When we think about lipofilling we consider the following steps: collection, processing and placement.
Although collecting and processing can be easily standardized, fat placement is subject to investigation, especially given the degree of resorption. The size of the local vasoconstriction cannula, aspiration, are easily investigated to quantify the amount of viable fat and mesenchymal cells available before processing.
The fat processing stage ranges from not collecting fat to the use of devices, this step being used to quantify the amount of viable cells ready to be placed in the receptor site.
Once viable cells are grafted with or without fat cells derived from stem cells, it is very difficult to finalize and quantify the variables responsible for the end result.
The following questions can be asked:
- Which cells, adipose or mesenchymal are responsible for the end result and in what percentage
- Receiving areas differ in graft acceptance, simultaneous surgery (face lift + lipotransfer) before surgery (scar tissue), radiotherapy (poorly vascularized tissue) or congenital vascular deformities (Romberg disease) interfere with reception of grafts, and in what proportion?
- Besides the clinical assessment which method is reliable, applicable, non-invasive to assess the surgical outcome within the specificity and sensitivity of distinguishing native transplanted fat cells? will there be changes in the corrected tissue?
These questions remain open to new technological advances.