자가 지방 주사이식 28예에 대한 임상적 고찰 = CLINICAL REVIEW FOR THE 28 CASES OF AUTOLOGOUS FAT INJECTION

다국어 초록 (Multilingual Abstract)

According to medical literature, the clinical fat graft was first reported by Dr. Neuber 1893 at the 23rd congress of the German surgical society. The fat graft became popular during the next few decades and accordingly basic studies for tissue transplantation developed. However in 1965 the new development of liquid injectable silicone lead to diminishing of the use of fat graft for a while.
After that, the fat graft became popular once more because of serious complications of silicone. This resulted in a new harvesting method of the fat by use of liposuction in 1976. It is a very simple method which sucks fat tissue from the donor site with negative pressure through the cannular adopted syringe and then fat is immediately injected into the recipient site.
The fat that has been sucked out has small globula shapes which has several advantages such as (1) a shorter period of neovascularization into the grafted fat which will result in less reabsorption after the graft (2) minimal scars on the donor and recipient sites (3) repeated use with intervals is possible if needed.
We performed 28 cases of auto fat graft during last 8 months, 8 were corrections of nasolabial fold, 6 were augmentations of the forehead or glabella, 5 were augmentations of sunken cheeks, 5 were augmentations of depressed temples, 2 were correction of wrinkles around orbit and upper lip and 2 were corrections of depressed scars in the trunk.
For a better result of fat injection, the injection needle should be placed directly under the surface of the fold or wrinkles, and the spreading of the injected fat to adjacent areas should be avoided. The space between the skin and muscle under the fold or winkles is so narrow and less expandable compare to the adjacent areas that it can easily result in the spreading of the injected fat into the adjacent areas. It is important that assistant put pressure on the adjacent areas with their fingers during the injection of fat to prevent the spreading. A certain amount of the injected fat will be reabsorved. The degree of absorption depend on the site and the individual. In my experience, there is a tendency of less reabsorption in facial areas than in the trunk.
Except for transitional ecchymotic change of the skin around the fat graft, there were no serious complications in our cases. A few patients were not completely satisfied with the results which was solved by an additional supplement of fat 3-6 months after the first operation.
We think this procedure is safe and simple for the correction of any kinds of sunken deformities of the body, skin folds and wrinkles as a substitute for silicone or collagen injection.