Clinical Applications of Cell Optimized Nanofat and Nanofat Biocream
Stromal vascular fraction (SVF) is the matrix portion of fat containing a heterogenous population of stem and regenerative cells. SVF can be obtained with enzymatic or mechanical dissociation. Nanofat was a term introduced by Tonnard in 2013 to describe a mechanical means of dissociating fat into a stromal vascular fraction that could be injected through a 27G needle. Cell optimization of nanofat was described more recently as a means to increase the number of regenerative cells in the nanofat, while preserving the ability to inject through smaller needles and to compound with a liposomal transport agent as a unique biocream. Herein, we describe a method of making cell optimized nanofat and discuss the clinical applications.
Methods/Technique
:Under local anesthesia, a 14G needle puncture is made and gently dilated. Fat is harvested using a Khoury cannula with a 2 mm hole size (Marina Medical, Stuart, Florida). The fat is then cleaned with Ringer’s lactate and decanted. The fat is now placed in a 10- or 20-ml syringe and processed into a cell optimized nanofat (Lipocube, London, UK). This involves passing the fat through a mechanical cutting screen to create a 1 mm parcel size, then passing the 1 mm product 10X through a 1 mm tunnel for smoothing and lastly, through a 500-micron cutting screen. The end product is a cell optimized nanofat that can be injected through a 27G needle, placed as a graft through a cannula, microneedled into the dermis, or compounded with a liposomal transport agent into a biocream for home application.
Results/Complications
:Nanofat has been used by cannula injection into the subcutaneous lower eyelid, by microneedling into the entire face, neck, décolletage, hands, arms; and by sharp needle injection intradermally into the radial wrinkle lines of the lips and into the deep creases of the neck. Nanofat biocream is routinely used with fractional lasers and after facial fat grafting with and without facelifting. Nanofat is an important component of our treatment for vaginal rejuvenation and is routinely microneedled into the vaginal mucosa and clitoral region. In addition, nanofat is used for alopecia. Clinical cases will be shown to demonstrate the techniques and outcomes.
Conclusion
:Nanofat and SVF have become widely available. This report clarifies the differences between Nanofat and SVF as well as between different techniques of obtaining Nanofat. Nanofat in conjunction with lasers have improved the clinical outcomes and have both sped up healing as well as promoted ongoing repair to the skin. More objective studies are required to further define the use of nanofat in alopecia and vaginal rejuvenation although preliminary results have been promising.