Autologous fat grafting has seen exploding growth in market size, revenues, patient acceptance, technologies due to the improved methods for harvesting and re-introduction techniques used. Typical facial augmentation procedures using fat transfer yields almost 80%+ revascularization rates and yields much higher duration for the life of the augmentation that can last for (7) years or more. Newer centrifuge units and technologies allow for greater preservation of the fat harvested and micro cannulas now allow for precise placement of the fat as well as greater control over the volume. Patients prefer fat because it is a more permanent, safe, and more natural looking result by using the fat from one area and introduce the fat to large deficit areas (lipoatrophy) or to the smallest of rhytids and hollows across the face and other body part areas.
If you know how to place dermal fillers, have an aesthetic eye, and willing to make a minimal investment in technology then autologous fat grafting is ideal for integration within your practice. Patients if having the option would prefer their own natural fat compared to synthetic HA products and other bio-stimulation augmentation procedures. The average price for these procedures for patients are between $2,500 and $3,000 and eliminates the need for synthetic fillers in future periods. In comparison with dermal fillers, the patient will be able to receive more volume and the physician will make a higher professional fee and profit from the AFT procedure as there is very little expense with the procedure.
Manual Aspiration Technique for Fat Grafting
Fat grafting/Transfer is a minimally invasive procedure that allows for the harvesting of adipose fat using either manual aspiration (MAL) or power assisted liposuction (PAL). The areas of harvesting (donor sites) are typically the abdomen, gluteal fold (buttocks, lateral thigh) or love handle areas where fat is typically stored and easily harvested. Tumescent anesthesia is used to limit the amount of anesthesia associated with the procedure. Once harvested the fat is then cleansed and isolated using a centrifuge system allowing for only undamaged fat cells to be used for the injection. Typical areas for injection of the fat include most facial areas, buttocks, and lipoatrophy areas from trauma or surgery across the body.
Autologous Fat Transfer Technique using Cannulas
Transplantation is the final step of the procedure where the injection of the fat is accomplished using blunt tip cannulas of various sizes and contour to evenly replace fat into the targeted areas that has been diminished through the aging process. Common facial areas need only one fat injection for noticeable and long-lasting improvement, whereas other areas of the body may require additional procedures for final correction. The rationale behind why additional procedures might be needed is that there are limits to each injection to ensure vascularization of the fat, if you infiltrate too much fat per injection you may interfere with the vascularization of the fat due to the body breaking down the excess fat introduced.
The improvements to the harvesting and transplantation of fat in the past few years now allow physicians to perform this “clean” procedure within their offices using a sterile field. Manufacturers now offer “disposable kits” that allow for the physician to be able to perform the procedure with the minimal of capital investment. Newer vented blunt tip cannulas allow for multiple linear threads to be introduced and there are specialty cannulas that contour to the face for problem areas around bone, larger lengths also allow for fewer access port entries across the areas. Most commercial centrifuge systems dedicated to the purification of fat are closed systems that minimizes any exposure to the procedure room environment.
The adipose fat once cleansed and isolated now allows for excess fat to be frozen for a period of (30) days with viability rates of almost 80% reducing the expense and time of re-harvesting fat for minor touch ups or repeat procedures. Implanted fat also contains estrogen receptors that will improve skin appearance and skin value to the patient while also increasing the biological processes of supporting tissue.
The AAOPM Autologous Fat Transfer Training Course allows for physicians to expand your tissue augment procedures with the “natural” filler, it is non-immunogenic and when placed properly is semi-permanent or even permanent in some cases. During your Fat Transfer Course study you will be able to train, observe, and study fat transfer methods from a Board Certified Physicians or other specialty instructors that successfully perform these fat grafting procedures. Learn to successfully integrate and perform these procedures within your present office setting from people who perform fat transfer within their offices.
The revenue for the physician and cost to the patient is dependent on the volume of fat transfer an individual patient presents, the extent and amount of revision to be done, the geographic region where the procedure is desired, and the physician’s desired professional fee. Most surgeons will charge $2,500.00 to $3,000.00 per surgical hour or a minimum of $1,500.00 for shorter procedures. The average time for the fat grafting procedure is around 30-45 minutes depending on the extent of patient consultation.
The AAOPM Fat Transfer Training Workshop includes a complete digital resource guide of forms, informed consents, and standardized protocols. You will receive as part of your fat grafting training all course materials presented during the course including a detailed color manual of the didactic given as well as other materials given to AAOPM attendees to help them in introducing these new procedures within their office.
Re-Introduction Technique for Facial Fat Pads
Upon Completion of this program, the physician should be able to:
Harvest and Preparation for Fat Grafting Procedure
Speaker Introduction, Market Size, Benefits to Patients, and viability of offering Fat Grafting Procedures in your medical practice. Physician patient selection: pre-operative assessment, preparation, and evaluation of potential patients. Pre-operative test workup for patients with a past medical history contradicting treatment. Initial consultation, concerns, and desired outcomes for patients. Introduction to Tumescent Anesthesia, Pharmacological Solutions, and other patient considerations.
Advantages and disadvantages of performing Tumescent Anesthesia. Klein Formulation, modified tumescent options, and the influence on adipose tissue. Protocols and guidelines for anesthesia including approximate volumes according to body site. Review pharmacodynamics and pharmacokinetics of anesthesia options and “standard of care” guidelines possible complications. Review the harvesting (extraction of fat) procedures using the various liposuction techniques including limitations and influence on adipose tissue. Anatomical areas for the safe harvesting for liposuction (donor sites) including port sites of entry and access points.
Review the male/female gender differences including the quality of fat, ease of removal, and the ability to contour. Response to tumescent anesthesia, fibrous fat, and superficial fat deposits of males in comparison with females. Histology of fat, specific areas of adherence for harvesting, and adverse events for associated risks and complications associated with the procedure (i.e. accumulation of fat particles, fat emboli, excessive ecchymosis and edema, and asymmetries).
Lunch (on your own).
Manual Aspiration and Power Aspiration procedure, objectives for fat transfer, new equipment technologies, centrifuging of fat, and low vacuum aspiration and snap-syringes for fat harvesting. Possible areas of the face, fat pad (deposits) anatomy, marked patient areas of injection, patient considerations for correction. Injection methods including established protocols and guidelines for suggested levels (amounts) of lipogems injection including per injection volume. Review blunt tip cannulas for reinjection, disposable cannulas, by needle injections, nano-fat preparation, and fat autograft muscle injection (FAMI). Demonstration of the facial procedure using anatomical models.
Augmentation of the buttocks, indications and options including treatment pearls, injection techniques, port entries for reinjection, and volume considerations. Review other body areas for fat transfer augmentation including hands and breasts. Post procedure review, need for “touch-ups” and additional treatments for augmentation. Before and After Photo Gallery and video of a complete autologous fat micro grafting procedure of the face.
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