Expansion vibratory lipofilling has been introduced as a technique to allow for higher fat grafting transfer volumes. To appreciate why expansion vibratory lipofilling offers such an advantage to fat grafting, we must consider the physiology of fat grafting. Fat must be transferred in small packs typically 1cc or smaller in order to ensure that the fat cells can re-establish blood flow in the area delivered.
This process relies on microscopic blood vessels, called capillaries, from attaching to and supporting these cells. Unfortunately, if the area where the fat cells are transferred is too tight, then these small blood vessels will literally be compressed shut.
If the fat cells are packed too tightly in a small space then the collapse of these capillaries is inevitable and fat cell death results. Instead, expansion vibratory lipofilling allows for use of percussion oscillating motion cannulas with a basket tip that is used to dilate any tight spaces in the soft tissues.
What is Expansion Vibratory Lipofilling?
This process was introduced by Del Vecchio and allows BBL surgeons to pack generous fat volumes or modest fat volumes in these areas. When small volumes of fat transfer are desired, expansion vibratory lipofilling is not as critical. However, when larger volumes are desired, then expansion vibratory lipofilling has a critical role.
Three patient populations are most affected by the need to perform expansion vibratory lipofilling. The first includes the patient who desires generous mid-buttock and lateral hip filling. In these patients, the lateral gluteal depression must be expanded to allow for larger volumes of fat transfer.
The other includes the patient who desires generous central buttock projection which will require dilation of a central buttock cheek that is often narrower than that desired for maximum fat injection. A final group of patients includes patients with buttock implants who subsequently desire further buttock augmentation with fat grafting.
Due to the compression of the buttock implant on the gluteus muscle and overlying soft tissues, both layers are thinned out. This results in an even narrower space to graft fat as well as the risk of inadvertently grafting fat into or even under the muscle. Intramuscular and more importantly submuscular fat grafting must be avoided at all costs as it can result in detrimental fat emboli.
In summary, expansion vibratory lipofilling provides buttock surgeons the luxury of safety and more effective fat graft into the buttocks. Expansion vibratory lipofilling allows surgeons to both transfer larger amounts of fat and ensure that the fat graft takes are high. Interestingly, fat graft take can be variable depending on the harvesting technique, processing technique, as well as whether expansion vibratory lipofilling is utilized.
Look at this 51-year-old female following HD liposuction and BBL to correct her back appearance.
