Studies on fat grafting especially to the gluteal region has been kept under caution as the headlines related to the procedure are always alarming. There are frequent complications associated with the large area fat grafting likefatal fat emboli, inability to locate the cannula during the procedure, fat transfer with too many syringes, and extended operating time causing more strain to the operator.

Expansion vibration lipofilling is a breakthrough technique which involves seperation, aspiration and fat equalisation [safe lipo] to produce desirable results beyond the simple liposuction technique. This technique is used when a large volume fat transfer is required. The three main concepts involved in this technique are as follows:

• Simultaneous disruption of connective tissue in the operating area.
• Internal expansion to create space for fat grafting.
• Backfilling of the created spaces with fat.

Role of expansion vibration technique:

Possibilities of fat cell injury is expected and fat cannot act as an expander for the constricted area. Eventually injected fat may traverse to areas of low resistance failing to correct contour deformity. Evpl plays a role here.

There are two possible ways for fat embolism. Venous injury and high state pressure. High state pressure cannot be eliminated and the only certain way to avoid fat embolism is to avoid venous injury. evpl plays a role here.

Advantages:

• Safety and absolutely no mortality
• Operating time is less
• Aesthetic results  are achieved due to homogenous distribution of fat
• Corrects existing contour irregularities and reduces the risk of contour deformity
• Surgeon friendly