Scarless* Fat Micrografting Procedures

Providing the Best in Natural Breast Reconstruction to Orlando & nearby areas of Florida

Scarless fat micrografting techniques are used in breast reconstruction, breast augmentation and other cosmetic procedures such as facial fillers and scar treatments. The technique used for fat grafting is critical. Whenever fat is removed with liposuction and re-injected, some of the fat survives, and some of the fat dies. Modern techniques of fat grafting strive to understand precisely how to harvest, prepare and then re-inject the fat. In addition to the grafting procedure itself, we incorporate additional measures and techniques such as the BRAVA® device, and internal shaping and suspension techniques to enlarge, reconstruct, lift and shape the breast.

Even with the best techniques, some loss of fat can be expected each time fat is injected. It is for this reason that more than one procedure is often required depending on the final result desired. By paying attention to the details of fat grafting techniques we can make fat grafting more and more predictable, and get the desired result with fewer procedures.

Fat Harvested by Liposuction

The first step in the process is to remove fat with liposuction. This technique is advantageous because it is minimally invasive and small parcels of fat can survive as free grafts. An added benefit of course is the body contouring achieved with liposuction.

Fat must be harvested as gently as possible with minimum trauma, and in small enough parcels for micrografting. These parcels contain fat cells or adipocytes as well as stem and regenerative cells. These ADRCs are associated with blood vessels and are thought to be crucial to the "take" of the graft.

Different types of liposuction may have different amounts of fat survival. We use numerous techniques depending on the situation, which appear to provide high levels of tissue survival. These include Syringe Liposuction, Tickle Lipo™, Body-Jet®, and sometimes Vaser®.  Liposelection. SmartLipo® is not recommended when performing fat grafting as the heat of the laser destroys the cells.

Body contouring liposuction is an additional benefits of using your own fat for breast reconstruction or augmentation. The thighs and abdomen appear to be the best harvest sites for fat to be used in fat grafting.

Fat Preparation and Processing

After the fat is removed with liposuction, it must be cleaned and prepared for delivery. To process the fat, we use the Cytori Puregraft®  method to prepare the fat. The Puregraft® device is a sterile bag that removes unwanted components like oil and blood from the fat. Once these contaminants are removed, the clean purified fat can be used for micrografting immediately, or transferred to our Liquid Gold® Lipobank to be cryopreserved for future grafting procedures. We have developed a completely closed process whereby the fat is protected from dehydration and contamination throughout the harvesting, processing and grafting process.

In some situations there is the option to create a  cell enriched graft where added concentrations of ADRCs are added to the fat graft. In this process a portion of the fat may be used to collect ADRCs. In a centrifuge, the ADRCs are isolated from the fat, or "adipose," cells. The adipose cells are discarded, and the ADRCs are added back into the remaining portion of unprocessed fat, creating an enriched fat graft. Presently we only recommend this option in select situations like reconstruction of lumpectomy defects in areas that have been treated with radiation therapy.

Reinjection - Rationale of Micrografting

The fat graft is loaded into a syringe device that allows the fat to be injected into the breast with a special needle.

Fat must be placed in small enough parcels to ensure as much fat as possible survives. Microthreads of fat are injected into the breast in an interweaving, layered pattern. The fat must be injected as diffusely as possible to allow revascularization of the graft for optimal results. 

Rationale of Tissue Preparation with BRAVA®

In some cases, especially in the case of breast reconstruction after mastectomy, the BRAVA® device may need to be worn prior to the reconstruction procedure. BRAVA® is an external device that uses suction to expand the breast tissue, creating more space for the placement of fat.

The amount of fat that can be injected in a single fat grafting procedure can be increased greatly by pre-expansion of the tissues. The device also causes new blood vessels to grow, increasing circulation to the tissues. Traditionally, reconstruction cases are completed in numerous stages. Prior to the use of BRAVA®, a total mastectomy reconstruction would require 7-8 procedures. With BRAVA®, reconstruction can usually be completed in 3-5 grafting procedures depending on the desired breast size.

Additional Scarless Techniques include internal suture suspension techniques such as the RAFT procedure, which not only lift, tighten and enlarge the breast, but also provide a scarless upper tummy tuck.

*Fat grafting and suture suspension techniques are performed using only small needles for the procedures, thus the procedures will result in either no visible scars or possibly very small, almost invisible scars.

Learn about Using Fat Grafting and Scarless techniques to Correct Breast Surgery Complications.

To learn more about fat grafting and breast reconstruction for women living in Winter Park, Orlando and the surrounding Florida areas, please contact plastic surgeon Dr. Jeffrey Hartog to schedule a consultation.

4355 Bear Gully Road
Winter Park, FL 32792