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Concentrated fat can be transferred to a small syringe (which is our preferred size for fat injection) by using an adapter. It is convenient to use 1 cc clear syringes for small-volume fat injections; the syringes cause very little friction or resistance during injection and thus allow the surgeon to easily control the amount of fat injected. It is necessary to remove the air bubble that is inside the syringe before the procedure, so that the surgeon can accurately determine the amount of fat injected. We have also used a 3 cc syringe to inject large volumes of fat into the body.

You can either use a special syringe to collect the fat or use a process that causes the fat to be frozen and thus be infused by gravity or by crushing the fat with a special device.

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Some of the larger fat processing systems (such as the LipoGraft, from Medi-Khan, in West Hollywood, CA) claim that their devices produce equivalent or higher concentrations of purified fat with reduced red blood cell debris and free oil compared with alternative methods such as centrifugation. Some of the studies have problems with their experiment designs and were not independently checked. These studies failed to show that they were superior in terms of the percentage of fat grafts that are viable and the rate at which they maintained grafts in vivo.

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Some surgeons strongly recommend that surgeons use a device that filters or even use gravity to separate fat grafts. Some surgeons prefer to use a filtration device or use sedimentation to purify the fat; other surgeons prefer to use a centrifuge to remove potentially inflammatory compounds.

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Khouri et al. reported that they have developed a technique that allows them to process large or mega volume fat grafts. Lipoaspirate is harvested by a cannula that has 12 side-holes that lets it pass through the skin at a low pressure (300 mm Hg) to give a supersonic flow. The fat is collected from a patient with an incision in his limb and then centrifuged at 15 g for 3 minutes (using a machine that centrifuges by hand). Once the fluid is drained, the fat is gathered in the same container and is used to make a graft delivery container. Unlike the solid graft material obtained from centrifuges that produce a paste-like consistency, the graft material obtained from low g centrifuges yields a more homogeneous material. It is a method that has been recommended for large or mega volume fat grafting with the specially designed device because of its speed and effectiveness.

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Kybella

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We are blessed that our medical field continues to evolve and provide patients with innovative treatments. It is exciting and satisfying to see successful medical technology such as the Kybella system being developed. Kybella is the first and only FDA-approved drug that can reduce the appearance of double chin (submental fullness caused by excess fat in the chin) in adults. Kybella is a synthetic form of naturally occurring deoxycholic acid (DCA), which kills adipocytes by inducing their death. It is not known whether Kybella can be safely used to treat fat under the skin outside the submental region.