Fat

Fat transfer remains a popular treatment option because there is no cost for materials and no risk of rejection. The source of the fat is a metabolically resistant part of the body, usually the lateral hip, abdomen, or flank. The donor site is infused with tumescent local anesthesia for collection of the adipose tissue,which is aspirated or manually excised and placed in storage. At a later date, a saline suspension of this tissue is injected into the cutaneous layer for treating lipoatrophy, rhytids, and folds [4].

Fat autograft muscle injection (FAMI) is a modification of existing methods for fat transfer that creates a natural living graft that is long lasting or permanent [5].Unlike traditional fatgrafting methods, in this procedure, fat is injected solely into the muscle and immediately adjacent tissues in the direction of the muscle fibers. This allows immediate incorporation into the atrophied space and subsequent hypertrophy of the muscle. Seven specifically sized cannulas are used for each area to be injected. Fat injected into the muscle has greater longevity than when it is injected into the cutaneous layer.Preliminary findings reported that 30% of patients followed for 5 years retained at least 80% of the FAMI graft [6].