Lower Leg Augmentation with Fat Grafting, MRI and Histological Examination.
INTRODUCTION
Nowadays, there is an increasing demand for contouring of the entire lower leg, in addition to corrections at the level of the muscle only. Accordingly, it becomes advantageous to use fat tissue for this purpose, for its availability in high quantities, potential for its easy implantation in all leg parts, biological compatibility, low antigen potential, and minimal donor morbidity.


METHODS
Forty-eight female patients, aged 20-54 (47.1 % younger than 35 and 52.9 % older than 35), underwent lower leg augmentation with autologous fat. We compared pre- and 1, 3, and 6 months postoperative morphological and volumetric characteristics of the recipient region by circumferential measuring of particular parts of the lower legs and evaluating the presence of live transplanted fat by MRI and histological examination.


RESULTS
The augmentation of certain circumferences of the lower leg at the 6-month follow-up examination is significantly related to preoperative circumference as well as to the quantity of infiltrated fat. Therefore, lower the baseline circumference, the greater the augmentation, and the greater the quantity of infiltrated fat, the greater the augmentation.


CONCLUSION
Ensuring adequate technique in the transfer of fat tissue from the donor region to the recipient region of the lower leg is definitely the least invasive method of lower leg contouring. For patients with muscle dystrophies or those with injuries, this technique could become the first choice for its minimal complications. The simplicity of the procedure invites its wide application in plastic surgery.


LEVEL OF EVIDENCE III
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['Skorobac Asanin|Violeta|V|http://orcid.org/0000-0003-1493-3795', 'Sopta|Jelena|J|']
D000273:Adipose Tissue D000328:Adult D001707:Biopsy, Needle D015331:Cohort Studies D004954:Esthetics D005260:Female D005500:Follow-Up Studies D006084:Graft Rejection D006085:Graft Survival D006801:Humans D007150:Immunohistochemistry D035002:Lower Extremity D008279:Magnetic Resonance Imaging D008875:Middle Aged D011182:Postoperative Care D012189:Retrospective Studies D013518:Surgery, Plastic D016378:Tissue Transplantation D014182:Transplantation, Autologous D016896:Treatment Outcome D055815:Young Adult
Lower leg augmentation MRI Autologous fat graft Calf augmentation Fat graft viability Fat reabsorption Fat survival Lipo-filling