Aesth. Plast. Surg.
10:115-117, 1986
Liposuction Fat Grafts in Face Wrinkles and Hemifacial Atrophy
Abel Chajchir, M.D. and Iliana Benzaquen, M.D.
Buenos Aires, Argentina
Abstract. We present the idea of correcting soft tissue
defects with an injection of fat obtained by liposuction.
Our method has great advantages, with few serious com-
plications. The technique is described and the results are
demonstrated in several patients treated over a period of
one year.
Key words: Fat graft - - Liposuction - - Face wrinkles - -
Hemifacial atrophy - - Depressions - - Nasolabial sulcus
- - Cheek depressions
We present a method of correcting soft tissue de-
fects using material other than collagen or silicone.
It is based on the use of the patient's own fatty
tissue, r e m o v e d by liposuction from some other
area of the body. Using liposuction, we can obtain
material that is abundant, and, when injected, pro-
vides the augmentation required in depressed areas.
We have used, for 2 years, Z y d e r m | collagen
implants [5] with good results. We have used also
collagen 2 from Koken. Recently there have been
m a n y articles on autoimmune illnesses and colla-
gen. These authors indicate that collagen implants
m a y depress the immunity m e c h a n i s m s [12].
Because of these problems, we have decided to
find a r e p l a c e m e n t material [3, 4, 6]. Histologically
[4], the traditional injected materials are c o m p o s e d
o f globules of fat (Fig. 1). T h e y can be described as
autografts, containing foreign bodies which will
cause inflammation (Fig. 2), zones of cystosteatone-
i Zyderm | is a registered trademark owned by the manu-
facturer Collagen Corporation, Pale Alto, CA, USA
2 Koken Atelocollagen Implant, a trademark of Koken
Co., Ltd, Japan
Address reprint requests to Abel Chajchir, M.D.,
Ayacucho 1772 I~ Buenos Aires (1112), Argentina
Aesthetic
_ Plasnc
Surgery
(t') 1986 Springer-Verlag New York Inc.
crosis with polynucleus (Swiss cheese effect) (Fig.
3), lipocytes, giant multinucleated cells, lympho-
cytes, and a great m a n y vessels of neoformation
(Fig. 4). All this produces an augmentation that can
be a b s o r b e d in the same way as collagen in only 10
months to a year. A liposuction fat graft has great
advantages o v e r traditional materials.
1. It is an autograft.
2. It is easily obtained.
3. There are no immunity phenomena.
4. The procedure can be repeated several times.
5. The cost is very low.
6. It can be applied to all small depressions
where filling material is required: nasolabial sulcus,
vermilion lines, glabelar creases, c r o w ' s feet, surgi-
cal irregularities, trauma, acne, scars, atrophy from
disease (surgical liposuction iatrogenia).
Technique
We use a small cannula (author's design) Ill with a
very fine point (5 mm) (Fig. 5) to take out the fat
globules. It is connected to a polyethylene tube,
which in turn is attached to a receptacle of sterile
glass (Fig. 6) connected to the v a c u m n motor. We
also use a syringe with rings and a trocar for inject-
ing (1 m m or less).
We use local or combined anesthesia. The donor
area m a y be chosen from the following: a b d o m e n ,
trochanter, thigh, knee, and gluteals. We take out
the fat tissue using the usual liposuction method
from an aseptic area.
The tissue must be treated carefully as not to
cause injury to the delicate cells. The transplant will
not graft when the material is crushed. This aspirate
is put in the syringe and injected into the defective
zone (Fig. 7).
A c o m p r e s s i v e bandage or a facial contouring
mask is used to c o m b a t edema, the effects of gray-
116 Liposuction Fat Grafts

Fig. 1. Cells of fat globules Fig. 4. Giant multinucleated cells responding to inflam-
mation and vessel of neoformation

Fig. 2. Inflammatory reaction Fig. 5. Author-designed cannula

Fig. 3. Zones of cystosteatonecrosis Fig. 6. Cannula connected to glass receptacles by poly-

ethylene tubing

ity, and hematoma, and to give a comfortable sup- really necessary, because the excess fat is absorbed
port after the procedure. in 8 to 11 months.
Over-correction is required with this method. Post-operative antibiotic therapy is indicated to
Fifty percent more fat needs to be applied than is reduce the possibility of infection.