Fat Grafting Review and Fate of the Subperiostal Fat Graft

Abstract

Fat grafting has been widely used over 100 years for soft tissue augmentation. Despite a number of publications which show poor long term results, it is still one of the mostly preferred soft tissue fillers. After liposuction became popular in 1980s, an easier method of transfer, lipoinjection, once again brought attention to fat grafting. New methods to increase durability of the fat grafts were developed. Placing the fat graft to a well vascularized recipient site was one of the mostly accepted ideas. Fat grafting into the muscle and over periosteum showed satisfactory results in the long term. All the fat tissue transplanted in a recipient site will probably not survive; the area that contains necrotic fat tissue and this can cause depressions which are easily seen if the skin overlying is thin and has been previously traumatized. Placing the fat grafts subperiosteally can be a solution to this problem. In our experimental study, we compared subperiosteal fat grafting with supraperiosteal fat grafting in a rat model. Fat graft weight changes and histopathologic examinations in both of the groups showed similar properties. Thus subperiosteal grafting is an alternative augmentation technique in areas where the overlying skin is thin.