A New Technology for Liposuction and Fat Transfer

A SUPPLEMENT TO
PSP
A New
Technology for
Liposuction and
Fat Transfer
Hydrasolve® Gets the Only
FDA Nod for Fat Transfer
BY WENDY LEWIS
O
ver the last few years, autologous fat
transfer has experienced increasing
attention globally for aesthetic and
reconstructive procedures. There is significant interest among plastic surgeons
in using fat for breast reconstruction, as
well as for aesthetic breast augmentation and additional treatment options.
Historically, however, there have been
technical challenges that have made it difficult to standardize
treatment protocols and outcomes.
In April 2013, HydraSolve® by Andrew Technologies LLC
received FDA 510 (k) clearance for Autologous Fat Transfer,
so that the adipose tissue harvested during a HydraSolve®
liposuction procedure can be reinjected into the same patient
for rejuvenation or augmentation. No other liposuction device
has been FDA cleared for this use. This marks a significant
development for HydraSolve®, which may offer clinical
advantages to expand treatment options for patients.
As Dr. Mark S. Andrew, Chief Scientific Officer of Andrew
Technologies, explains, “HydraSolve® is an energy assisted
liposuction system that combines natural saline solution with
low levels of pressure and thermal energy to liquefy only targeted fat tissue. Because fat tissue is liquefied, the cutting of
fat by forceful thrusts of the cannula is no longer required. The
specially designed HydraSolve® cannula has aperture edges
that have a rounded radius of curvature that do not cut tissue. The energized saline stream inside the cannula liquefies
targeted fat tissue while preserving blood vessels, nerves and
connective tissue integrity.”
What is HydraSolve®’s point of difference? “What makes
it unique is that it is a low-energy system which achieves true
target tissue specificity, allowing liposuction to be done in a
totally new manner that is gentler, less traumatic and more
October 2013
PlasticSurgeryPractice.com
PHOTOS COURTESY OF CHRIS GODEK, MD
1 year post implant exchange, nipple reconstruction, and 6 months
after 350 cc of HydraSolve fat grafted to each breast.
precise. The gentleness is also beneficial for fat grafting,” says
Andrew.
Only available currently to select board-certified aesthetic
plastic surgeons in the U.S., HydraSolve® is an innovative
liposuction technology that features a gentler, more efficient
and precise method of fat removal. Plastic Surgeon Chris
Godek in Toms River, N.J., lead clinical investigator says,
“The system combines natural saline solution with low levels
of pressure and temperature to liquefy only the unwanted
fat - while preserving blood vessels, nerves and other tissues.
The advantages to patients are faster, smoother and more
even fat removal, plus less discomfort, bruising, swelling and
recovery.”
FAT GRAFTING FOR BREAST SURGERY
According to a recent study published in Plastic and
Reconstructive Surgery®, the official medical journal of the
American Society of Plastic Surgeons (ASPS), 70 percent of
U.S. plastic surgeons have used fat grafting for breast operations. The study indicated that 88 percent of plastic surgeons
who currently perform fat grafting to the breast use it for breast
reconstruction techniques, and often apply fat grafting along
with implants or flap procedures. The surgeons found fat grafting particularly useful for improving the shape of the breast,
including reconstruction after lumpectomy for early-stage
breast cancer. Nearly 90 percent of the surgeons use fat graft-
PlasticSurgeryPractice.com
ing for breast reconstruction, yet only 28 percent perform fat
grafting to the breast for aesthetic augmentation. 55 percent
use hand-held suction (a syringe) to harvest the fat, which is
considered to be a very time-consuming process.
Among the common concerns over the use of fat grafting
to the breast are the lack of consistency of fat graft retention
rates, and the prevalence of unreliable results. “Fat grafting
to the breast, in the right hands, can achieve satisfactory
results,” says Winter Park, FL Plastic Surgeon Jeffrey Hartog.
For breast cancer patients seeking a natural reconstruction,
HydraSolve® offers the first FDA cleared option to provide
your own fat for transfer. “HydraSolve® may offer a more natural alternative for those who seek to reconstruct their breasts
after cancer,” says Hartog.
Hartog decided to add breast reconstruction with autologous fat into his practice when his own wife Michelle Hartog,
RN was diagnosed with breast cancer. As she explains, “For
me autologous fat transfer was the best choice after considering all the options.” Hartog has since performed numerous
autologous fat breast reconstruction procedures. “I find fat
to be simply the most natural approach to breast reconstruction, without additional scarring and significantly lower risk of
complications,” he says. “HydraSolve® delivers very pure fat
that is simple to process and injects easily into the breast tissue for reconstruction. We are still early in the adoption of this
technology, but it appears to be a great option for fat transfer”.
Fat grafting to the breast is not just about aesthetics
anymore, according to Dr. Terence Myckatyn, Associate
Professor in the Division of Plastic and Reconstructive Surgery,
Washington University, St. Louis, MO. “We performed 180
liposuction and fat grafting combined cases in our practice
last year – most are from breast defects after breast cancer,”
he says.
According to Dr. Bruce Van Natta of Meridian Plastic
Surgeons in Indianapolis, IN, “I am fat grafting virtually everywhere I am operating. Using fat grafting post radiation reverses
the changes of hard, fibrotic breasts, improves skin color, softens tissue, and some patients even get sensation back. Hands
down, fat grafting is the most exciting development I’ve seen
in 25 years in practice.”
IMPROVED FAT HARVESTING AND PROCESSING
Van Natta calls HydraSolve® a kindler, gentler form of liposuction; “I have found that HydraSolve® rapidly removes fat
and produces a nearly bloodless fat layer of uniform particles
that can be easily injected into breasts and other target tissues. It may be the best system I have used for autologous
fat grafting.”
“In our practice, the majority of cases that require liposuction also require fat grafting. One area where we use a lot of
fat is in the breasts for reconstructive surgery. With fat grafting
you are introducing liposuction to the reconstructive surgery
population. The patients approach us for reconstruction, and
liposuction is a bonus,” says Myckatyn.
“When I heard that HydraSolve® is less traumatic to fat
cells and more cells survive, I was interested. The big question
surrounding fat grafting is that it is somewhat unpredictable –
survival rates are 50-60 percent. If you are dealing with more
living fat cells, you tip the balance in your favor to get more
viable fat cells to survive,” Myckatyn says. “In our experience,
HydraSolve® seems to be faster for large volume liposuction.
October 2013
AFTER
PHOTOS COURTESY OF CHRIS GODEK, MD
BEFORE
BEFORE
AFTER
PHOTOS COURTESY OF CHRIS GODEK, MD
6 months postop after
HydraSolve® used to
remove 250 cc from
the flanks and thighs.
1 year postop after
lower facelift and neck
contouring performed
with HydraSolve® to
remove 25 cc from the
neck and face.
It combines viable fat cells with quicker harvesting which is
beneficial for these larger volumes. The most remarkable thing
is how clean and bloodless the fat looks, and how much less
non-fat extraneous tissue there is. But we do not have long
term data on how well the fat is retained. Early results show
good retention, but the longest case we have is now four
months out. So far, the harvested fat appears to be cleaner.”
According to Godek who has been using HydraSolve® for
over three years, “I have done 70 cases of liposuction, and 20
of those also involved fat grafting. I have used HydraSolve®
everywhere, for the face, breasts, buttocks, and for contour
irregularities post liposuction.”
“What I like most is that it is an easier harvest, less traumatic, less bleeding and bruising. The fat comes out cleaner
with less contaminants. The fat that is removed is virtually
bloodless,” says Godek. Myckatyn agrees. “We don’t have
vast experience yet, but it seems that patients are at least at
the lower end of the spectrum of pain, bruising and swelling,”
says Myckatyn.
is less trauma, it is easier on the surgeon, and we see minimal
blood loss. This is where I believe it will be the best fit.”
Van Natta adds, “For large volumes, I wouldn’t want to use
anything else. There is nothing I am aware of that can remove
large volumes of fat as safely and efficiently as HydraSolve®.
I also offer it to abdominoplasty patients to contour the flanks
and hips. When you explain that it may save an hour in OR
time and they will have a faster recovery, patients are willing
to pay a premium.”
Godek concurs that HydraSolve® speeds up a case. “I
can extract fat twice as fast so it saves me OR time. There is
less swelling, pain and bruising, and I get a better result in my
opinion. I tell my patients they can be in a bathing suit in three
to four weeks,” he says.
In Godek’s view, the next goal would be to integrate
HydraSolve® in a contained system instead of collection in
a secondary sterile container. Andrew Technologies has the
potential to make that happen in the not too distant future.
LIPOSUCTION BY HYDRASOLVE®
FOR MORE INFO, VISIT HYDRASOLVE.COM
According to Hartog, “The concept of HydraSolve® is
attractive to plastic surgeons due to what appears to be the
very gentle nature of the technology and early studies showing
good fat viability. It will be most valuable on large volume liposuctions and appears to be a much gentler technology. There
October 2013
PlasticSurgeryPractice.com