31įor several decades following the publication of these studies, fat grafting was mostly limited to injection fat grafting and transplantation, as previously noted. Lexer et al first presented a case of chronic cystic mastitis in 1931 that was completely reconstructed by autologous adipose tissue that was rotated as a local flap from the axilla, rather than injected as previously described. This injection technique was later modified by Miller et al, in which he used a metal cannula to transfer autologous fat, which was an early predecessor to those that we use today. 29 However, he was first to note that these aesthetic results were short lived due to the reabsorption of the grafted fat over time. He was the first to inject the autologous fat graft into the subcutaneous space to correct the aesthetic result of a rhinoplasty procedure. In 1911, Brunning et al demonstrated the first use of a needle and syringe to transplant fat. From this time forward, hundreds of studies have been published that have continued to develop, modify, and refine the technique of autologous fat transfer to the modern techniques we have today. 27, 28 Silex followed with fat transfer for cosmetic repair of periorbital scars, similar to the reconstructive use demonstrated by Neuber et al several years prior. 26 Czerny et al in 1985 performed a similar transfer of autologous fat in the form of a lipoma from the back for breast reconstruction. 25 However, the more relevant transfer of adipose tissue was reported by Neuber et al in 1893 when he took fat from the forearm and used this to fill a volume and contour irregularity of the face caused by a scar, for which he obtained excellent aesthetic results. In this study, omental fat was grafted between the liver and diaphragm to help treat a diaphragmatic hernia. The first attempt at transferring autologous adipose tissue dates back all the way to 1889, in the first report by Meulen et al. The history of fat grafting is one of the most interesting and abundant within the field of plastic surgery. These include recipient site preparation, harvesting, processing, and engraftment. In this review, the authors will summarize the rich history of autologous fat grafting and describe a comprehensive summary of the science and theory behind autologous adipocyte transplantation, as well as the techniques commonly used. 23, 24 Additionally, until recently there has been little evidence demonstrating the superiority of various harvesting and processing techniques, such as centrifugation, cotton gauze filtering, and sedimentation. 19–22 It is often difficult to decide the ideal donor site based on patient characteristics, recipient site volume requirements, and healing implications. Widespread use has also led to the development of dozens of different techniques in both donor and recipient site preparation, fat harvesting, and postharvest processing. 13, 14 A lack of immunogenicity, low cost, and easy accessibility make this the technique of choice in the face of many reconstructive and cosmetic challenges. 1–12 Autologous grafting provides for inherent biocompatible properties, leading to a very successful treatment modality for general soft tissue augmentation and volume replacement, with little patient morbidity. Autologous fat grafting has become increasingly popular in recent years, with many new reconstructive applications for the breast and face, postradiation and burn injuries, and congenital anomalies, as well as the plethora of aesthetic applications in body contouring, breast augmentation, facial contouring, and more.
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