The popularity of fat transfer by injection continues to grow due to the appeal of a natural biologic filler material for both small and large soft tissue volume needs. This interest continues to grow despite ongoing issues of inconsistency in graft take and survival. While the critical steps in fat transfer are well known, harvest, processing and injection, their exact influences on graft survival are less well understood. Each step in the process introduces variables and inconsistencies that play some role in eventual graft survival.
Because of the inconsistency in fat graft survival, the historic tendency has been to overfill or overcorrect. This technique seem logical but it results in a lot of short-term swelling and patient management issues. A fat transfer kit, Viafill (Aesthetic Factors LLC) was developed to overcome these fat transfer problems. It is based on a more efficient and self-contained method that reduces graft exposure to air, handles the graft more gently and produces more optimally-sized fat globules…all methods known to reduce fat cell death.
The viability of fat cells would seem to be better with virtually no exposure to air. Centrifuging the harvested fat at 50G for only two minutes removes unwanted liquids and cellular debris but has been shown to not damage adipocyte viability. Acquiring a collection of fat cells that are not larger than 2mm would seem to bolster survival due to quicker access to a critical oxygen supply. These three potential benefits of the Viafill system allow it to be used to the point of good fill with no need to overfill.
Complementing the Viafill kit is Viasilk cannulas. They are a disposable set of precision cannulas. Rather than using re-sterilizeable injecton cannulas, Viasilk cannulas are one-time use devices that have an internal coating that allows the fat to be passed through the cannula with minimal trauma to the cell.
Aesthetic Factors also owns Selphy, a platelet-rich fibrin matrix. When combining all three products, a comprehensive system is available to provide autologous tissue regeneration. Whether Selphyl can be an additive benefit to fat grafting to further improve survival is theoretical but is an ongoing area of clinical study.
Dr. Barry Eppley