Nano Fat Grafting

Nono Fat Grafting

For the areas in the face that are relatively delicate areas  such as eyelids & lips, a novel technique of micro & nanofat grafting can be used, typically with harvesting cannulas as small as 0.7 mm in diameter.

The term “nanofat grafting” was first used by Tonnard et al. & they  highlighted the clinical application of the micro & nanofat grafts & sought to determine the cellular content of nanofat grafts.

Their study exposed that the nanofat grafts were devoid of adipocytes & the native architecture was disrupted. However, the nanografts retained a rich supply of adipose stem cells, which were similar to the macro and micro samples in terms of stem cell proliferation & differentiation. Other studies have  has analysed the nanofat for adipocyte viability & found the CD34+ in its  stromal vascular fraction (SVF). Therefore obtaining nanofat grafting is the simplest method to achieve limited number of adipose-derived stem cells (ADSCs) & performing the injection with small cannulas in very small amounts is another advantage of this procedure.

To obtain the nanofat graft, according to the report of Tonnard et al., emulsification of the fat was achieved by shifting the fat between two 10-cc syringes connected to each other by a female-to female Luer-Lock connector (Tonnard et al. 2013). In this way the microfat lipoaspirate was processed into nanofat. Processing consisted of emulsification & filtering of the lipoaspirate. After 30 passes, the fat became liquid and this was filtered over a filter so as to remove the connective tissue and the effluent (nanofat graft) was collected. Then the nanofat graft will transfer to 1- mL syringes then, inject it into the treatment area using 23-G cannula.

Nanograft can be used easily for skin rejuvenation purposes due to its small size and the fact that it contains stem cells (Tonnard et al. 2013). Several clinical cases using nanofat grafts resulted in improved skin quality 6 months post-operatively. Therefore Tonnard has suggested that while nanografts do not contain viable adipocytes, the high content of stems cells in nanografts may be clinically useful in skin rejuvenations.

Although the regeneration properties of adipose-derived stem cells ADSCs in clinical usage have been reported for radio-dermatitis, atrophic scars, chronic ulcerations and anti-ageing therapy, but, also nano fat graft applications has been extended for the management of a wound healing problems including  combining it  with skin grafting. It is consider as a proven method for long lasting remodeling facial contours & rejuvenating the skin. besides treating the horizontal neck wrinkles & lines. Studies shows its effect for atrophic scars & stretch marks improvement &  many others. 

Read More-References:

  1. Bertheuil N, Varin A, Carloni R, Girard P, Chaput B. Mechanically isolated stromal vascular fraction by nanofat emulsification techniques. PlastReconstr Surg 2017;140:508e‑9e. doi: 10.1097/PRS.0000000000003630.
  2. Bi H-S, Zhang C, Nie F-F, Pan B-L, Xiao E. Basic and Clinical Evidence of an Alternative Method to Produce Vivo Nanofat. Chinese Medical Journal. 2018;131(5):588-593. doi:10.4103/0366-6999.226074.
  3. Cemal Alper KemaloğluNanofat grafting under a split-thickness skin graft for problematic wound management.Kemaloğlu SpringerPlus (2016) 5:138
  4. Dasiou-Plakida D. Fat injections for facial rejuvenation: 17 years experience in 1720 patients. J Cosmet Dermatol 2003; 2:119-25; PMID:17163916
  5. Gause TM, Kling RE, Sivak WN, Marra KG, Rubin JP, Kokai LE. Particle size in fat graft retention: A review on the impact of harvesting technique in lipofilling surgical outcomes. Adipocyte. 2014;3(4):273-279. 
  6. Gu Z, Li Y, Li H. Use of Condensed Nanofat Combined With Fat Grafts to Treat Atrophic Scars. JAMA Facial Plastic Surgery. 2018;20(2):128-135. doi:10.1001/jamafacial.2017.1329.
  7. Kemaloğlu CA. Nanofat grafting under a split-thickness skin graft for problematic wound management. Springerplus. 2016 Feb 20;5:138. 
  8. Mashiko T, Wu SH, Feng J, Kanayama K, Kinoshita K, Sunaga A, et al. Mechanical micronization of lipoaspirates: Squeeze and emulsification techniques. Plast Reconstr Surg 2017;139:79‑90. doi: 10.1097/PRS.0000000000002920.
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  3. Robert W. Alexander, Understanding Mechanical Emulsification (Nanofat) versus Enzymatic isolation of tissue stromal vascular fraction (tSVF) cells from adipose tissue- potential uses in biocelluar regenrative medicine
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  6. Wei H, Gu S-X, Liang Y-D, et al. Nanofat-derived stem cells with platelet-rich fibrin improve facial contour remodeling and skin rejuvenation after autologous structural fat transplantation. Oncotarget. 2017;8(40):68542-68556. doi:10.18632/oncotarget.19721.

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