Fat Grafting 101
Fat grafting refers to the process of fat collection via liposuction from a donor site (usually your thighs, abdomen, or flanks), fat purification, then re-injection back into another area (ie. the face, breasts, or buttocks) requiring volume augmentation. Because the fat is your own tissue, the hope is that it will survive in its new location and look and behave in much the same way your native fat would.
Ideally, the surviving fat would last for longer than fillers like Restylane, and avoid allergic reactions and granulation tissue formation that sometimes occur with such fillers. The downside of fat grafting is that its variable survival rate makes the long-term cosmetic outcome unpredictable, and that harvesting of fat requires liposuction and its associated side effects.
To add to the confusion, fat grafting is sold as several different services. Names like "regular fat grafting", "PRP fat grafting", and "stem-cell fat grafting" are presented to patients, most of whom are confused how they are different.
So what exactly do these terms mean?
PRP fat grafting
PRP (aka platelet-rich plasma) is a component of blood that is a light yellowish fluid. It contains platelets, which make growth factors that aid in tissue healing. In PRP fat grafting, PRP is harvested by collecting blood from the patient and spinning it in the centrifuge to concentrate and separate blood into its various components, one of them being the PRP portion. This concentrated PRP is then added back into the fat collected from the donor site, and together, this mixture is reinjected back into the recipient site.
Stem cell fat grafting
In stem cell fat grafting, stem cells which occur naturally in fat (adipocyte-derived stem cells, ADSCs) are extracted along with the fat during liposuction. During purification of the fat, the stem cells are also concentrated by centrifugation. Together, the fat and stem cells are reinjected back into the recipient sites. The goal is for the stem cells to grow and transform into fat cells and other types of cells (blood vessels, collagen, etc) that support the survival rate and volume retention of the fat graft.
Basically PRP and stem cells are "add on" services that aim to increase the retention of the fat graft. Stem cell fat grafting tends to be more expensive than PRP fat grafting, with regular fat grafting being the cheapest option.
The studies currently available do show increased survival of fat grafts enhanced with PRP or stem cells.
Micro and Nano fat grafting simply refers to a smaller size of the fat droplets injected during grafting. A smaller droplet will hopefully give a better aesthetic outcome in areas of thin skin, like the eye area, where potential lumpiness due to uneven grafting showing through is more of a concern.