Kaufman Matthew R, Miller Timothy A, Huang Catherine, Roostaien Jason, Wasson Kristy L, Ashley Rebekah K, Bradley James P
Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles.
Plast Reconstr Surg. 2007 Jun;119(7):2287-2296. doi: 10.1097/01.prs.0000260712.44089.e7.
Clinical use of autologous fat grafts for facial soft-tissue augmentation has grown in popularity in the plastic surgery community, despite a perceived drawback of unpredictable results.
The authors' review of the literature and their current techniques of autologous fat transfer focused on (1) the donor site, (2) aspiration methods, (3) local anesthesia, (4) centrifugation and washing, (5) exposure to cold and air, (6) addition of growth factors, (7) reinjection methods, and (8) longevity of fat grafts.
Clinical experience and basic science data showed a slight preference for the following: harvesting abdominal fat with "nontraumatic," blunt cannula technique, preparation by means of centrifugation without washing or addition of growth factors, and immediate injection of small amounts of fat by means of multiple passes. Quantitative evidence of clinical fat survivability and predictability of volume restoration does not exist, yet reports of patient satisfaction with this procedure do. Clinicians report the need for revisionary procedures to optimize results.
Although there is an increased trend in replacement of soft-tissue volume with autologous fat transfer, the literature fails to provide definitive evidence of fat survival. A large-scale clinical assessment using three-dimensional volumetric imaging would provide useful outcome data.
尽管自体脂肪移植存在效果不可预测这一公认的缺点，但在整形外科领域，其用于面部软组织填充的临床应用却越来越普遍。
作者对文献的回顾以及他们目前的自体脂肪移植技术主要集中在以下方面：（1）供区；（2）抽吸方法；（3）局部麻醉；（4）离心和冲洗；（5）暴露于寒冷和空气中；（6）添加生长因子；（7）再注射方法；（8）脂肪移植的持久性。
临床经验和基础科学数据显示出对以下方面的轻微偏好：采用“无创”钝针技术采集腹部脂肪，通过离心制备而不进行冲洗或添加生长因子，以及通过多次少量注射脂肪。目前尚无临床脂肪存活率和体积恢复可预测性的定量证据，但有患者对该手术满意的报告。临床医生报告需要进行修复手术以优化效果。
尽管使用自体脂肪移植替代软组织体积的趋势有所增加，但文献未能提供脂肪存活的确切证据。使用三维容积成像进行大规模临床评估将提供有用的结果数据。
