title: Lower Leg Augmentation with Fat Grafting, MRI and Histological Examination.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the A3 online Instructions to Authors. www.springer.com/00266 .
authors.affiliation: Special Hospital for Plastic, Reconstructive and Aesthetic Surgery "DIONA", Medical Faculty University of Belgrade, Belgrade, Serbia. dr.violeta@dionahospital.com.
authors.forename: Violeta
authors.identifier: http://orcid.org/0000-0003-1493-3795
authors.initials: V
authors.lastname: Skorobac Asanin
authors.affiliation: Medical Faculty Belgrade, Institute of Pathology, University Belgrade, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Sopta
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; 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 / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods*; D016378:Tissue Transplantation / Q000009:adverse effects / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Autologous fat graft; Calf augmentation; Fat graft viability; Fat reabsorption; Fat survival; Lipo-filling; Lower leg augmentation; MRI