title: A Comparison of Two Fat Grafting Methods on Operating Room Efficiency and Costs.
abstract: BACKGROUND
  Centrifugation (Cf) is a common method of fat processing but may be time consuming, especially when processing large volumes.
  
  
  OBJECTIVE
  To determine the effects on fat grafting time, volume efficiency, reoperations, and complication rates of Cf vs an autologous fat processing system (Rv) that incorporates fat harvesting and processing in a single unit.
  
  
  METHODS
  We performed a retrospective cohort study of consecutive patients who underwent autologous fat grafting during reconstructive breast surgery with Rv or Cf. Endpoints measured were volume of fat harvested (lipoaspirate) and volume injected after processing, time to complete processing, reoperations, and complications. A budget impact model was used to estimate cost of Rv vs Cf.
  
  
  RESULTS
  Ninety-eight patients underwent fat grafting with Rv, and 96 patients received Cf. Mean volumes of lipoaspirate (506.0 vs 126.1 mL) and fat injected (177.3 vs 79.2 mL) were significantly higher (P < .0001) in the Rv vs Cf group, respectively. Mean time to complete fat grafting was significantly shorter in the Rv vs Cf group (34.6 vs 90.1 minutes, respectively; P < .0001). Proportions of patients with nodule and cyst formation and/or who received reoperations were significantly less in the Rv vs Cf group. Based on these outcomes and an assumed per minute operating room cost, an average per patient cost savings of $2,870.08 was estimated with Rv vs Cf.
  
  
  CONCLUSIONS
  Compared to Cf, the Rv fat processing system allowed for a larger volume of fat to be processed for injection and decreased operative time in these patients, potentially translating to cost savings. LEVEL OF EVIDENCE 3.
authors.affiliation: Drs Gabriel and Champaneria are plastic surgeons in private practice in Vancouver, WA. Ms Griffin is a Senior Manager of Biostatistics and Outcomes Research, Acelity, San Antonio, TX. Dr Maxwell is a plastic surgeon in private practice in Nashville, TN. Ms Parekh is a Global Health Economics Manager and Mr Macarios is a Vice President of Health Economics and Outcomes Research, Acelity, Bridgewater, NJ.
authors.forename: Allen
authors.initials: A
authors.lastname: Gabriel
authors.affiliation: Drs Gabriel and Champaneria are plastic surgeons in private practice in Vancouver, WA. Ms Griffin is a Senior Manager of Biostatistics and Outcomes Research, Acelity, San Antonio, TX. Dr Maxwell is a plastic surgeon in private practice in Nashville, TN. Ms Parekh is a Global Health Economics Manager and Mr Macarios is a Vice President of Health Economics and Outcomes Research, Acelity, Bridgewater, NJ.
authors.forename: G Patrick
authors.initials: GP
authors.lastname: Maxwell
authors.affiliation: Drs Gabriel and Champaneria are plastic surgeons in private practice in Vancouver, WA. Ms Griffin is a Senior Manager of Biostatistics and Outcomes Research, Acelity, San Antonio, TX. Dr Maxwell is a plastic surgeon in private practice in Nashville, TN. Ms Parekh is a Global Health Economics Manager and Mr Macarios is a Vice President of Health Economics and Outcomes Research, Acelity, Bridgewater, NJ.
authors.forename: Leah
authors.initials: L
authors.lastname: Griffin
authors.affiliation: Drs Gabriel and Champaneria are plastic surgeons in private practice in Vancouver, WA. Ms Griffin is a Senior Manager of Biostatistics and Outcomes Research, Acelity, San Antonio, TX. Dr Maxwell is a plastic surgeon in private practice in Nashville, TN. Ms Parekh is a Global Health Economics Manager and Mr Macarios is a Vice President of Health Economics and Outcomes Research, Acelity, Bridgewater, NJ.
authors.forename: Manish C
authors.initials: MC
authors.lastname: Champaneria
authors.affiliation: Drs Gabriel and Champaneria are plastic surgeons in private practice in Vancouver, WA. Ms Griffin is a Senior Manager of Biostatistics and Outcomes Research, Acelity, San Antonio, TX. Dr Maxwell is a plastic surgeon in private practice in Nashville, TN. Ms Parekh is a Global Health Economics Manager and Mr Macarios is a Vice President of Health Economics and Outcomes Research, Acelity, Bridgewater, NJ.
authors.forename: Mousam
authors.initials: M
authors.lastname: Parekh
authors.affiliation: Drs Gabriel and Champaneria are plastic surgeons in private practice in Vancouver, WA. Ms Griffin is a Senior Manager of Biostatistics and Outcomes Research, Acelity, San Antonio, TX. Dr Maxwell is a plastic surgeon in private practice in Nashville, TN. Ms Parekh is a Global Health Economics Manager and Mr Macarios is a Vice President of Health Economics and Outcomes Research, Acelity, Bridgewater, NJ.
authors.forename: David
authors.initials: D
authors.lastname: Macarios
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D002017:Budgets; D002498:Centrifugation / Q000009:adverse effects / Q000191:economics*; D003357:Cosmetic Techniques / Q000009:adverse effects / Q000191:economics*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects / Q000191:economics*; D008875:Middle Aged; D018803:Models, Economic; D009873:Operating Rooms / Q000191:economics* / Q000458:organization & administration*; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D057188:Workflow; D055815:Young Adult