Autologous fat transplantation began in 1893, and Illouz proposed the injection of fat granules in 1986. This technique has become more widely used with the widespread use of liposuction. For the fate of transplanted fat granules, some scholars have thought that it will not survive after autologous fat transplantation, and all of them are absorbed by autologous tissue or wrapped by fibers to form scar-like tissue. Recent studies have shown that autologous fat after transplantation can partially survive, especially the theory of pre-adipocytes provides a more convincing basis for survival after fat transplantation [1, 2]. Of course, the ultimate goal of applying autologous fat grafting is to fill the sag and improve the appearance. Therefore, no matter whether the transplanted fat survives or not, as long as the volume of the transplanted part is maintained for a long time, the goal has been achieved, even after the transplanted fat is fiber. Tissue hyperplasia fills the concave deformity, as long as the surface is smooth and flat, it is acceptable.
Since the volume of fat transplantation has been reduced to a certain extent, and the purpose of our transplantation is precisely to fill the tissue depression with the graft, we are very concerned about the factors affecting the survival of the transplanted autologous fat. It is generally believed that the amount of live fat after autologous fat transplantation is affected by the way fat is taken and treated, the method of fat injection, and the amount of fat injected per unit area. The fat obtained by sucking with a fine needle is small, and the contact area with the plant bed after injection is large, which is beneficial to the survival of the cells. The fat particles obtained by the aspiration can be purified by rinsing and standing, and the high-speed centrifugation causes damage to the fat cells [3], and thus is not used. A number of studies have confirmed that basic fibroblast growth factor can promote the division and proliferation of vascular endothelial cells, promote angiogenesis, and improve the survival rate after autologous fat transplantation [4,5]. The fat injection is slightly thicker than the needle used for suction. Before injection, the needle is separated under the skin to form a cavity, and then the needle is injected while the needle is removed. This can reduce the resistance during injection, and the transplanted fat is evenly distributed in the receiving area. Damage to the transplanted fat granules by high pressure is avoided. There are certain limits on the nutritional conditions that can be provided for the graft in the depressed part. Excessive transplantation can not ensure that the transplanted autologous fat obtains sufficient nutrients, so the lesions such as depressions are serious, and the transplants can be considered to ensure a higher survival rate. The transplanted autologous fat cannot establish a blood circulation locally, and will be absorbed or centrally necrotic to form an induration.
Since the amount of transplanted fat is estimated, the survival rate after fat transplantation also has differences between individuals and parts. Therefore, it is difficult to avoid excessive or inadequate correction after surgery. These need to be clearly explained to patients before surgery. Fractional surgery can improve the survival rate of the graft, and it is safer to estimate the transplant volume more conservatively and avoid overgrowth and overcorrection.
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