Fat transplantation for soft tissue augmentation in the lower limbs.

Attempts at fat transplantation in humans began as early as 1893 with Neuber [1] and came to the fore again with the introduction of liposuction. In his 1988 paper, titled "Present Results of Fat Injections," Illouz [2] concluded that permanent results were achieved in only 20 to 30% of cases. Numerous other authors also reported poor outcomes. The uniform conclusion of almost all the authors was that the outcome was the result of the common method they followed, that is, injecting fat subcutaneously. However, the poor perfusion of the subcutaneous tissue does not appear to be adequate for the timely revascularization of adipocytes. Around 1983 Jose Guerrerosantos [3,4] successfully injected fat intramuscularly in guinea pigs. Subsequent removal and histological examination of the grafts demonstrated revascularization and almost-complete survival of adipocytes, presumably due to the rich perfusion of the muscle.