Fig 1 - uploaded by Juan Monreal
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Instrumental patentado y empleado por el autor desde 1998 para la realización de todo tipo de injertos de grasa autóloga.
Source publication
The “permanence” of fat as long-term implant material is a fact that, while controversial for many plastic surgeons, has been proven in clinical practice and in histologic studies. The goal of this article is to describe, first, the technique used by the author for transplanting autologous fat, and second, the instru- ments designed for performing...
Contexts in source publication
Context 1
... de grasa: Las zonas donantes preferen- tes son las ya descritas por otros autores por la pre- sencia de un tejido graso menos vascularizado ( zona infraumbilical, cara interna alta del muslo o trocánte- res). Para la extracción de la grasa el autor emplea una cánula (patentada) diseñada por él mismo en 1998 específicamente para este fin (Fig. 1). Se trata de una cánula de 3 ó 4 mm de diámetro externo que presenta cuatro hileras de orificios. El tamaño y distribución contribuyen a la aspiración de pequeños fragmentos de tejido graso (1,5 a 2 mm de diámetro) de una forma atraumática, así como a obtener mayor cantidad de grasa con menos movimientos de cánula. La aspira- ción ...
Context 2
... de la grasa: En condiciones normales no suele ser necesario más de un lavado para eliminar los restos sanguíneos del aspirado. A continuación se colocan en gradillas especiales (patentadas) diseñadas para acoger cualquier tamaño de jeringa entre 1 y 50- 60 cc (Fig. 1). En todo momento hay que evitar el con- tacto de la grasa con el aire; cualquier burbuja de aire detectada en la jeringa debe ser expelida inmediata- mente y la jeringa tapada con su correspondiente tapón. No se han encontrado beneficios adicionales con el uso de la centrifugación. Una jeringa de 50 cc con la grasa ya preparada tarda ...
Context 3
... muy pare- cida en los primeros tres meses. No obstante a los 12 meses la reducción de volumen fue de al menos un 50% si se compara con el resultado obtenido a los tres meses. Los casos de engrosamiento de pene fueron valorados, además, midiendo el incremento en el perí- metro del pene a los 3-4 meses y a los 12 meses des- pués de la intervención (Fig. 8-11). Todos los casos salvo 5 mantuvieron un incremento mínimo en el perímetro de 1,25 cm y máximo de 2 cm a los 12 meses. Cinco casos tuvieron incrementos menores de 1 cm, siendo nulo en uno de ellos. Sólo en 6 casos (todos ellos de engrosamiento de pene) se detectaron nódulos palpables persistentes al cabo de los 3 meses; la extirpación ...
Context 4
... de 2 cm a los 12 meses. Cinco casos tuvieron incrementos menores de 1 cm, siendo nulo en uno de ellos. Sólo en 6 casos (todos ellos de engrosamiento de pene) se detectaron nódulos palpables persistentes al cabo de los 3 meses; la extirpación de dos de ellos reveló pseudoquistes y en dos ocasiones se trató de un nódulo de grasa viable encapsulada (Fig. 10). Hasta la fecha sólo se ha detec- Cirugía Plástica Ibero-Latinoamericana -Vol. 31 -Nº 2 de 2005 Monreal Vélez, J. tado un caso de sobrecrecimiento del implante como consecuencia de una ganancia considerable de peso. No se han detectado sobrecrecimientos espontáneos como los descritos por otros autores (9,20). Los 46 pacientes que han ...
Citations
Background: Autologous fat grafting is a safer and convenient alternative to permanent or semipermanent injectables due to better results and fewer and lesser side effects than synthetic injectables.
Objectives: The author reports his experience in fat grafting to the nose using his personal technique in 48 consecutive patients. The experience covers primary treatments of non-operated noses, treatment of postrhinoplasty deformities, and the combination of fat grafting to the nose with rhinoplasties.
Methods: The technique used by the author for fat grafting to the nose does not differ too much from that used in other body or face areas. It is based in the atraumatic extraction of fat fragments using a multi-orifice cannula and the injection of these fragments using 1.4–1.6-mm cannulas or needles. When combining rhinoplasties with fat grafting, fat grafts were used instead of prosthesis or cartilage grafts in the same location.
Results: The initial analysis of postoperative results showed a good to high level of patient satisfaction, particularly in primary cases, with virtually absence of complication or severe side effects. Some easily corrected side effects were probably learning curve dependent.
Conclusions: Autologous fat grafting is an effective and reliable technique to perform aesthetic and reconstructive nose reshaping in those patients who refuse surgical treatments. Although clinicians can get optimal results with this technique, these are not comparable to those obtained by surgical rhinoplasties, and this is an important issue to discuss with the prospective patient.
Clinicians are facing an increasing trend toward nonsurgical nose reshaping using synthetic injectables, mainly for patients who refuse standard rhinoplasties. Autologous fat grafting is a safer and convenient alternative to permanent or semipermanent injectables due to better results as well as fewer and milder side effects. The author reports his experience with fat grafting to the nose using his personal technique for 36 consecutive patients. The experience covers primary treatments of noses not treated by surgery, treatment of post rhinoplasty deformities, and combination fat grafting and rhinoplasties.
The technique used by the author for fat grafting to the nose does not differ significantly from that used for other body or face areas. It is based in the atraumatic extraction of fat fragments using a multi-orifice cannula and injection of these fragments using 1.4- to 1.6-mm cannulas or needles. In combining rhinoplasties with fat grafting, fat grafts are used in the same location instead of a prosthesis or cartilage grafts.
The initial analysis of postoperative results showed a good to high level of patient satisfaction, particularly in primary cases, with virtually no complications or severe side effects. Some easily corrected side effects probably were learning curve dependent.
Autologous fat grafting is an effective and reliable technique for aesthetic and reconstructive nose reshaping for patients who refuse surgical treatments. Although optimal results can be achieved with this technique, they are not comparable with those obtained by surgical rhinoplasties, and this is an important issue to discuss with the prospective patient.
