Trim the fat, save it for later

ORLANDO, Fla. – Giving new meaning to the phrase “recycle, repurpose, reuse,” a Florida plastic surgeon is opening a fat bank so patients who have fat removed during liposuction can store it for future use.

Cosmetic surgeons who perform fat-transfer procedures typically transfer the patient’s fat immediately after removing it through liposuction, often within the hour. Common sites for the transferred fat are the face and breasts.

Having their fat in the bank would allow patients to draw on it later, when they want to plump up body parts that have succumbed to age, said Dr. Jeffrey Hartog, whose new Liquid Gold center is next to his cosmetic-surgery clinic. “I will present it as an option to any patient having liposuction,” he said.

The fat bank is a unique concept, say those behind its launch. But opponents of the idea say such centers are rare for good reason.

Dr. Daniel Del Vecchio, a plastic surgeon at Massachusetts General Hospital who has studied fat transfer, is among those concerned.

“Animal data shows that frozen fat doesn’t hold up as well as fresh fat,” he said. Plus, he added, storing it poses “a logistical nightmare. There are better solutions.”

Although fat-transfer procedures – minus the freezing – have been around for some time, they aren’t too common because of their mixed results. In a 2007 national consensus survey published in the Plastic and Reconstructive Surgery Journal, the authors wrote, “Unfortunately, the clinical optimism expressed by the proponents of the procedure has not been corroborated by objective scientific assessments.”

The difficulty lies in the fact that human fat is harder to control than synthetic fillers, including implants. Once relocated, some of the transferred fat absorbs. Just how much is tough to predict. Physicians take an educated guess, but if they over-fill, they leave a lump; under-fill, and they need to add more.

Without fat in the bank, if a patient needs more fat in the transferred site, then a repeat liposuction procedure, which requires anesthesia, is necessary, said Hartog.

“Fat banking takes this procedure to a whole new level,” said Hartog. “We put the patient to sleep once. Do the lipo. Get the fat out once and have as much as we need for later injections.”

Del Vecchio says he would still rather harvest the fat and use it when it’s fresh. “You only need 30 to 50 cc’s for a facial procedure. You can always find that somewhere on a woman’s body. And that’s the best bank of all.”

At Hartog’s new center, once fat is harvested through liposuction, it’s drained, cleaned and put in containers for freezing.

Though Hartog declined to state specifics because it’s a “patented process,” he said he then adds “protectants” to the fat and puts it into a slow freeze, ultimately taking the fat to minus 192 degrees Celsius, a very deep freeze, where the fat tissue can stay for the patient’s life, he said.

The cost to store 250 to 300 cubic centimeters of fat, which would fill a coffee cup, is $900 for the first year and $200 a year after that, he said.

Dr. Stephen Baker, associate professor of plastic surgery at Georgetown University, also has serious reservations about the banking and reuse of frozen fat.

“No good data exists to substantiate the fact that frozen fat does well or is metabolically viable,” said Baker.

Hartog cited a study published in 2005 in the Annals of Plastic Surgery. It looked at optimal freezing and thawing conditions for fat tissue and stated that “longer storage times may be harmful” and concluded that the study didn’t answer the question of whether the body would accept the tissue.

Another paper published in 2007 in Cryobiology found that freezing fat tissue “may become a real option after further refinements.”

Baker also registered concern about the potential for error in what is essentially a privately run tissue bank. “Even in the best-run tissue banks, which require multiple layers of tissue identification, humans make mistakes. If a patient gets the wrong fat injected, the results could be serious,” said Baker.