CLINIMED NANO 500 µm fat harvesting cannula

Nanofat vs microfat: the instruments behind each technique

Microfat and nanofat are not two sizes of the same thing. Microfat is a living graft of small parcels that adds volume. Nanofat is microfat that has been mechanically emulsified and filtered: it no longer contains viable fat cells, adds no volume, and is used to improve the skin. Each technique needs different instruments at every step. This article explains the difference and the CLINIMED instruments for each.

Macrofat, microfat, nanofatParcel size, how each is harvested and the tool used to place it (Ding 2022; Nguyen 2012; Tonnard 2013)Macrofatintact parcels, >2 mm1 mm (field magnified)Harvest: cannula >2.4 mmPlace: blunt cannula ≥2 mmVolume: cheeks, temples, jaw, bodyMicrofatparcels <1.2 mm1 mm (field magnified)Harvest: ≈1 mm side holesPlace: 0.7–1.2 mm microcannulaVolume: tear trough, lips, fine contourNanofatemulsified, 400–600 µm1 mm (field magnified)Made from microfat: emulsify, filterPlace: needle, up to 27 GSkin quality, not volume
Macrofat, microfat and nanofat drawn at one magnification. Figures from published classifications and technique papers.1–4

Microfat

Microfat grafting was described as a way to use fat almost like a dermal filler: fat is harvested with a multi-perforated cannula with 1 mm holes and injected through very fine cannulas; in a mouse model, 20, 23 and 25 G cannulas were compared against Coleman's 17 G.2 Harvesting through a 2 mm multi-hole cannula rather than a 3 mm single-hole Coleman cannula gave isolated stem/stromal cells with higher viability and migration, with similar yield.5 Microfat is used where volume is needed but the skin is thin: the lower eyelid, the orbitomalar groove and the malar area,6 the upper lip and the nasolabial folds.7

Nanofat

Nanofat was introduced by Tonnard and colleagues in 2013. Microfat harvested with a multiport, small-hole cannula is emulsified and filtered, and the result can be injected through needles as fine as 27 G. In their samples no viable adipocytes were seen, but adipose-derived stem cells were still richly present. They used it in 67 cases for superficial rhytides, scars and dark lower eyelids, with no infections, fat cysts or granulomas.3 Because the particles are so small, nanofat gives no notable volume.4 Between the two sits fractionated fat: Rohrich and colleagues emulsify centrifuged fat through a 2 mm filter 60–80 times and use it for the periorbital region.11 A related technique, sharp-needle intradermal fat (SNIF), places fat intradermally through a sharp needle for fine wrinkles.8

Making nanofat: five stepsNanofat is made from microfat. It is a skin-quality treatment, not a volume filler.1HarvestMicrofat with a multi-port, small-hole cannula2CleanRinse or decant toremove fluid and blood3Emulsify≈30 passes between two10 mL syringes, luer connector4FilterThrough a fine mesh tohold back connective tissue5InjectThrough needles up to27 G, intradermal / subdermal
The nanofat method as described in the literature: emulsification by about 30 passes between two 10 mL syringes, then filtration.3,4

Side by side

Microfat Nanofat
What it is Small intact fat parcels Emulsified, filtered fat; no viable adipocytes
Main purpose Volume in thin-skinned areas Skin quality: fine lines, scars, dark lower lids
Harvest Multi-hole cannula, ≈1 mm holes Same microfat harvest, then processing
Processing Decant or rinse; transfer to small syringes Emulsify (≈30 passes), then filter
Placement 0.7–1.2 mm blunt microcannula Needle up to 27 G, intradermal or subdermal
Adds volume? Yes No
CLINIMED harvest MICRO 1000 µm, P. Tonnard 5x4 NANO 500 µm, A. Trivisonno, R. Bensimon
CLINIMED processing Anaerobic & sizing hubs, decant stand PNF™ hub + mesh screens
CLINIMED placement S. Coleman Fig. 1, Little Injector Fine needle; or S. Coleman "NANO" Fig. 1 for subdermal placement

Why microfat lumps happen

Visible or palpable lumps after facial microfat are mostly put down to fat placed too superficially. One periorbital series noted that the deeper the injection, the less chance of skin irregularities, and that the medial periorbita, including the tear trough, was more susceptible.9 In one series, visible lobules under the lower lid resolved once the injection cannulas and technique were changed.10 The instrument lessons are simple: harvest small parcels in the first place, place them through a fine blunt cannula in small amounts on withdrawal, keep them deep under thin skin, and leave the skin itself to nanofat.

The instruments

Harvest

A fine harvester keeps the regenerative cells intact. In a laboratory study, stem/stromal cells from fat harvested with a 2 mm cannula with sharp side holes under 1 mm kept the same multilineage differentiation and immunomodulatory properties as cells from Coleman-harvested fat.12

CLINIMED NANO 500 µm harvester, 240 radial holes, 360° extractionCLINIMED NANO 500 µm240 holes of 500 µm · finest parcelsCLINIMED MICRO 1000 µm harvester, 50 radial holes, 360° extractionCLINIMED MICRO 1000 µm50 holes of 1000 µm · microfatP. Tonnard Harvesting Liposuction Cannula – 5x4 Radial Holes, 360° ExtractionP. Tonnard 5x4Microfat harvestingA. Trivisonno Nano Harvesting Liposuction Cannula – 3x4 Radial Holes, 360° ExtractionA. Trivisonno 3x4Superficial-layer harvestingSwivel & Snap syringe locksSwivel & Snap (twist) syringe lockHolds the plunger back for steady, low vacuumClick & Snap syringe locksClick & Snap syringe lockClick-lock plunger hold · 10 to 60 mL sizes

Process and place

Anaerobic & Sizing transfer hubsAnaerobic & sizing hubsSyringe-to-syringe transferPURE Nano Fat Transfer (PNF™) hub, completePURE Nano Fat (PNF™) hubEmulsify and filter in one closed systemPURE Nano Fat (PNF) mesh screens (pack/ 5)PNF mesh screensPack of 5CLINIMED syringe decant stand, black, 12 syringes (3cc & 10cc)Syringe decant stand, black12 syringes, 3 mL and 10 mLCLINIMED syringe decant stand, violet, 9 syringes (10cc & 60cc)Syringe decant stand, violet9 syringes, 10 mL and 60 mLS. Coleman Fat Grafting Liposuction Cannula – Infiltration / Re-Injection, Fig. 1S. Coleman Fig. 1Fine blunt placement

Prefer a ready-made tray? The Facial Fat Transfer Set covers infiltration, fine re-injection, nanofat processing and lumen care. See all facial instruments on our facial and under-eye fat grafting page.

Frequently asked questions

What is the difference between nanofat and microfat?

Microfat is a graft of small, intact fat parcels that adds volume. Nanofat is microfat that has been emulsified and filtered; it contains no viable adipocytes, adds no volume and is used to improve skin quality.

What hole size is used to harvest microfat?

The original microfat technique used a multi-perforated cannula with 1 mm holes. The CLINIMED MICRO harvester has 50 radial holes of 1000 µm.

How is nanofat made?

Microfat is emulsified by passing it about 30 times between two syringes through a connector, then filtered to hold back connective tissue. The result can be injected through needles up to 27 G.

Can nanofat fill the tear trough?

No. Nanofat does not provide notable volume. The hollow is filled with microfat placed deep; nanofat has been used to improve dark, thin lower-eyelid skin.

Which CLINIMED instruments do I need for nanofat?

A fine harvester such as the CLINIMED NANO 500 µm or MICRO 1000 µm, the PURE Nano Fat (PNF™) hub with mesh screens to emulsify and filter, and a fine needle or S. Coleman "NANO" Fig. 1 cannula to place it.

References

  1. Strong AL, Rohrich RJ, Tonnard PL, et al. Technical precision with autologous fat grafting for facial rejuvenation: a review of the evolving science. Plast Reconstr Surg 2024;153(2):360–77. doi:10.1097/PRS.0000000000010643
  2. Nguyen PSA, Desouches C, Gay AM, Hautier A, Magalon G. Development of micro-injection as an innovative autologous fat graft technique: the use of adipose tissue as dermal filler. J Plast Reconstr Aesthet Surg 2012;65(12):1692–9. doi:10.1016/j.bjps.2012.06.014
  3. Tonnard P, Verpaele A, Peeters G, et al. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg 2013;132(4):1017–26. doi:10.1097/PRS.0b013e31829fe1b0
  4. Ding P, et al. Research progress on preparation, mechanism, and clinical application of nanofat. J Burn Care Res 2022;43(5):1140–4. doi:10.1093/jbcr/irab250
  5. Alharbi Z, et al. Conventional vs. micro-fat harvesting. J Plast Reconstr Aesthet Surg 2013;66(9):1271–8. doi:10.1016/j.bjps.2013.04.015
  6. Tonnard PL, Verpaele AM, Zeltzer AA. Augmentation blepharoplasty: a review of 500 consecutive patients. Aesthet Surg J 2013;33(3):341–52. doi:10.1177/1090820X13478966
  7. Tonnard PL, Verpaele AM, Ramaut LE, Blondeel PN. Aging of the upper lip: Part II. Evidence-based rejuvenation of the upper lip—a review of 500 consecutive cases. Plast Reconstr Surg 2019;143(5):1333–42. doi:10.1097/PRS.0000000000005589
  8. Zeltzer AA, Tonnard PL, Verpaele AM. Sharp-needle intradermal fat grafting (SNIF). Aesthet Surg J 2012;32(5):554–61. doi:10.1177/1090820X12445082
  9. Larsson JC, et al. Integrating fat graft with blepharoplasty to rejuvenate the Asian periorbita. Plast Reconstr Surg Glob Open 2019;7:e2365. doi:10.1097/GOX.0000000000002365
  10. Lindenblatt N, van Hulle A, Verpaele AM, Tonnard PL. The role of microfat grafting in facial contouring. Aesthet Surg J 2015;35(7):763–71. doi:10.1093/asj/sjv083
  11. Rohrich RJ, Dayan E, Savetsky IL. Fat grafting to the face as an isolated procedure. Book chapter 13. New York: Thieme.
  12. Rossi M, Alviano F, Ricci F, et al. In vitro multilineage potential and immunomodulatory properties of adipose derived stromal/stem cells obtained from nanofat lipoaspirates. CellR4 2016;4(6):e2212.

Educational information for qualified surgeons. It does not replace clinical judgment or the instructions for use. COLEMAN™ is a trademark of its owner. MicroAire®, PAL®, Nouvag®, Liposurg® and VASER® are trademarks of their respective owners; CLINIMED is not affiliated with the owners of these marks.

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