Free fat tissue transplant to correct congenital or posttraumatic defects has been used occaisonally for the last 100 years. With the explosive gain in the popularity of liposuction, many many authors recently turned toward the use of autologous
fat
transplant by injection of fatty tissue suspension obtained by manual power or vaccum machie-assisted suction as a soft tissue substitute.
Fat tissue injection acquired a priviledged position in plastic surgery due to the simplicity of the procedures, the low complication rate, the absence of apparent scars, and the possibility of repeating the procedure many times.
During the last few years, various reports have appeared about the use of fat obtained by vaccum aspiration for the improvement of the facial contour and depression. Many publications on the operative technique are available, but the results were
unpredictable because of the lack of knowledge of the proper technique and indications.
Recently, one of the most dramatic developments in adipose research has been the identification of the fat precusor in adults. After the graft of the mature autotransplanted fat goes through initial ischemia, fat cells either necrose or
dedifferentiated
into immature cells. Under suitable conditions, the immature fat cells revert to mature adipocytes. Central to this theory is the "Preadipocytes or fat precusor.".
The preadipocyte has the capacity for lipogenic activity and are more resistant to trauma that mature cells, thus the role and influence of the preadipocyte one the viability of the fat graft was confirmed in vitro and vivo.
Author reviewed the literatures of the autologous fat transplant by injection and discussed the phases of the technique of fat injection, each of them influence the take of the grafts: choice of donor site, method of fat removal, method of
preparation
and transplantations, selection of the recipient site and preparation of the recipient site.
In the near future, we hopefully await that with new culture techniques, preadipocyte in a single suspension may provide an injectable soft tissue replacement.
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