Optimizing Fat Grafting Using a Hydraulic System Technique for Fat Processing: A Time and Cost Analysis

Vincenzo Verdura; Antonio Guastafierro; Bruno Di Pace; Mario Faenza; Giovanni Francesco Nicoletti; Corrado Rubino

doi:10.1055/s-0042-1744361

Optimizing Fat Grafting Using a Hydraulic System Technique for Fat Processing: A Time and Cost Analysis

Arch Plast Surg. 2022 Apr 6;49(2):266-274. doi: 10.1055/s-0042-1744361. eCollection 2022 Mar.

Authors

Vincenzo Verdura¹, Antonio Guastafierro¹, Bruno Di Pace^{2

3

4}, Mario Faenza¹, Giovanni Francesco Nicoletti¹, Corrado Rubino^{5

6}

Affiliations

¹ Multidisciplinary Department of Medical Surgical and Dental Specialties, Plastic Surgery Unit, University of Campania "Luigi Vanvitelli," Naples, Italy.
² Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," PhD School of Translational Medicine of Development and Active Aging, University of Salerno, Salerno, Italy.
³ Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
⁴ Anglia Ruskin University School of Medicine, Cambridge and Chelmsford, United Kingdom.
⁵ Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
⁶ Plastic Surgery Unit, Department of Oncology and Haematology, University Hospital Trust of Sassari, Sassari, Italy.

Abstract

Background Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a "hydraulic system technique" optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure. Methods Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, "1-track," and "2-tracks" systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat. Results In 15 cases the standard system was used (mean treated fat 72 [30-100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the "1-track" system (mean treated fat 183.3 [120-280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the "2-tracks" one (mean treated fat 311[220-550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the "1-track" system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the "1-track" system and "2-tracks" system becomes statistically significant from 240 mL of fat in 15 minutes ("1-track") versus 9.3 minutes for the "2-tracks" system. Conclusion Data analysis would indicate the use of the standard system, "1-track," and "2-tracks" to treat an amount of fat < 90 mL of fat, 90 ÷ 240 mL of fat, and ≥ 240 mL of fat, respectively.

Keywords: fat grafting; fat washing; hydraulic system; lipofilling; regenerative surgery.

The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).