Abstract

PLANAS, Jorge; MUNOZ, Juan  and  GONZALEZ, Dorian. Description of a new closed system to process fat and to obtain nanofat: analysis of clinical and cytometric results. Cir. plást. iberolatinoam. [online]. 2017, vol.43, n.1, pp.23-32. ISSN 1989-2055.

Background and Objective. Currently, fat is one of the most important tools in Aesthetic and Reconstructive Plastic Surgery. In fact, it has changed the approach of multiple treatments and protocols in the last decade. Nanofat is a new procedure derived from emulsifying the fat and injecting it into the dermal layer. The authors describe how to harvest the fat with a closed loop that they have developed, and their experience with nanofat technique. The procedure, clinical applications, cases reports, and tissue studies to evaluate its stem cell content will be explained. Method: Between March 2013 and February 2015, the nanofat technique was performed in 56 healthy patients. We apply this technique to the skin of cheeks, nasolabial folds, neck, hands, neckline and in particular to correct the color of dark circles in combination or not with micrograft to treat the nasal groove. For the infiltration of nanofat we used a needle of 27G, The infiltrated quantity of nanofat varied depending on the area to be treated, in the case of the dark circles the average was 2 ml, in face and neck was 7.5 ml and in hands was 4.8 ml per hand. The infiltration of nanofat was performed at the subdermal level. The emulsified tissue was evaluated with flow cytometry to determine the viability of the cells of the product of this emulsified fat, as well as the presence of CD34 + cells. The clinical assessment was done by means of photography and the Likert satisfaction scale at 3, 6 and 12 postoperative months. Results. All clinical cases showed significant improvement from 3 to 6 months after treatment. There were no major complications or undesirable effects. There was only 1 minor complication (inflammatory hyperpigmentation). With the use of flow cytometry, we have demonstrated that viable CD34+ cells were present in the emulsified fat. Conclusions. Nanofat looks like an effective tool for skin rejuvenation. We have observed a significant improvement in the quality and elasticity of the skin, decrease in fine wrinkles and pigmentation in areas such as dark circles. The use of a closed circuit avoids direct manipulation, in which the authors reduce the exposure of the tissue to ambient air. The physiological mechanism of nanofat through which these positive results are obtained has not yet been fully elucidated; the paracrine effect of stem cells derived from adipose tissue (ADSC) cannot be ruled out as a mechanism of action.

Keywords : Fat graft; Micrograft; Stem cells; Adipose-derived stem cells (ADSCs); Skin rejuvenation.

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