Power-Assisted Liposuction (P.A.L.) Fat Harvesting for Lipofilling: The Trap Device

DEAR EDITOR Coleman classically described four phases in fat grafting including harvesting, refinement, transfer and placement. The harvesting phase can be simplified by using the “trap device” instead of the conventional 10-cc Luer-Lock syringes. The “trap device” for harvesting fat by Power Assisted Liposuction and Medinorm tank is a convenient, wholly sterile, time saving method to provide fat for lipostructure in various part of the body.1 The harvesting phase can be simplified by using Power-Assisted Liposuction (P.A.L.) instead of the conventional 10-cc Luer-Lock syringes.2 This study evaluated the trap device of P.A.L. in fat harvesting for lipofilling. MicroAire P.A.L.TM (MicroAire Surgical Instruments LLC, 1641 Edlich Drive Charlottesville, VA 22911) is an electric device for liposuction, composed of a motorized handle (mod. 600-E) connected to an aspiration cannula of varying size and types, a standard plastic tubing for fat aspiration, and an electric control console (mod. 1020). The P.A.L. produces oscillating reciprocal “to-and-fro” movements of the cannula tip2 with a 2,4 millimetres stroke and a 0 to 4500/min vibration range. We thought the same system would find ready application to fat harvesting if an efficient sterile fat trap could be fashioned. Thus, instead of directly connecting the plastic suction tube to a common aspirator, we deviced a trap composed of the reservoir of an “High Vacuum Wound Drainage System” of 600 cc (Medinorm Medizintechnik GmbH, Gewerbepark 7–9, D-66583 Spiesen-Elversberg, Germany) deprived of its two rubber caps. The P.A.L. tube was connected to the longest of the two beaks of the 600 cc reservoir by using the forefinger of a surgical glove as a gasket (both tube and beak were stiff and they otherwise would not fit one another); the other beak was directly connected with the tube of the customary aspirator. To avoid leaks and loss of suction, two small Opsites TM (Smith and Nephew, Inc 1450 E Brooks Rd Memphis, TN 38116) were used as an “insulating tape” around the two connections. The P.A.L. harvesting cannulas that we employed were a single-hole MicroAire of 3 mm in diameter (PAL-R300LS single-port) and a triple-hole MicroAire of 4 mm (PAL-R402LS Triport II) (Figure 1). In a 38 years old patient (1.75 cm tall, weighing 57 kg, with a body mass index of 18.6) undergoing lipostructure for a severe pectus excavatum, we easily harvested high quality fat from both medial knees and the abdomen, after infiltration with 500 ml of a modified Klein formula (a dilution solution of 1% lidocaine, 50 ml), Letter to Editor