Viafill

About Viafill

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Autologous Fat: The Ideal Filler

The realization that soft tissue loss is an important part of the aging process has renewed interest in fat as cosmetic filler.  Autologous fat has many qualities that make it the ideal filler.  These include:

• Autologous and completely biocompatible
• Naturally integrated into the host tissue
• No risk of allergic or foreign-body reactions
• Readily available, easily obtained, and inexpensive
• Appears naturally with the same consistency as surrounding tissue
• Does not cause a Tyndall effect*

*:As light passes through the skin, the colors of the spectrum scatter and those with a shorter wavelength, such as blue, scatter backward. If injected too superficially, some hyaluronic acid dermal fillers cause a bluish Tyndall effect at the injection site, which represents visible hyaluronic acid seen through the translucent epidermis. [References: 1. Tyndall effect. http://medical-dictionary.thefreedictionary.com. 2. Dermal Fillers. http://emedicine.medscape.com /article/1125066-overview.]

Challenges of Autologous Fat Transfer

Although fat is viewed by many as the ideal filler, standard systems of harvesting and preparing fat for transfer have presented challenges. One of the most important challenges is maintaining adipocyte viability. Fat tissue is fragile, and the viability of harvested and purified fat cells is not high. Consequently, a consistent majority of transferred fat is resorbed by the body.¹

Resorption

A variable amount of transplanted fat is resorbed after transplantation, making it difficult to determine the amount necessary to fill a defect.² It is theorized that the key to fat transfer success is viable fat cells, as only living adipocytes have the potential to develop a blood supply and provide durable benefit to the patient.³ Successful survival of the transferred fat cells depends on the cells receiving adequate nutrition and respiration via contact between the host tissues with its capillaries. Dead cells and debris can also act as an insulator between the grafted fat cells and nutritional and oxygen resources.¹ Overall, when less trauma occurs during harvesting, graft preparation, and transfer, there appears to be a correlation with more consistent long-term volume maintenance.² Causes of trauma to fat cells with traditional fat harvest techniques may include:

• Manipulation and exposure to air during harvest, graft preparation, and transfer⁴
• High negative pressures created when using a liposuction device⁵
• High centrifugation forces¹
• Internal corrosion of reusable cannulas, which may damage cell membranes as they move through the tube, causing them to lyse and die

Overfilling

To compensate for fat graft resorption, physicians often overfill the treated area. According to a survey of plastic surgeons, 87% of physicians believe that it is important to overcorrect autologous fat grafts by overfilling⁶:

• 19% believed 10% overcorrection is required
• 60% recommended overcorrecting by 20% to 30%
• 21% overcorrected by 40% to 50%

The Viafill™ System

The Viafill™ System is a patented system for the aspiration, harvesting, filtering and reinjection of autologous fat. It was designed to incorporate the latest research on centrifugation and fat cell viability. The Viafill™ System addresses most of the current fat transfer challenges by limiting manipulation, exposure to air, trauma, and excessive g forces during the fat transfer process. Key findings from a pivotal study by Boschert, published in Plastic and Reconstructive Surgery in 2002 and used to develop the Viafill™ System, include

• G forces >50 result in increased destruction of cells and a larger oil layer component; a 50-g centrifuge setting is ideal
• Centrifugation beyond 2 minutes is unnecessary
• The bottom-most layer of fat from a liposuction aspirate provides 2.5 times as many viable fat cells as the top layer
• Using only this bottom layer for transplantation will yield a fat graft with more viable cells, potentially improving graft survival and decreasing resorption

What Makes the Viafill™ Fat Transfer System Unique?

Fat Cell Harvesting

• The Viafill™ short, broad 20-cc harvest syringe is operated manually, avoiding the generation of high negative pressure and cell damage that typically results from mechanical aspiration⁵
• A disposable, stainless steel aspiration cannula with a lubricious coating allows delicate fat cells to flow smoothly during transfer, potentially minimizing damage to their outer membrane.

  Benefits of Viafill™ Disposable Cannulas vs Reusable Cannulas

  • Removes the risk of cross-patient contamination
  • Virtually eliminates infection due to instrument contamination
  • Decreases liability concerns
  • Decreases risk of cannula leakage and breakage
  • Eliminates protein residue and corrosion from autoclaving
  • Lubricious coating minimizes cell damage and internal blockages
  • Reduces investment in costly, reusable equipment

Handling

• The Viafill™ fat harvest syringe contains a proprietary removable plunger arm that is not available in competing systems.  The Viafill™ plunger arm is removed from the syringe that holds the aspirate while the rubber stopper, which protects the aspirate from air, remains in place.
• The Viafill™ fat harvest syringe (with plunger arm removed) is placed in a specially designed, disposable, sterile centrifuge tube with built-in filter and dropped cleanly into the centrifuge.

The Centrifugation Process

• Lipose™ Corp. has developed a countertop centrifuge that can be used as a companion to the Viafill™ System Kit
• The Viafill™ Centrifuge is designed to provide the ideal force (50 g) to filter and compact fat with the least amount of trauma for the proper time (2 minutes), which allows a greater number of viable fat cells to be transplanted.²
  • In a study by Puckett and Bechert evaluating various centrifuge speeds, “…there was a 26percent decrease in the number of viable cells from 50 g to 500 g and cell loss progressively increased up to the speeds recommended by Coleman (1,286g).”¹
• The tip of the syringe remains open to allow tumescent fluid, blood, and other debris to pass through the tip of the syringe and through the filter as it is centrifuged.
• The centrifuge rotor arm is not fixed and swings out at a 90⁰ angle during the centrifugation process.

Oil Removal

• The special design of the plunger arm and rubber stopper allows the user to use a standard needle and syringe, included in the Viafill™ System kit, to pierce the center of rubber stopper and extract oil without disturbing the fat or exposing it to air.
• The bottom layer of centrifuged fat, which contains the largest number of viable cells, is not disturbed by manual decanting or wicking of oil, common to other fat transfer procedures.⁷

Re-injection

• Once the plunger arm is reinserted in the harvest syringe, the fat can be transferred to a small 1-cc syringe via a leur-to-leur transfer device with minimal exposure to air, or injected directly from the harvest syringe.
• If desired, the physician can transfer and reinject only the bottom portion of the centrifuged fat, which contains the greatest number of viable cells.²
• The single use injection cannula with a lubricious coating results in a smooth fat cell flow into the graft area.

Viafill™ System Is Supported by Evidence Summaries From the American Society of Plastic Surgeons (ASPS) Fat Graft Task Force

In 2009, the ASPS Fat Graft Task Force published an assessment regarding the safety and efficacy of autologous fat grafting. ⁸

Other Viafill™ System Benefits Over Current Fat Transfer Techniques

• Fast (less than 15 minutes), and easy to use
• Completely disposable, including cannulas, reducing contamination risks
• Inexpensive—no up-front costs for expensive medical equipment

For detailed instructions on using the Viafill™ Fat Transfer System, click here.