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Book and Media Reviews

Fat Injection: From Filling to Regeneration. 2nd Edition

Varkarakis, George M. M.D.

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Plastic and Reconstructive Surgery: December 2018 - Volume 142 - Issue 6 - p 1665-1666
doi: 10.1097/PRS.0000000000005070
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As a service to our readers, Plastic and Reconstructive Surgery® reviews books, DVDs, practice management software, and electronic media items of educational interest to reconstructive and aesthetic surgeons. All items are copyrighted and available commercially. The Journal actively solicits information in digital format for review.

Reviewers are selected on the basis of relevant interest. Reviews are solely the opinion of the reviewer; they are usually published as submitted, with only copy editing. Plastic and Reconstructive Surgery® does not endorse or recommend any review so published. Send books, DVDs, and any other material for consideration to: Arun K. Gosain, M.D., Review Editor, Plastic and Reconstructive Surgery, Brookriver Executive Center, 8150 Brookriver Drive, Suite S-415, Dallas, Texas 75247.

Arun K. Gosain, M.D.

Review Editor

Fat grafting is an integral part of the modern plastic surgeon’s practice. Systematization of the fat grafting technique, along with the discovery of adipose-derived stem cells and the stromal vascular fraction, is associated with the recent surge of popularity. Adipose tissue is considered the greatest reservoir of adult mesenchymal cells, capable of differentiating into other types of tissues. In this second edition of Fat Injection: From Filling to Regeneration, Drs. Coleman, Mazzola, and Pu analyze thoroughly the fat grafting principles and its regenerative effects, and present the clinical experience of 90 of the world’s expert surgeons in fat grafting. Dr. Coleman is an authority in this field and pioneer with his over 30 years’ work in New York City. There are many questions, however, still unanswered in fat grafting, especially with regard to harvesting, processing, placement, and recipient preparation. The scope of this updated edition is to provide the cutting-edge knowledge in fat grafting from both basic and clinical science points of view.

The book is organized into three parts and has 53 chapters. The first part contains Dr. Coleman’s description of his named technique, and discusses the biology behind the survival of fat grafts based on the described “niche theory.” Dr. Rubin describes the nomenclature of stromal vascular fraction and sheds light on antiinflammatory stem cell principles. Dr. Yoshimura give us the latest information on the anatomy and physiology of adipose tissue, describes the benefits of stromal vascular fraction and adipose-derived stem cells in wound healing, and reviews several laboratory tests that study the viability of fats grafts. The role of growth factors in the lipoaspirate and the mechanism of enhancing the survival of the adipose tissue graft is also described. The second part is focused on the biological principles and the regenerative potential of adipose tissue, which studies have shown to be a premier source of cells for evolving tissue engineering and regenerative therapies. The role of platelet-rich plasma and strategies to improve the clinical outcomes of fat grafting, such as tissue volumization and revascularization and revitalization of adipose tissue, are discussed. The third and largest part of the textbook is dedicated to the clinical use of adipose tissue in all aspects of plastic surgery. The detailed effects of adipose tissue in skin regeneration with the differentiation of the fat’s mesenchymal cells into fibroblasts and stimulation of collagen secretion are presented both histologically and clinically. Impressive photographs following fat transfer in various cases, such as burns, irradiated wounds, scleroderma, and others, confirm the amazing healing properties of adipose tissue. In aesthetic surgery, the addition of volumizing techniques definitely has improved the results of the surgical procedures. The authors describe in detail the techniques for fat transfer in the supraorbital region, nasolabial folds, lips, nose, chin, jawline, neck, and during face-lift surgery. Volume replacement therapies with fat in aesthetic and reconstructive breast surgery are described with emphasis also on the oncologic risks of fat grafting on the breast. The role of fat transfer in the upper and lower extremities and body and pain syndromes are discussed. Finally, ways to avoid and handle complications after fat transfer are presented.

A few of the book’s many strengths are the quality of the content, bringing the most current information on the topic by the world’s experts. The excellent color illustrations, the e-book, and the videos add significantly to its value. This book is certainly one of the most comprehensive review textbooks on fat transfer. I wholeheartedly recommend this book as a resource for understanding the concepts and regenerative properties of adipose tissue and the techniques for achieving a profound result with fat transfer procedures.

Copyright © 2018 by the American Society of Plastic Surgeons