The future of fat
Promises and Precautions
There are lots of ways to harvest fat, from simple syringe or cannula systems to fancy in-line depots that keep the fat sterile but remove serum and blood, according to Dr. Johnson. Some doctors centrifuge the fat; some don't, she says.
“Everyone appears to get similar results, so there's no absolute ‘right way’ to harvest and concentrate the fat,” Dr. Johnson says.
According to Dr. Talei, emulsified fat, or Autologous Micronized Lipocyte Injection (ALMI), is a method for breaking down fat particles into a creamy smooth substance, so surgeons can inject it where they want.
“The risks are dramatically minimized with this method. The survival of the grafting is reduced as well we believe, but that's ok,” Dr. Talei says. “This method can now safely be used to treat difficult areas like the temples, marionette lines and nasolabial folds.”
“I'm still hesitant to place fat directly under the eyes because of the complications,” Dr. Talei says. “And we should always be cautious of injecting the lower face. If you cause the face to weigh down or produce irregularities like peau du orange, how will you fix this? I can't most of the time.”
Fat transfer, according to Dr. Talei, is much safer and easier to use in the body.
“It has become extremely popular to perform liposuction and reinject the fat into the buttocks and waist for sexier curves. Men are also doing this now for larger pecs, shoulders, arms and even manipulating these procedures to get six-pack in the abs,” Dr. Talei says.
Another promising area for fat or emulsified fat is hair restoration, he says.
“So far, we have seen that Platelet Rich Plasma (PRP) can have a positive effect in many but not all patients with androgenic alopecia,” he says. “The results from a combination of PRP mixed with ALMI or A cell matrix have been promising, although nothing has been proven yet.”
There is a new option in the pipeline, which could have promise. It’s an off-the-shelf fat graft that will be available soon, according to Dr. Johnson.
“It is denatured fat, so, there is apparently no allergic response,” she says. “This might be a nice option in patients who need more volume than a typical hyaluronic acid syringe, those who metabolize other fillers quickly, or very thin patients who don't have adequate donor areas for standard fat grafting. It remains to be seen how long this fat filler will last.”
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