Plastic surgeons like predictability, which is why many continue to have a love/hate relationship with fat. We love the idea of using a patient’s own material but historically, it has been difficult to guarantee how much of a fat graft will “take.” The evolution of certain techniques such as SAFELipo® has certainly influenced my confidence level with fat grafting in several significant ways.
- The way in which fat is obtained during liposuction is strongly linked to the overall fat grafting result. Fat is fragile and must be handled with care. When I “harvest” the fat from the donor site it’s important to minimize any potential damage because fat destroyed during removal will not come back to life. While no technique can promise 100% survival, I have been impressed with the quality and quantity of viable fat when using the SAFELipo® technique. The steps involved in both fat removal and transfer make SAFELipo® head and shoulders above anything else I have ever used. Other liposuction methods such as those involving ultrasound or laser introduce energy into the area that kills fat, so fat can be removed, but not transferred.
- The secret to SAFELipo® lies in its multistep process. In order to understand the uniqueness of SAFELipo®, it’s important to compare and contrast it with standard liposuction. Traditional liposuction uses a cannula to simultaneously suction the fat and remove it. This sounds efficient, however it requires a more aggressive technique literally pulling fat away from the surrounding tissue. In contrast, SAFELipo® uses specialized cannulas that separate fat from the delicate structures under the skin. Once the fat is released, step two is going back and gently suctioning out the fat that is already detached. I am not using the cannula to release and suction fat at the same time, which is the most traumatic part of the procedure. When the fat is released and then gently suctioned, it literally floats into the cannula, theoretically increasing the viability of the fat cells surviving. The viability of the grafted fat is crucial to the overall aesthetic result. Once the fat is harvested I use a closed system to reintroduce it to the desired location. This means that we are handling the fat in the least traumatic way and likely optimizing survival. The fact that there is no double or triple handling translates into little potential trauma to the delicate fat cells, allowing a more robust harvest and increases the likeliness that the fat will live once grafted. It requires more tools and more time, but the increased predictability helps me deliver the absolute best result achievable in a particular patient.
- Even the best tools and techniques can only take you so far. Liposuction is the premier way to improve body contour. Fat grafting is akin to sculpting. A keen artistic eye is paramount. The basic science and technical benefits of SAFELipo® provide the tools and foundation for a great result. But without a heightened aesthetic sense, it is just moving fat from one area to another. A deep knowledge of an individual’s anatomy and associated variations coupled with the understanding of what they would like to accomplish helps me envision the end result during surgery. Artists believe their creations are complete when the overall effect would be compromised should anything be added or subtracted. I always keep this in mind. The ability to recognize exactly how much (or little) fat to place in a certain location can be the difference between a good and great result.