Adipose graft: how to proceed the fat grafting: a study based on the histologic analysis

RESUMO

The authors documentation on histologic alterations observed in the autologous adipose grafts disclosed the tissue capacity to establish nutrition through plasmatic imbibition at approximately 1,5 mm from the vascularized edges. Thus, the findings suggest that fragmented adipose tissue should be proceeded through syringes and cannulae in thin threads or vertical, horizontal and non-contiguous planes, not exceeding 3,0 mm in thickness. Moreover, the time interval between the first and second grafting sessions should be approximately 35 days. There are two distinct stages related to the use of adipose grafts for the body contour remodeling. Until the 195O's, the grafting was proceeded using single blocks harvested from the donor sites with sharp instruments(1-4). Peer presented histologic studies suggesting the adipose graft viability by this technique, and documented a loss of weight and volume of about 50 per cent one year after transplantation(5,6). The adipose graft application reemerged later, in 1984(7), after the first publication on suction assisted lipectomy (SAL) and its sequelae. The fat grafts were obtained with cannulae or needles, and transplanted as small cylindric or cuboidal blocks, under negative and positive pression regimen, respectively. Studies on this subject were published demonstrating remarkable resorption rates and difficulties in clinical evaluation(8-12). Our recent studies on the histologic alternations and adipose viability in autogenous fat transplantations, using an experimental model(l3) as well as human cases(14), led us to suggest some parameters related to the transplant thickness and grafting intervals in clinical applications.