Hello everyone, today, I would like to share about cellular fat graft.

Fat graft has 100 years of history. In the early 20th Century, Eugene Hollander wanted to retain the lost sink hole type fat on the breast and conducted fat graft for the first time. (1912) Ever since, injections were used for fat graft more and more.

US had the most advancement in fat graft. The breast augmentation was very popular in US and at first, fat graft was mainly used for breast augmentation. However, the doctors realized that the injected fat did not last for a long time and turned their attention to implants.

In 1987, ASPRS announced that fat graft would influence of having breast cancer and pushed for a ban in fat graft for breast augmentation. Since then for about 20 years, there were no practices of fat graft.




In 2000, Prof. Sidney Coleman from NYU announced findings on his study on fat grafted patients. The finding was that fat graft can have enhanced prompt engraftment and there is no problem in detecting the severe case of seroma.

There were many critics that were already expected and in 2009, ASPRS retracted the ban on the fat graft for breast augmentation. ASPRS accepted Prof. Coleman’s findings.
Prof. Coleman’s fat graft gained momentum.

He became a pioneer and his technique called “Coleman technique”, which involves low pressure fat collection, centrifuging, 17 gauge thick pipe injection, became a standard for fat graft worldwide.
The official name for Coleman technique is “Structural fat graft” or “Coleman System”.



Much time passes since then. Doctors all over the world studied the effectiveness, safety of fat graft and the methodology in detail as well. There were many doctors who judged that Coleman technique was good and retained it, but there were many doctors who believed that the technique had to be changed.

Then in the early 2000’s, Plastic surgery team from Pittsburg, US finds out about ADSC. It finds out that fat is the largest storage module for stem cells. This was the most innovative turning point in fat graft technique development.

The history of fat graft is divided between before and after of this finding on stem cells. In WW1, the soldiers with facial damage used fat graft for treatment that resulted in very positive end but nobody know how that had happened.



Today, many doctors think that ADSC has expedited the growth of stem cells.
In 21st century, we accept that there are 2 large concepts to fat graft.

First is the “filling” and the second is “cell growth”. When you get fat from somewhere and inject it to another spot, the fat must be preserved in an undamaged state and engraft filling up the wrinkle or breast. There is 1 million stem cell per ml of fat and this must be preserved properly and injected. There must be both “filling” and “growth” effect achieved in this process.



Then what is the methodology? Traditional fat graft method is made with a few changes. Fat graft should not be perceived to be just for “volume up” but maintaining the state of the cell and leading to cell growth. We call this cellular fat graft. This is the biggest attractive point of fat graft compared to filler injections.

1) Fat can be collected from any part of the body; Stomach, thigh, waist, knee or elsewhere. There is no fact that fat from a certain part of the body is better than another. Fat should be collected from the body part that has the most fat.

2) Recompressed fat collection is the basic method with the usage of injection (Do not use any mechanical equipment)

3) There is no evidence that centrifuging is necessary for better engraftment. Do not enrich the fat cells but let them swell down naturally. Both the surrounding environment and the fat must be well preserved.



4) Fat collection should be done as quickly as possible. One must meet quick freezing conditions if wanting to use frozen fat. Therefore it is dangerous to use any normal freezer for such case.

5) Fat engraftment cannot be enhanced with the help of using stem cells or medication. It is important how much fat can be used and live to grow in the new spot for better engraftment.



6) Most people to not apply more than 100cc of fat on midface. About 30-40% get engrafted permanently.

Today, there are many patients who are interested in filler. The process is quick, cheap, and there are no complications followed.

But this commercial purposed filler cannot be injected too much into the body as it is a foreign substance. Also it causes some damage to the skin.

Also there is no connection between filler and cell growth. It is not effective for anti aging. You could say that it is currently in a transition period.

Fat graft involves moving fat from one part of the body to another so if there is no engraftment, the fat gets removed. Condensed substance such as filler tend to build-up together therefore cannot be removed at times.

Also, as stated previously, stem cells have the ability to reproduce damaged cells.



There are some discussions on whether fat stem cells can lead to anti-aging. We do not have the medical ability to avoid aging, but we can expect the stem cells to help in reproducing the damaged cells on the skin.

One example can be skin damage from ultraviolet. We expect that stem cells could help recover the damage skin. It may not be rejuvenating but there are certain expectations.
'Cellular fat graft' has two goals of filling up the volume and recovering the damaged skin tissue.

It is not important to control the state of the fat in some way, but it is more important to maintain its natural state without any damages for engraftment. Exact amount that can be engrafted on the face or breasts much be used and the injection needs to be quick as the fat should not be contaminated or damaged.

The main objectives of Cellular fat graft are recovering the damaged skin tissue, anti-aging through filling volume and improving the shape. Another goal is to enhance volume through high engraftment level in breasts or buttocks.

This is all for today. Thank you very much.