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Dong Y, Huang Y, Hou T, Li P. Effectiveness and Safety of Different Methods of Assisted Fat Grafting: A Network Meta-Analysis. Aesthetic Plast Surg 2024; 48:2484-2499. [PMID: 38772943 DOI: 10.1007/s00266-024-04060-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/09/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE Numerous studies have proposed the utilization of stromal vascular fraction (SVF), adipose-derived stem cells (ADSCs), and platelet products as auxiliary grafting techniques to improve the survival rate of fat grafts. This study aimed to evaluate the efficacy and safety of various fat grafting methods since 2010 through a network meta-analysis, aiming to identify the most effective technique for fat grafting. METHODS Clinic trials on assisted fat grafting were searched from Pubmed, Embase, Web of Science, and the Cochrane Library, spanning the period from January 1, 2010 to March 2024. The risk of bias in the included trials was meticulously assessed using the Cochrane risk of bias tool. The survival rate of fat grafts served as the primary evaluation metric for effectiveness, while complications were employed as the indicator for safety. RESULTS The study incorporated 31 clinic trials, involving a total of 1656 patients. The findings indicated that the survival rate with assisted fat grafting significantly surpassed that of simple fat grafting (SUCRA, 10.43%). Notably, ADSC-assisted fat grafting exhibited the highest survival rate (SUCRA, 82.17%), followed by Salvia miltiorrhiza (SM)-assisted fat grafting (SUCRA, 69.76%). In terms of safety, the most prevalent complications associated with fat grafting were fat sclerosis and fat necrosis. Adc-assisted fat grafting was correlated with the lowest incidence of complications (SUCRA, 41.00%), followed by simple fat grafting (SUCRA, 40.99%). However, PRP-assisted (SUCRA, 52.86%) and SVF-assisted fat grafting (SUCRA, 65.14%) showed higher complication rates. CONCLUSION Various methods of assisted fat grafting can significantly enhance the survival rate, but they often fail to effectively mitigate the incidence of complications. Compared to other methods, adipose mesenchymal stem cells-assisted fat grafting consistently yielded a higher survival rate of grafts and fewer complications. Consequently, this approach represents a relatively effective method for assisting in fat grafting at present. LEVEL OF EVIDENCE III 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 online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yue Dong
- Department of Burn and Plastic Surgery-Department of Medical Cosmetology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225000, Yangzhou, Jiangsu Province, China
- Clinical Medical College, Yangzhou University, 225000, Yangzhou, Jiangsu Province, China
| | - Yanling Huang
- Department of Burn and Plastic Surgery-Department of Medical Cosmetology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225000, Yangzhou, Jiangsu Province, China
- Clinical Medical College, Yangzhou University, 225000, Yangzhou, Jiangsu Province, China
| | - Tuanjie Hou
- Department of Burn and Plastic Surgery-Department of Medical Cosmetology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225000, Yangzhou, Jiangsu Province, China.
- Clinical Medical College, Yangzhou University, 225000, Yangzhou, Jiangsu Province, China.
| | - Pingsong Li
- Department of Burn and Plastic Surgery-Department of Medical Cosmetology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225000, Yangzhou, Jiangsu Province, China.
- Clinical Medical College, Yangzhou University, 225000, Yangzhou, Jiangsu Province, China.
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Hu S, Xu H. Volume retention rate after breast autogenous fat grafting and related influencing factors: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 2024; 89:105-116. [PMID: 38160589 DOI: 10.1016/j.bjps.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/18/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
The volume retention of breast autologous fat grafting is unpredictable, and the volume retention rate and related influencing factors have not been systematically reviewed. Therefore, this systematic review and meta-analysis aimed at evaluating the volume retention rate and related influencing factors of breast autologous fat grafting, which is for reconstructive or esthetic purposes. Literature search was conducted using the PubMed, Embase, Cochrane Library, and Web of Science databases from inception of study to December 2022. Sensitivity analysis was performed for all outcomes. Begg's test was performed to test publication bias. Subgroup analysis was performed based on population, method of fat preparation, method of volume measurement, number of fat grafting, and injected fat grafting volume. A total of 25 studies were included in this systematic review and meta-analysis. The follow-up time ranged from 3 to 36 months. Results showed that the pooled volume retention rate at the latest follow-up point was 54% [95% confidence interval (CI): 48.5%-59.5%]. Based on the fat preparation methods, the pooled rate was 51.5% (95%CI: 41.5%-61.5%) for centrifugation, which was higher than that for sedimentation [38.7% (95%CI: 30.9%-46.5%)]. In addition, the enrichment of stromal vascular fraction obtained after centrifugation was found to be associated with higher volume retention rate (weighted mean difference: 17.36, 95%CI: 8.84-25.87). Our findings may provide guidance for evaluating the volume retention rate of breast autologous fat grafting in clinical settings. Further studies are needed to verify our findings.
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Affiliation(s)
- Shuchun Hu
- Medical Aesthetic Department, Yongkang Hospital of Traditional Chinese Medicine, Yongkang 321313, P.R. China.
| | - Huaiyuan Xu
- Dermatology Department, Yongkang Hospital of Traditional Chinese Medicine, Yongkang 321313, P.R. China
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Huang Y, Jin X, Hong KY, Chang H. Enhanced Effect of Secondary Administration of Adipose-Derived Stromal Cells Concurrent with Fat Grafting. Plast Reconstr Surg 2024; 153:390-399. [PMID: 37159916 DOI: 10.1097/prs.0000000000010648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Cell-assisted lipotransfer, a fat graft mixed with adipose-derived stromal cells, is known to enhance fat graft retention. Previously, the authors showed that intravenous injection of adipose-derived stromal cells can improve the survival of grafted fat. In the present study, the authors investigated the effects of a secondary intravenous injection of adipose-derived stromal cells on fat grafting. METHODS Wild-type C57BL/6J (B6) mice were used as donors for grafted fat and as recipients. Adipose-derived stromal cells were harvested from green fluorescent protein and DsRed B6 mice. The recipient mice were divided into three groups: SI ( n = 10), RI1 ( n = 10), and RI2 ( n = 11). All groups received intravenous injections of green fluorescent protein adipose-derived stromal cells immediately after fat grafting. The RI1 and RI2 groups received repeated intravenous injections of DsRed adipose-derived stromal cells at 1 and 2 weeks, respectively, after fat grafting. The grafted fat volume was measured using micro-computed tomography. RESULTS Secondarily injected DsRed adipose-derived stromal cells were recruited to the grafted fat and resulted in a higher retention of graft volume and vascular density ( P < 0.05). The stromal-derived factor-1 and C-X-C chemokine receptor type 4 genes related to stem cell homing were highly expressed in the grafted fat and adipose-derived stromal cells ( P < 0.05). The RI2 group showed a higher graft volume and vascular density than the SI and RI1 groups ( P < 0.05). CONCLUSIONS A secondary intravenous injection of adipose-derived stromal cells at a 2-week interval enhances the effect of adipose-derived stromal cell enrichment in fat grafting. These findings refine clinical protocols and enhance the therapeutic value of cell-assisted lipotransfer. CLINICAL RELEVANCE STATEMENT In a modified animal model of cell-assisted lipotransfer, the authors demonstrated that secondary intravenous administration of adipose-derived stromal cells improved retention of grafted fat.
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Affiliation(s)
- Yan Huang
- From the Departments of Interdisciplinary Program in Stem Cell Biology
| | - Xian Jin
- Plastic and Reconstructive Surgery, Seoul National University College of Medicine
| | - Ki Yong Hong
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine
| | - Hak Chang
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine
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Goncharov EN, Koval OA, Igorevich EI, Encarnacion Ramirez MDJ, Nurmukhametov R, Valentinovich KK, Montemurro N. Analyzing the Clinical Potential of Stromal Vascular Fraction: A Comprehensive Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:221. [PMID: 38399509 PMCID: PMC10890435 DOI: 10.3390/medicina60020221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/11/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
Background: Regenerative medicine is evolving with discoveries like the stromal vascular fraction (SVF), a diverse cell group from adipose tissue with therapeutic promise. Originating from fat cell metabolism studies in the 1960s, SVF's versatility was recognized after demonstrating multipotency. Comprising of cells like pericytes, smooth muscle cells, and, notably, adipose-derived stem cells (ADSCs), SVF offers tissue regeneration and repair through the differentiation and secretion of growth factors. Its therapeutic efficacy is due to these cells' synergistic action, prompting extensive research. Methods: This review analyzed the relevant literature on SVF, covering its composition, action mechanisms, clinical applications, and future directions. An extensive literature search from January 2018 to June 2023 was conducted across databases like PubMed, Embase, etc., using specific keywords. Results: The systematic literature search yielded a total of 473 articles. Sixteen articles met the inclusion criteria and were included in the review. This rigorous methodology provides a framework for a thorough and systematic analysis of the existing literature on SVF, offering robust insights into the potential of this important cell population in regenerative medicine. Conclusions: Our review reveals the potential of SVF, a heterogeneous cell mixture, as a powerful tool in regenerative medicine. SVF has demonstrated therapeutic efficacy and safety across disciplines, improving pain, tissue regeneration, graft survival, and wound healing while exhibiting immunomodulatory and anti-inflammatory properties.
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Affiliation(s)
| | | | | | | | - Renat Nurmukhametov
- Neurological Surgery, Peoples Friendship University of Russia, 103274 Moscow, Russia
| | | | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), 56100 Pisa, Italy
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Ferreira MY, Carvalho Junior JDC, Ferreira LM. Evaluating the quality of studies reporting on clinical applications of stromal vascular fraction: A systematic review and proposed reporting guidelines (CLINIC-STRA-SVF). Regen Ther 2023; 24:332-342. [PMID: 37662694 PMCID: PMC10474569 DOI: 10.1016/j.reth.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/26/2023] [Accepted: 08/13/2023] [Indexed: 09/05/2023] Open
Abstract
Background The stromal vascular fraction (SVF) has been widely explored in a number of therapeutic applications in several specialties. Its therapeutic potential is being increasingly demonstrated, although its mechanism of action is still unclear. Objective To evaluate the quality of studies reporting on clinical applications of SVF. Method This is a systematic literature review that followed the PRISMA guidelines with the search of the studies from December 1, 2012, to December 1, 2022, in the following databases: MEDLINE, LILACS and EMBASE. The level of evidence of the studies was assessed using the GRADE system, and the rigor used in the publication of the results was assessed in relation to adherence to the guidelines indicated by the EQUATOR Network Group. The CLINIC - STRA-SVF reporting guideline was developed after the completion of this systematic review. Results A total of 538 articles were found, and 77 articles were selected after reading the titles and abstracts and removing duplicates. Then, 15 studies were removed for not meeting the inclusion criteria, leaving 62 studies. The CLINIC - STRA-SVF was developed and consists of 33 items and two tables. Conclusion There is scientific evidence, although mostly with a low level of evidence, that the use of SVF in clinical applications is safe and effective. The information published in these studies should be standardized, and the CLINIC - STRA-SVF reporting guideline proposed in this study may assist in the design, conduct, recording and reporting of clinical trials and others clinical studies involving the SVF.
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Affiliation(s)
- Marcio Yuri Ferreira
- Translational Surgery Graduate Program of Universidade Federal de São Paulo - Unifesp, São Paulo, SP, Brazil
| | | | - Lydia Masako Ferreira
- Plastic Surgery Division, Universidade Federal de São Paulo - Escola Paulista de Medicina, SP, Brazil
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Wu Q, Chen S, Peng W, Chen D. Current perspectives on cell-assisted lipotransfer for breast cancer patients after radiotherapy. World J Surg Oncol 2023; 21:133. [PMID: 37069583 PMCID: PMC10108507 DOI: 10.1186/s12957-023-03010-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/30/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Cell-assisted lipotransfer (CAL), a technique of autologous adipose transplantation enriched with adipose-derived stem cells (ADSCs), has the potential to improve cosmetic outcomes at irradiated sites. However, many concerns have been raised about the possibility of ADSCs increasing oncological risk in cancer patients. With the increasing demand for CAL reconstruction, there is an urgent need to determine whether CAL treatment could compromise oncological safety after radiotherapy, as well as to evaluate its efficacy in guiding clinical decisions. METHODS A PRISMA-compliant systematic review of the safety and efficacy of CAL in breast cancer patients after radiotherapy was conducted. The PubMed, Ovid, Cochrane Library, and ClinicalTrials.gov databases were comprehensively searched from inception to 31 December 2021. RESULTS The search initially yielded 1185 unique studies. Ultimately, seven studies were eligible. Based on the limited outcome evidence, CAL did not increase recurrence risk in breast cancer patients but presented aesthetic improvement and higher volumetric persistence in a long-term follow-up. Although breast reconstruction with CAL also had oncological safety after radiotherapy, these patients needed more adipose tissue and had relatively lower fat graft retention than the non-irradiated patients (P < 0.05). CONCLUSIONS CAL has oncological safety and does not increase recurrence risk in irradiated patients. Since CAL doubles the amount of adipose required without significantly improving volumetric persistence, clinical decisions for irradiated patients should be made more cautiously to account for the potential costs and aesthetic outcomes. There is limited evidence at present; thus, higher-quality, evidence-based studies are required to establish a consensus on breast reconstruction with CAL after radiotherapy.
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Affiliation(s)
- Qiuwan Wu
- The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, 55 Zhenhai Road, Siming District, Xiamen, Fujian, 361003, P. R. China
- The Third Clinical Medical College, Fujian Medical University, Xiamen, Fujian, P. R. China
| | - Shuai Chen
- The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, 55 Zhenhai Road, Siming District, Xiamen, Fujian, 361003, P. R. China
| | - Wuyun Peng
- The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, 55 Zhenhai Road, Siming District, Xiamen, Fujian, 361003, P. R. China
| | - Donghan Chen
- The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, 55 Zhenhai Road, Siming District, Xiamen, Fujian, 361003, P. R. China.
- The Third Clinical Medical College, Fujian Medical University, Xiamen, Fujian, P. R. China.
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Liu M, Shang Y, Liu N, Zhen Y, Chen Y, An Y. Strategies to Improve AFT Volume Retention After Fat Grafting. Aesthetic Plast Surg 2023; 47:808-824. [PMID: 36316460 DOI: 10.1007/s00266-022-03088-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/28/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Autologous fat grafting has gained increasing popularity used in plastic surgery as a strategy to improve functional and aesthetic outcome. However, variable augmentation results have concerned surgeons in that volume loss of grafted fat reported fluctuates unsteadily. AIM An optimal technique that clinically maximizes the long-term survival rate of transplantation is in urgent need to be identified. METHOD The PubMed/MEDLINE database was queried to search for animal and human studies published through March of 2022 with search terms related to adipose grafting encompassing liposuction, adipose graft viability, processing technique, adipose-derived stem cell, SVF and others. RESULTS 45 in vivo studies met inclusion criteria. The principal of ideal processing technique is effective purification of fat and protection of tissue viability, such as gauze rolling and washing-filtration devices. Cell-assisted lipotransfer including SVF, SVF-gel and ADSCs significantly promotes graft retention via differentiation potential and paracrine manner. ADSCs induce polarization of macrophages to regulate inflammatory response, mediate extracellular matrix remodeling and promote endothelial cell migration and sprouting, and differentiate into adipocytes to replace necrotic cells, providing powerful evidence for the benefits and efficacy of cell-assisted lipotransfer. CONCLUSION Based on the current evidence, the best strategy can not be decided. Cell-assisted lipotransfer has great potential for use in regenerative medicine. But so far mechanically prepared SVF-gel is conducive to clinical promotion. PRP as endogenous growth factor sustained-release material shows great feasibility. LEVEL OF EVIDENCE IV 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 online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Meiling Liu
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yujia Shang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
- College of Traditional Chinese Materia Medica, Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Na Liu
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
- College of Traditional Chinese Materia Medica, Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Youbai Chen
- Department of Plastic and Reconstructive Surgery, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yang An
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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Kwon H, Lee S, Kim J, Song SH. Efficacy and safety of stromal vascular fraction on scar revision surgery: a prospective study. J DERMATOL TREAT 2023; 34:2171260. [PMID: 36661928 DOI: 10.1080/09546634.2023.2171260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Cell-based therapies are popular in the field of reconstructive surgery. The stromal vascular fraction (SVF), comprised of mature adipocytes or blood, reportedly has a regenerative effect; however the mechanism remains unclear. This study aimed to prove the viability and effectiveness of using SVF in scar treatment. METHODS This prospective double-blind study involved 20 patients who visited an outpatient clinic for 2 years, from July 2016 to July 2018, and underwent scar revision for traumatic or surgical scars. After scar revision surgery performed by a single surgeon, patient scars were divided into experimental and control sides. The subcutaneous layer of the experimental and control sides were injected with 0.1 mL/cm of SVF and normal saline, respectively. Each side was evaluated using the Patient and Observer Scar Assessment Scale (POSAS) before and six months after the surgery. RESULTS Of the 20 patients who underwent scar revision surgery and SVF treatment, 4 dropped out for personal reasons. In 11 of 12 POSAS items, the experimental side showed significant improvements compared to the control side. CONCLUSIONS Although more research is needed, autologous SVF is a valuable source of regenerative medicine that can be swiftly and inexpensively prepared from human fat tissue.
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Affiliation(s)
- Hyeokjae Kwon
- Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon, South Korea.,Department of Plastic and Reconstructive Surgery, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seokui Lee
- Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon, South Korea
| | - Jiyoung Kim
- Healthcare Data Science Center, Konyang University Hospital, Daejeon, Korea
| | - Seung Han Song
- Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon, South Korea.,Department of Plastic and Reconstructive Surgery, College of Medicine, Chungnam National University, Daejeon, South Korea
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Zhao J, Chen J, Xu C, Yang S, Guo S, Zhou B. The efficacy of cell-assisted versus conventional lipotransfer: A systematic review and meta-analysis. Asian J Surg 2023; 46:35-46. [PMID: 35504778 DOI: 10.1016/j.asjsur.2022.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 03/27/2022] [Accepted: 04/15/2022] [Indexed: 12/16/2022] Open
Abstract
Autologous lipotransfer is an essential component of soft tissue reconstruction. However, it is not widely applied or accepted by surgeons due to its unstable survival rate and uncertain efficacy. The cell-assisted fat transfer (CAL) is a promising technique that increases the fat survival rate. However, it is controversial based on various clinical studies. Here, we assessed the fat survival and complication rates of CAL, compared to the conventional autologous lipotransfer. To conduct our research, two reviewers independently screened related articles published in Medicine (via PubMed), EMBASE, Cochrane Library, and Web of Science. The combined effect estimates for efficacy evaluation was performed by the Review Manager software (RevMan 5.4.1). In total, 14 articles were included in our analysis (n = 722). Based on our analysis, the survival rate of the fat graft in CAL was significantly higher than the conventional fat grafting group (non-CAL group) (SMD = 2.81, 95%CI [1.54, 4.08], P < 0.01). In the subgroup, the fat retention of CAL in the facial filling was higher than the conventional one (SMD = 3.01, 95%CI [1.68, 4.33], P < 0.01). After breast augmentation, however, the difference between the experimental and control group was not statistically significant (SMD = 1.80, 95%CI [-0.31, 3.91], P = 0.09). Moreover, the CAL group exhibited comparable complications as the non-CAL group. Based on our analysis, the CAL group was significantly better than the conventional lipotransfer in terms of fat survival, particularly, during facial filling. However, it failed to reduce the complication rate, compared to the non-CAL group.
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Affiliation(s)
- Jiayuan Zhao
- The First Clinical College, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
| | - Jing Chen
- The Second Clinical College, Shengjing Hospital affiliated to China Medical University, Shenyang, 110004, China
| | - Chengyang Xu
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Shude Yang
- Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
| | - Shu Guo
- Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
| | - Bo Zhou
- Department of Clinical Epidemiology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
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The Importance of Protecting the Structure and Viability of Adipose Tissue for Fat Grafting. Plast Reconstr Surg 2022; 149:1357-1368. [PMID: 35404340 DOI: 10.1097/prs.0000000000009139] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Fat grafting is widely used for soft-tissue augmentation; however, the related clinical outcome remains variable and technique-dependent. The mechanisms underlying fat graft survival are not fully understood, particularly regarding the contributions of different cell types, such as functional adipocytes. This study evaluated the importance of adipose tissue structure and viability in fat grafting and, to some extent, revealed the effect of adipocytes in fat grafting. METHODS Human lipoaspirate was harvested using suction-assisted liposuction and processed using three separate methods: cotton-pad filtration, soft centrifugation (400 g for 1 minute), and Coleman centrifugation (1200 g for 3 minutes). Then all samples were subjected to second cotton-pad concentration. Adipose tissue structure and viability, the numbers of adipose-derived stem cells, and their proliferation and multilineage differentiation abilities were compared in vitro. The volume retention rate and fat graft quality were evaluated in vivo. RESULTS Cell structure destruction and viability decline were more evident in the Coleman centrifugation group compared to the cotton-pad filtration group and the soft centrifugation group. However, no intergroup differences were observed in the numbers, proliferation, or multilineage differentiation abilities of adipose-derived stem cells. After transplantation, the volume retention rates were similar in the three groups. However, greater structural and functional damage was associated with poorer graft quality, including decreased levels of graft viability, vessel density, and vascular endothelial growth factor secretion and increased levels of vacuoles, necrotic areas, fibrosis, and inflammation. CONCLUSIONS Protecting adipose tissue structure and viability is crucial for improving fat grafting outcomes. CLINICAL RELEVANCE STATEMENT The protection of the structure and viability of adipose tissue should be ensured throughout the whole process of fat grafting to reduce complications and improve graft quality.
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Hu Y, Wang X, Jiang C. Clinical Efficacy Analysis of Augmentation Mammoplasty with Cell-Assisted Autologous Fat Transplantation. Aesthetic Plast Surg 2022; 46:2218-2227. [PMID: 35169917 DOI: 10.1007/s00266-022-02778-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the clinical efficacy of augmentation mammoplasty with cell-assisted autologous fat transplantation. METHODS Thirty-four cases of micromastia patients in our hospital were randomly divided into control group (n = 17) and observation group (n = 17). Breast augmentation with autologous fat transplantation alone and cell-assisted autologous fat transplantation were performed, respectively, compare and observe the therapeutic effect. RESULTS Compared with the control group, the effective rate of breast augmentation was higher in the observation group. After six months of treatment, the increase value of chest circumference (CC), Sternal notch-nipple distance (SN-N),distance between nipple and inframammary fold (N-MF) was higher in the observation group, and the uplift value was higher after six months surgery, with statistical significance (p < 0.05). MRI showed higher postoperative fat retention rate, QLQ-30 Quality of life scores showed no significant difference (p > 0.05). LEVEL OF EVIDENCE IV 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 online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yiming Hu
- Department of Plastics and Aesthetic Surgery, The Second Xiangya Hospital of Central South University, No.139 Furong Road, Changsha, 410011, Hunan, China
| | - Xiancheng Wang
- Department of Plastics and Aesthetic Surgery, The Second Xiangya Hospital of Central South University, No.139 Furong Road, Changsha, 410011, Hunan, China.
| | - Conghang Jiang
- Department of Plastics and Aesthetic Surgery, The Second Xiangya Hospital of Central South University, No.139 Furong Road, Changsha, 410011, Hunan, China
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Cao P, Xiang X, Chen C. Letter on a Prospective Study of the Efficacy of Cell-Assisted Lipotransfer with Stromal Vascular Fraction to Correct Contour Deformities of the Autologous Reconstructed Breast. Aesthetic Plast Surg 2021; 45:1359. [PMID: 33141320 DOI: 10.1007/s00266-020-02020-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Ping Cao
- Tianyou Hospital, Wuhan University of Science and Technology, No. 9 DingZi Bridge TuJiaLing, WuChang District, Wuhan, 430064, People's Republic of China
| | - Xi Xiang
- Tianyou Hospital, Wuhan University of Science and Technology, No. 9 DingZi Bridge TuJiaLing, WuChang District, Wuhan, 430064, People's Republic of China
| | - Chunying Chen
- Central South Hospital of Wuhan University, No.169 Donghu Road Wuchang District, Wuhan City, Hubei Province, People's Republic of China.
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Qu Y, Luan J. Invited Discussion on: A Prospective Study of the Efficacy of Cell-Assisted Lipotransfer with Stromal Vascular Fraction to Correct Contour Deformities of the Autologous Reconstructed Breast. Aesthetic Plast Surg 2021; 45:864-865. [PMID: 33037474 DOI: 10.1007/s00266-020-01985-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/19/2020] [Indexed: 01/21/2023]
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Overcoming functional challenges in autologous and engineered fat grafting trends. Trends Biotechnol 2021; 40:77-92. [PMID: 34016480 DOI: 10.1016/j.tibtech.2021.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022]
Abstract
Autologous fat grafting offers significant promise for the repair of soft tissue deformities; however, high resorption rates indicate that engineered solutions are required to improve adipose tissue (AT) survival. Advances in material development and biofabrication have laid the foundation for the generation of functional AT constructs; however, a balance needs to be struck between clinically feasible delivery and improved structural integrity of the grafts. A new approach combining the objectives from both the clinical and research communities will assist in developing morphologically and genetically mature AT constructs, with controlled spatial arrangement and increased potential for neovascularization. In a rapidly progressing field, this review addresses research in both the preclinical and bioengineering domains and assesses their ability to resolve functional challenges.
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