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Water Jet Assisted Liposuction (BodyJet) and Fat Grafting

Water Jet Assisted Liposuction (BodyJet) and Fat Grafting. LLC NIKE-MED Satellite Symposium Moscow - 13 th of December 2012. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed)

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Water Jet Assisted Liposuction (BodyJet) and Fat Grafting

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  1. Water Jet Assisted Liposuction (BodyJet) and Fat Grafting LLC NIKE-MED Satellite Symposium Moscow - 13thofDecember 2012 BEAULI-HumanMed

  2. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  3. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  4. Dr. Daniel MünchLiposuction since 1993 (5000 Op)Fat Transfer since 2010 (110 Op)liposuction.ch BEAULI-HumanMed

  5. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  6. First Report on Fat Auto-Grafting in Humans in 1893 Gustav Adolf Neuber (1850-1932) BEAULI-HumanMed

  7. Meeting of the «Deutsche Gesellschaft für Chirurgie», April 12-15, 1893 BEAULI-HumanMed

  8. Holländer, 1910: Partial breast reconstruction through injection of autologous adipose tissue • Peer, 1950: Study of Loss of weigth and volume in human fat graft • After Introduction of liposuction: Fischer, Illouz, Fournier (1983): adipose tissue transplantation come into vogue BEAULI-HumanMed

  9. Strong upswing in scientific investigation of autologous fat transfer with publications and research by Chajchir (1986, 1989), Coleman (1998, 2001), Delay (2005, 2009) and Rigotti (2008, 2009) Results depend essentially on the methode BEAULI-HumanMed

  10. ”…. structural fat grafting is going to revolutionize breast surgery and completely change the way plastic surgeons deal with the female breast."-- Sydney Coleman, M.D. Original technique (LipoStructure) used by Coleman in bilateral breast enlargement took at least 5 – 7 h BEAULI-HumanMed

  11. Coleman: Successfull transplant of fat is possible in principle • Problem: facility for harvesting large quantities in realistic surgery time BEAULI-HumanMed

  12. WAL: Technique for cell friendly harvesting of fat cell particles which would reduce operation time and result in a high integration rate Reinjection of the fat after separation from superfluous water by means of the LipoCollectorR Water-Jet Assisted Liposuction (BodyJetR ) BEAULI-HumanMed

  13. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  14. Fat Grafting Methode should be • Clinically safe • Easy to perform • Fast to perform • Render reproducible results BEAULI-HumanMed

  15. Blood supply Size of the fat droplets 0-300µm: survival 300-550µm: regeneration ≥550µm: necrosis/cysts BEAULI-HumanMed

  16. Fat droplets of until1mm diameter are save Survival max. 1mm Regeneration BEAULI-HumanMed

  17. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  18. Patient Selection BEAULI-HumanMed

  19. Patient Selection BEAULI-HumanMed

  20. Patient Selection Patients with lipodystrophy in the trunk/thighs and small breasts is are „good candidates“ BEAULI-HumanMed

  21. Patient Selection: be aware • Slim, young women with small breasts and tight skin envelope, BMI under 19 • Unrealistic expections • Is there enough fat (and money) for later transfers? • Prevoius surgery, scarring • Weight loss after the transfer BEAULI-HumanMed

  22. Patient Information: Volume gain • 200mlinjected Volume • 75% pure Fat, 25% Water: Volume 150ml • Uptake: 70%: Volume 105ml Volume gain: about half oftheinjectedvolume Shrinking: max. loss in 3 weeks, final result in 2-3 months BEAULI-HumanMed

  23. Volume gain Water Not Absorbed 200ml injected Volume Pure Fat 105ml Volume gain Volume gain BEAULI-HumanMed

  24. Volume gain 100ml BEAULI-HumanMed

  25. Patient Information • General information about possible cyst formation or calcification • Mammogram • Infections • Bleeding BEAULI-HumanMed

  26. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  27. Prevent Cooling • Klein Solution: 350C • Patient warming blankets (Inditherm, Bair Hugger) BEAULI-HumanMed

  28. Prophylaxis • Antibiotic for 7 days • Low dose Liq. for 3 days BEAULI-HumanMed

  29. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  30. Klein Standard Tumescence Solution (Body temperature) BEAULI-HumanMed

  31. Infiltration(Cannula 2mm) Fragmentation BEAULI-HumanMed

  32. Additional Analgesia • Entonox (50% nitrousoxide + 50% oxygen) • Analgesic + anxiolyticagent • Effective • Rapide • Patient acceptable • Safe (noanesthesiologist!) BEAULI-HumanMed

  33. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  34. Cannula Applicator BodyJet Collector BEAULI-HumanMed

  35. Water Jet Harvest • Water carries the delicate fat tissue (pulsing water jet, 30bar, 90ml/min, 300 angle) • Small openings (0,9mm): tiny parcels of fatty tissue • Reduced negative pressure (-0,5bar) • Gentle movements BEAULI-HumanMed

  36. Infiltration and aspiration Result BEAULI-HumanMed

  37. Water Jet Harvest • Residue of 30% fluid permits easy reinjection and leads to a uniform distribution of the fat in the tissue • Duration of the invervention: only 1 ½ - 2 h Ueberreiter BEAULI Thieme 2010 BEAULI-HumanMed

  38. Water Jet Harvest • Water Jet Liposuction yields harvested fat of consistent quality (immediatly re-use without centrifugation) • Small cell packages containing adipocytes and pre-adipocytes are transferred BEAULI-HumanMed

  39. No Seperation of Stem Cells • 500ml of fat must be extracted in addition • The enzymatic preparation process takes 3h • Additional costs BEAULI-HumanMed

  40. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting/LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  41. Lipo Collector From Patient to BodyJet BEAULI-HumanMed

  42. LipoCollectorTM BEAULI-HumanMed

  43. Lipo Collector BEAULI-HumanMed

  44. My Person History of Fat Transfer Principles of Fatgrafting Patient Selection and Information Precautions Anaesthesia Fatgrafting with WAL/BodyJet (HumanMed) Fat Collecting /LipoCollector (HumanMed) Fat Injection Complications My Results Conclusion BEAULI-HumanMed

  45. Fat Injection Syringue: • 10ml • Luer Lock Cannula: • Diameter 2.00mm • Lenght 150mm • 2 Lateral Eyes BEAULI-HumanMed

  46. Fat Filling • 2/3 in the subcutis • 1/3 in the muscle and retroglandular • Not in the glandular tissue • Decollté • Compensating for asymmetry BEAULI-HumanMed

  47. Fat Filling • 2/3 in the subcutis • 1/3 in the muscle and retroglandular • Not in the glandular tissue • Decollté • Compensating for asymmetry 2/3 Gland 1/3 m.pectoralis BEAULI-HumanMed

  48. Cave: seeding fat lumps BEAULI-HumanMed

  49. Yoshimura/Autologous Fat Transfer Shifmann (Edit) Springer 2010 • Fan shaped • Several planes • Rotatingthecannula • Strunglikepearls • «3D»-Filling • Not overfill (to much fat kills the fat) • Patient in a upright 450 position BEAULI-HumanMed

  50. Fan shaped • Several planes • Rotatingthecannula • Strunglikepearls • «3D»-Filling • Not overfill (to much fat kills the fat) • Patient in a upright 450 position BEAULI-HumanMed

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