• dr stillaert

IFATS 2017, Miami, USA

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Dr Filip Stillaert is presenting at the IFATS Meeting in Miami, Florida (USA). He presents the hybrid technique in breast reconstruction, also called the “bioengineered breast” which is a combination of fat grafting with an implant to achieve natural results in breast reconstruction. This approach is not a standard technique in our department but an alternative to microsurgical tissue transfer. It minimizes the impact of an implant. Implant are known to induce scar formation, distort the breast over time, migrate with widening of the cleavage area and are responsible for breast animation when positioned behind the pectoral muscle. Besides his … Continued

18th International Course on Perforator Flaps

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Our department organizes the 18th International Course on Perforator Flaps in Ghent, Belgium. The first ever International Course on Perforator Flaps (ICPF) was organized in Gent, Belgium, 20 years ago in 1997, when perforator flap surgery was still in its pioneering phase. Perforator flap surgery was described as extravagant and exceptional in those days but it has now become the mainstream reconstructive technique for restoring defects throughout the body. What started as a small meeting among friends, has grown into a major international forum where colleagues share their new ideas in the field of perforator flap surgery. The course has … Continued

IFATS Meeting 2017

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In November 2017 the next IFATS Meeting will take place in Miami, United States. IFATS is the International Federation for Adipose Therapeutics and Science. Dr Stillaert is an IFATS member and will present his experience on breast reconstruction with implants and fat grafting. He will also moderate a scientific session on fat grafting. More on www.ifats.org.

World Symposium on Ergonomic Implants

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The World Symposium on Ergonomic Implants took place from September the 14th till September the 17th in Italy. Ergonomic implants are the next generation of breast implants and very promising results have been presented. The hybrid breast augmentation has been presented and the results are very natural. I’ve been using ergonomic implants for breast augmentation and breast reconstruction.

fat cells harvested by liposuction for breast reconstruction by lipofilling

Why lipofilling?

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  The derivation of the terms “adipose” and “lipid” originate, respectively, from the Latin “adeps” and the Greek “lipos” for fat. Adipose tissue is present in all mammalian species and a variety of non-mammalian species. White adipose tissue is the only tissue in the body that can markedly change its mass after adult size is reached. Thus, fat mass can range from 2 to 3% of body weight in extremely well conditioned athletes to 60-70% of body weight in massively obese individuals. Normal values for fat mass are 9-18% in males and 14-28% in females. In obesity, fat mass exceeds 22% … Continued

close-up of fat cells in syringes and preparing for lipofilling in plastic and reconstructive surgery

History of fat grafting

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On the 5th of July, 1601, the Archduke Albert began the siege of Ostend – described as ‘the long carnival of death – with 20,000 men and 50 siege guns. After each terrible encounter the Dutch surgeons brought in great bags filled with human fat, which was then esteemed the sovereignest remedy in the world for wounds and diseases (Silverman, 1988). Van der Meulen described the first use of fat in human autotransplantation in 1889. The procedure consisted of grafting a free omentum and fat autograft between the liver and diaphragm. The first use of free fat grafts in humans was by the German … Continued

microscopic view of fat cells used for lipofilling

The origin of fat tissue

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Adipose tissue is a connective tissue. Adipose tissue is derived from the embryologic mesenchyme (or embryologic connective tissue). Connective tissue is a tissue that is found in all mammalian tissues and has a supporting function. It contains the blood vessels and nerves that "connects" or "interconnects" organs. Adipose tissue consists not only of adipocytes or fat cells but also blood vessels, lymphatics, nerves. The stroma in an organ is the supporting tissue or framework (biological glue). It is build up by connective tissue. The stroma in fat tissue connects all the adipocytes with each other to form the "adipose organ". Adipose tissue consists … Continued

The cells in fat tissue

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Fat or adipose tissue hosts different cell populations. There are the fat cells or adipocytes and a wide population of other cells besides the adipocytes. Those "other" cells are found in the "stromal-vascular" fraction of the fat tissue. We have two fractions of cells in fat tissue: 1/ the fat cell fraction (population adipocytes) 2/ thestromal-vascular fraction The stromal-vascular fraction or SVF hosts blood vessel cells (endothelial cells), stem cells, young adipocytes that are not fully grown yet (pre-adipocytes), fibroblasts, etc. As mentioned before, in the SVF, cells with stem cell-like characteristics can be found. This implies that they can develop in any kind of cell under specific … Continued
  • fat cells harvested by liposuction for breast reconstruction by lipofilling
  • fat cells and adipose tissue used for lipofilling in plastic surgery
  • preparation of fat cells and adipose tissue used for lipofilling in plastic surgery

Where do you get the fat from?

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In humans the fat is stored in different “depots” in the body: 1/ in the abdominal cavity (visceral fat), 2/ the bone marrow and 3/ under the skin (subcutaneous fat depot). Humans do have a subcutaneous fat layer which is different from other primates. This fat layer functions as an insulation but has also various other functions, such as endocrinological functions. The subcutaneous fat layer is also referred to as the panniculus adiposus. The fat layer under the skin is easily accessible using the liposuction technique with minimal discomfort for the patient. Fat can be harvested from the abdominal region, … Continued