The autologous transplantation of adipose tissue (Lipofilling or autologous fat) is the removal of fat from a donor area (abdomen, lower limbs) and its consequent implantation in a receiving area.
This method, introduced for the first time in 1910 by Hollander for the treatment of substance loss in the face and the breast region, was later abandoned due to the high percentage of implant failure, due to the type of the graft (free fragments not vascularized).
The method was resumed later in 1985 by Illouz and Fournier (Paris), after the introduction of Liposuction which allowed to transfer no more free flaps of fat, but rather fat cells, thus ensuring the survival of the graft. In the early 90s Sidney Coleman has standardized the method by defining the exact mode of the levy, its treatment (washing and spinning) and the implantation technique. Further acquisitions have occurred recently (2001 - 2007) by many researchers including Gino Rigotti (Plastic Surgery at University of Verona), Sidney Coleman (Plastic Surgery at New York University), Maurizio Nava (Plastic Surgery at National Institute of tumors - Milan), Mario Rietjens (European Institute of Oncology - Milan), which have shown that adipose tissue, along with the bone marrow, has the highest concentration of totipotent stem cells of our body, able to, once implanted in a diseased tissue, to determine the regeneration of various tissues (adipose, connective, vascular, nervous, etc.) representing all the effects what today is universally recognized as Regenerative Medicine.
Run mode: The Lipofilling is usually performed under local anesthesia in Day Hospital (see Fig. 1, 2). The plant technique foresees the aspiration (after infiltration with local anesthetic and by the use of syringes and cannulas 10ml of 2mm diameter) of adipose tissue from the donor region (abdominal wall, trochanteric and knees); the aspirated adipose tissue (lipoaspirate) is then centrifuged (to separate the liquid component from the cell) and injected (with 1ml syringes and cannulas 2mm) at the recipient site. The treatment can be repeated after 30-60 days.
Directions: the main ones are represented by:
Substance loss and atrophy of soft tissues (post-traumatic, iatrogenic, scar, outcomes of poliomyelitis);
Trophic ulcers (vascular, diabetic, decubitus etc.);
Hypertrophic scars, keloid, retracting (burns);
Fibrosis of the skin, subcutaneous and periprosthetic post - radiotherapy;
Skin irregularities post quadrantectomy and after breast reconstruction after mastectomy;
Facial lipoatrophy by anti retro-viral (HIV +);
Romberg Syndrome (facial hemiatrophy);
Polland Syndrome (atrophy hemithorax: breast hypoplasia, absent major muscle and the pectoralis minor, hypotrophy costal cartilages);
Dupuytren's disease (retraction of palmar aponeurosis);
Skin irregularities (results of previous interventions such as Liposuction, mastoplasty, etc.);
The intervention: runs under the Convention for the pathologies described and scheme freelance for aesthetic alterations.
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