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Published on: January 7, 2015
Long-term volumetric retention of autologous fat grafting processed with closed-membrane filtration
David J Gerth1, Bethany King2, Lesley Rabach2
1Dr Gerth is a volunteer Assistant Professor at the University of Miami Miller School of Medicine, DeWitt Daughtry Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Miami, FloridaDr King is a facial plastic surgeon in private practice in Northampton, MassachusettsDr Rabach is a fellow in facial plastic and reconstructive surgery at Rutgers/Robert Wood Johnson University Hospital, New Brunswick, New JerseyDrs R. A. Glasgold and M. J. Glasgold are Clinical Professors, Department of Surgery, Division of Otolaryngology and Facial Plastic Surgery at Rutgers/Robert Wood Johnson University Hospital, New Brunswick, New Jersey d.gerth@med.miami.edu.
Background:
Some practitioners have criticized the unpredictable retention associated with autologous fat transfer. Potential causes of variations in predictability include intrinsic (patient-related) or extrinsic factors, such as harvesting, processing, and graft-delivery technique.
Objectives:
The authors sought to determine the long-term retention of autologous fat graft processed with a closed-membrane filtration system, to compare this retention with centrifuge-processed fat, and to analyze factors that affect graft retention.
Methods:
This was a prospective analysis of 26 female patients (representing 52 hemi-midfaces) who underwent autologous fat transfer to the midface via the closed-membrane filtration system. The Vectra 3D camera and software were employed for all photography, which was then analyzed to compare immediate preoperative images with long-term follow-up images (obtained at least 10 months postprocedure). The authors compared the findings with data from their previous study of centrifuge-processed fat grafts (historical controls).
Results:
Mean values were as follows: age, 55 years; follow-up period, 17 months; amount of autologous fat injected, 8.88 mL; absolute volume augmentation measured at the last postoperative visit, 3.71 mL; and retention, 41.2%. Results of Welch's t test, in which the membrane-filtration data were compared with the previous centrifuge data (31.8% long-term retention), showed a significant difference (P=.03). Retention in this study was significantly higher in patients younger than 55 years (53.0% vs 31% for older patients; P=.001) and lower in patients who underwent rhytidectomy (23.8% vs 47.6% for nonrhytidectomy patients; P<.001).
Conclusions:
Autologous fat processed by closed-membrane filtration had a significantly higher long-term retention rate than did centrifuged-processed fat injected by the same surgeons.
Level Of Evidence:
3.
