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I’ve been doing fat graft now for almost 20 years, and I wrote a textbook in 2006 call Complementary Fat Grafting. That was really became the number one seller in fat crafting books for over a decade, and it’s was sold for almost 15 years. I just don’t have the energy to go back and rewrite this textbook now many years later and I continue to evolve my technique. And so, what’s been featured in that textbook in 2006 that was published in 2006 by Lippincott, Williams & Wilkins is really outdated because I almost do nothing. Well, I shouldn’t say nothing. The basic techniques are still there, but I really don’t process the fat the way that I used to. In the old days, I would use a centrifugation process where I would centrifuge the fat at 3000 RPM for about 3 minutes. If you listen to some of my old lectures on YouTube, you’ll hear me say that. And my argument at the time for many years was that there wasn’t a huge difference in the processing whether you wash the fat centrifuge of fat etcetera. In the last few years, I’ve migrated over something called Pure graft. It’s a proprietary technique that is very different from centrifugation and is similar to washing but also very different. It’s an ultra-filtration process and washing system and what’s very interesting with it is my fat graft results have completely changed in the last., I would say, two to three years as I’ve been doing this, the things that I’ve noticed with this technique is significant reduction in swelling. So, my patients and some of the old recovery videos that you watch had a lot of swelling and bruising for the first week. And now with this technique, I’ve seen such a huge reduction in the amount of swelling and possibly even bruising, but I’ve been using something called tranexamic acid or txa that further reduces bruising. So, it’s hard to sort of figure out which one is causing which, but a large degree of reduction is swelling. So, used to be a lot of swelling in the first week. I just don’t see that as much a congested appearance, that I just don’t see as much. That’s one big thing and the second thing that I see is much better retention. So, my patients have much less recovery, much more consistent outcomes, much higher percentage of take after a fat graft and that has been just fantastic. So why is this different, what is the difference? So centrifugation process the old way that I used to do it, I would spin the fat down and then I would take what’s called the supernatant, which is the basically, the area above the fat, which is what you’ll see, is just some lidocaine and some lice fat cells and then on the bottom of it, which is a bloody area is called the infinite in which I would drain out, and then I would have a column of fat. It would look very pure, but what’s interesting is that it had a lot of inflammatory cells, or reason I know this is the results that I’m seeing. But also, what’s interesting is, if I’m in the old days, when I centrifuge fat, if I pulled out 80 milliliters of fat, from the body 80 cc’s of fat, I would get about 40 milliliters of usable fat and so I don’t think okay I’ve got these 40 milliliters. Now, when I put it through the pure graph system, if I take 80 milliliters out, I may get 8. So, it’s about 1/10 versus 1/2. So, you can think about how much of that extra that difference between, let’s say 40 milliliters and eight milliliters which is less than 1/4 of what it is that I couldn’t use this fat. What was that in there? So, I think it was probably some lice fat cells that were actually not caught that seemed to be okay, but they weren’t going to survive. And, a lot of inflammatory cells have been processed out. So now that I can take out all the non-viable fat cells, you know, you can’t guarantee a hundred percent but almost all the non-viable fat cells, the inflammatory components. It’s much more work for me because a harvesting takes so much work to get what I need. Especially in someone very thin but I get so much less so much greater reduction in swelling and a much higher percentage of take. So pure graft has become a huge component to how I perform fat grafting today.

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