Lipofilling is a surgical technique used by plastic surgeons for the treatment of functional and aesthetic skin scars and depressed areas. It consists in the transplant of centrifuged autologous subcutaneous adipose tissue (using the Coleman’s technique) (Fig. 1, 2, 3, 4). The lipoaspirate contains mature adipocytes and stromal stem cells from which depends the survival of the graft. Histological examination is the only objective evidence of adipocytes take. Contrast enhanced ultrasound (CEUS) can show the fat graft survival but a standardized method is not described...

In collaboration with our colleagues of U.O.A. Plastic Surgery during the period November 2009 – December 2011 were examined 18 patients (6 males, 12 females, mean age 38 years, range 19-59) for a total of 24 lipofilling interventions; 6 patients underwent surgery 2 times to the need to increase gradually the thickness of the subcutaneous tissue. We used devices with multifrequency linear probes and specific software for contrast medium (SonoVue-Bracco). All patients were examined with ultrasound B-mode and contrast-enhanced (CEUS) before surgery, 1 and 3...

Among the 26 interventions tested at 1 and 3 months, 22 showed a vascularization of the transplanted tissue comparable to that of pre-treatment subcutaneous adipose tissue, with a preservation of the transplanted tissue thickness (Fig. 6, 7, 8, 9) while in 4 cases we found a lack of blood supply already at the 1 month-control although correct displaying of the transplanted tissue (Fig. 10, 11) ; after 3 months this absence of vessels, further confirmed, was accompanied by resorption of transplanted adipose tissue (Fig. 12,...

Vascularization is one of the main limits to the survival of transplanted adipose tissue because adipocytes are very sensitive to hypoxia, it follows that the vascularity of transplanted adipose tissue is an index of a regular tissue engraftment however adipose tissue with poor or no vascularization is doomed to be reabsorbed resulting in graft failure. CEUS is the only test that can evaluate the microvasculature of adipose tissue. Due to this characteristic we can monitor the engraftment of transplanted adipose tissue and provide realistic and...

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