Objectives: Explain how different devices make different nanofat products
Discuss the various uses of nanofat as a regenerative product
Introduction: Nanofat, a name coined by Tonnard and Verpaele, describes a stromal vascular fraction (SVF) product that can be injected through a 27 gauge needle. SVF was first used in aesthetic surgery in 2003 by Cohen and Holmes and can be obtained both enzymatically and mechanically. Cell optimized nanofat is a mechanically derived, SVF product that preserves the fibrotic niche of the cells, optimizing the cell counts and hence the regenerative functions of the nanofat. Herein, we describe the how cell optimized nanofat is used in clinical plastic surgery, dermatology and aesthetic gynecology.
Materials / method: Fat is harvested under tumescent anestheia using a cannula with 2 mm holes. The fat is cleaned with normal saline or ringer's lactate and allow to decant. The decanted fat is transferred to a 10 or 20 ml syringe and passed from port 1-2, one time to convert the fat into a 1 mm parcel. Next, this fat is transferred back and forth 10 times from port 2-3 to smooth the product and lastly, the fat is transferred one time from port 3-4, to make the cell optimized nanofat. This nanofat when compared to Tulip's technique of emulsification and filtering, yields almost 2 times the number of SVF cells.
Results: Cell optimized nanofat can be delivered by cannula, by 27 gauge needles, by microneedling devices and as a unique topical biocream, by centrifuging the nanofat and compounding it with a liposomal transport agent and arnica. Cell optimized nanofat is used as component of isolated facial fat grafting to address skin regeneration, in conjunction with facelifting, in addition to fractional laser resurfacing both as a microneedled nanofat as well as a topical biocream. Cell optimized nanofat has been used for difficult wounds anywhere on the body, including areas of radiation.
Conclusion: Cell optimized nanofat is a highly effective biologic compound that can be used in many areas of plastic and reconstructive surgery for facial skin and tissue regeneration, difficult wounds, compromised tissue and a variety of dermatologic conditions especially when associated with autoimmune disorders. Vaginal mucosal regeneration is another promising application and is easily performed during vaginal rejuvenation procedures. Early evidence of signicant improvement in fractional laser outcomes have been demonstrated as has long term fat graft retention.
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