Obesity prevails in the West, as a result of a generous consumption of unctuous food products. The Western diet has increasingly plagued much of Asia, with the construction of golden-arched outposts in every conceivable location. Albeit still considerably less needed in the Japanese archipelago, body liposuction is becoming a much more popular option to attain the svelte physique celebrated in the media. This article will explain the senior cosmetic surgeon’s research on adipocyte physiology and explain how that knowledge has impacted surgical technique. The location and type of fat differs from individual to individual and is largely influenced by genetic factors. Dietary habits only exacerbate this predisposition toward obesity. Adipocytes proliferate in number until adolescence, after which time further increase in fatty deposition arises from hypertrophy of existing fat cells. Hyperplasia is only implicated in the rarer cases of morbid obesity.
Once fat cells are surgically evacuated, they will not return. The remaining fat cells, however, may continue to expand in size given dietary influences. The primary target of liposuction is reduction in the number of adipocytes and not overall weight loss. However, weight reduction may arise as a consequence of improved energy consumption rate and better response to diet and exercise. Two principle types of adipocytes predominate in the body: “fatty” and fibrous fat cells. The former tend to exhibit an oilier, more liquefied form, and are less ideal for lipotransfer. The fibrous fat cells are more solid and compact on gross inspection and are favored for autologous transplantation. Histologically, they appear to be more compressed signet-ring cells than the fatty type. After lipotransplantation, histological evaluation confirms that a greater population of fibrous than fatty adipocytes exists. This condition may arise owing to the greater viability of the fibrous variety or represent transformation of the fatty to the fibrous type. The senior cosmetic surgeon’s technique for liposuction harvesting and transfer has yielded consistent results in facial and breast augmentation over the past 23 years. Liposuction harvesting, or straightforward liposuction, should be carried out with a 3-mm blunt cannula outfitted with a side port and that is connected to a wall suction device. After the fat has been removed, it should be strained with iced normal saline through cotton gauze until dry (as will be explained in greater detail). This atraumatic technique ensures maximal fat preservation for transplantation.
Centrifugation removes the nutritive elements, e.g., collagen, that assist in fat survival, and it subjects the fat to unnecessary traumatic injury that reduces the likelihood of fat viability. Successful lipotransfer technique is contingent upon two factors. First, the pressure of the delivery should not be excessively high, as the combination of a small needle or cannula and a large syringe may fragment intact adipocytes and impair survivability. Second, the fat should be injected into the recipient site in a constantly moving radial fashion, moving from a deeper to a more superficial plane. This type of surgical delivery permits the fat to be distributed evenly throughout the host bed and to have maximal contact with the surrounding nutritive native tissue. Placement of a large aliquot of fat in a discrete location will promote resorption, as the surrounding nutrition cannot penetrate into the depth of the transferred fat. The bolus of transplanted fat will likely degenerate into a macrocystic entity or develop undesirable calcification. Selection of fibrous fat cells only for transplantation will also increase the yield. If all these tenets are adhered to, 50–60% of the transplanted fat will survive and persist indefinitely; therefore, overcorrection should be the objective in lipotransplantation.
Repeat augmentation can be judiciously undertaken after a 3-month period. Histological studies confirm that grafted adipose tissue undergoes neovascularization in the host bed after a 4-week period, a process that is mostly completed by 2–3 months. Once vascularization has occurred, the transplanted fat will remain for perpetuity. Biopsies taken at 1 year after transplantation confirm graft viability, which is corroborated by photographic documentation. Furthermore, conventional plain radiography reveals no adverse cystic degeneration or development of unwanted calcifications.
Our website is not responsible for the information contained by this article. Webworldarticles.com is a free articles resource thus practically any visitor can submit an article. However if you notice any copyrighted material, please contact us and we will remove the article(s) in discussion right away.
This article was sent to us by:
Tanya Hiarth at
01292010
1. Pamper Your Skin and It Pampers You
All articles in this directory are property of their respective authors. Additionally, read our Privacy Policy
© 2010 WebWorldarticles.com - All Rights Reserved. Partners: Gunblade Saga