Abstract
Body contouring after massive weight loss (MWL) is one of the fastest growing branches of esthetic and reconstructive surgery along with lipoplasty. Lipoplasty, a combination of liposuction and autologous fat grafting (AFG) is a tool to shape and contour the desired outlines of an esthetically appealing form. MWL results in uncontrollable changes in fat distribution and the idea of a simple transfer of surplus to shortage makes fat grafting seem like an ideal instrument to contour and augment the desired body shape of a MWL patient. The question is; what is the evidence?
This chapter is the first attempt, to our knowledge, to cover the topic of fat grafting in MWL patients. The text is based upon current scientific evidence from existing literature along with the authors own experience with emphasis on the principles and practice of fat grafting in MWL patients and considerations on the vast future possibilities, given increasing popularity of fat transplants and regenerative potentials of adipose-derived stem cells (ASCs).
We emphasize our postulation that less is more when it comes to fat grafting in general and this seems to be especially important in the MWL patient group as they seem able to grow fat faster than non-MWL. The grafted fat volume has to be balanced with the recipient site tissue volume and kept secure in place to optimize neovascularisation and blood supply until blood circulation is reestablished for the continuous growth of healthy fat tissue.
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1 Electronic Supplementary Material
Video 94.1
Syringe Assisted Lipo-Transfer (SALT) method is based on a set of principles used to harvest and graft fat, rather than to rely on equipment. In its most basic form SALT requires only a harvesting cannula and a syringe in order to harvest and transplant fat (MOV 161146 kb)
Video 94.2
Tissue rearrangement, mastoplasty with the use of autologous tissue is the mainstay of our current treatment of female breast reconstruction after MWL. Visualized here on a 32-year-old woman with moderate MWL breast deformity and hypoplasia, augmented with bilateral LICAP flaps and AFG (MOV 281528 kb)
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Gunnarsson, G.L., Thomsen, J.B. (2022). MWL and Post Bariatric Surgery Patients: The Role of Fat Grafting and Regenerative Surgery. In: Kalaaji, A. (eds) Plastic and Aesthetic Regenerative Surgery and Fat Grafting. Springer, Cham. https://doi.org/10.1007/978-3-030-77455-4_94
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DOI: https://doi.org/10.1007/978-3-030-77455-4_94
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