Fig. 215-39. Fat Graft combined with GF and Stem Cells Technique.
A) Fatty tissue and serous-sanguineous fluids separation.
B) Diluted stem cells are mixed with GF highly concentrated plasma and.
This preparation is later injected to the graft.
C) Fatty tissue injected to the muscular layer.
D) GF low concentrated plasma injected to the treated area.

Fig. 215-40.                                                                           Fig. 215-41.

Fig. 215-40. Face surgery combined with, blefaroplasty and fat graft as a face filler combined with GF and Stem Cells.

Fig. 215-41. Face surgery combined with, blefaroplasty, CO2 laser and fat graft combined with GF to fill naso-labial folds. Lip augmentation using SAMS (Fig. 215-35).

Fig. 215-42. Face surgery combined with, blefaroplasty, nose surgery, CO2 laser, fat graft with GF and SMAS for lip augmentation.

Fig. 215-43. Middle and lower third face surgery, blefaroplasty. CO2 laser and fat graft with GF for lip augmentation.

When the folds that are located at the back of the hand are too deep, we combine fat graft with GF and Stem Cells. Long tem results are very satisfying. (Fig. 215-49).

Conclusions:

* Fat graft was an innovating method that came to fill a very important gap in plastic surgery´s field as a minor technique that is still valid.
* Our histhopatological studies that include a 20 year follow up, show that fat grafts survive. This confirms the Cellular Survival Theory.
* Scientific investigations performed by doctor Guerrerosantos (México), show an excellent graft attachment in both, laboratory animal and clinical cases. He reassures that the bigger the blood supply, the grater the survival chances.
*There are very low chances of complications after this procedure.
* When GF are used with fat graft, the attachment is grater than 50%. This percentage increases even more when stem cells are used.
* Fat graft´s survival possibilities are grater when bigger diameter cannulas are used.
* Cylinders should not have a grate volume. They should also be separated to allow better vascularization.

Fig. 215-44. Buttocks augmentation and liposuction secondary depression filling with Fat graft,
GF and Stem cells.

Fig. 215-44. Buttocks augmentation and liposuction secondary depression filling with Fat graft,
GF and Stem cells.

Fig. 215-46. Liposuction and fat graft combined with GF used in buttocks modelling.

Fig. 215-47.                                                                                Fig. 215-48

Fig. 215-47. Liposuction body shaping, fat graft, GF and Stem Cells filler.

Fig. 215-48. Fat graft, GF and Stem Cells filler used for buttocks augmentation.

* In those patients that have gain weight, it has been seen that this tissue increases importantly; causing important deformations that must be corrected.
* Since we are working with an autologous graft, there are no immune effects, a great advantage when comparing this method to others.
* There are many different ways to perform this procedure because of the deferent needs it is used for.
* There are no complications in repeating the fat injection. The graft must not be washed, filtered or mixed with anesthetic solutions or additives. We can assure this because of what we have seen through our experience. These factors may change the graft´s attachment capacity.
* Failure to attach might be caused by a technique deficiency to obtain the material. Our purpose in not to discuss the history and evolution of autologous transplant, but to show the procedure’s efficiency and the long term results we have proved though many years.

Fig. 215-49.  Fat graft and GF filler used for hand rejuvenation.

Acknowledgments
This chapter would not have been done without the collaboration of all the Barrancas Medical Center team (Buenos Aires, Argentina)
We would like to thank doctor Iliana Benzaquen for her unconditional support through all these years and her collaboration in experimental studies; doctor Gustavo Chajchir for encouraging us to investigate new techniques; doctor Daniel Fabrizio and doctor Edgardo Celi (hematologist) for their technical cooperation with obtaining GF and Stem Cells; doctor Ignacio Calb (Piñeiro Hospital, Chief of the Pathological Anatomy Department) for his histological analysis and his long term follow ups; doctor Marco Antonio Salazar and doctor Alejandra Peláez (plastic surgeons, Fundación Universitaria de Educación Médica Continua, resident coordinators) for their cooperation in writing this text and image elaboration.

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