Fate of Fat Grafting In Vivo and In Vitro: Does the Suction-Assisted Lipectomy Device Matter?

Survival Mechanisms and Retention Strategies in Large-Volume Fat Grafting: A Comprehensive Review and Future Perspectives

INTRODUCTION

Large-volume fat grafting is emerging as a promising technique in plastic and reconstructive surgery. However, the unpredictable graft volume retention rate remains a critical challenge. To address this issue, we need a profound understanding of the survival mechanisms following large-volume fat transplantation. This review summarizes known survival mechanisms and strategies to enhance graft retention.

METHODS

This review comprehensively examines the current literature on the survival mechanisms and retention strategies in large-volume fat grafting. A thorough literature search was conducted using PubMed, Medline and Google Scholar databases, focusing on studies published from 2009 to 2023.

CONCLUSION

In the current research on fat survival mechanisms, few have focused on large-volume fat grafting. This review provides an overview of the survival mechanisms specific to large-volume fat grafting and identifies a survival pattern distinct from that of small-volume fat grafting. Additionally, we have summarized existing strategies to improve graft retention across five stages (harvesting, processing, enrichment, grafting and post-graft care), analyzed their advantages and disadvantages and identified some of the most promising strategies.

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.

Weight Loss After VASER-Assisted Liposuction

BACKGROUND

Liposuction is one of the most common procedures used for body contouring. In this study, we aimed to determine whether there is a weight change with VASER-assisted liposuction (VAL) procedure and the demographic factors affecting it.

METHODS

A total of 51 patients (30 females and 21 males) who underwent VAL between the years of 2020 and 2022 were included in the study. Participants' weights before VAL, body mass indexes (BMI), aspiration volumes, demographic data, and weights and BMIs one month after VAL were recorded and analyzed. In addition, the fat ratio in the aspirate was determined in ten patients.

RESULTS

The mean aspiration volume with VAL was 4832.50 ± 2373.26 ml in females and 5176.90 ± 1602.61 ml in males. Body weights (baseline, 90.34 ± 9.17 vs. 71.01 ± 8.87; one month later, 86.95 ± 8.34 vs. 66.28 ± 10.04: p < 0.001) and BMIs (baseline, 28.59 ± 2.97 vs. 26.40 ± 3.69; one month later, 27.54 ± 2.92 vs. 24.59 ± 3.76: p = 0.009) were higher in males than females, both at baseline and after VAL. There was a significant decrease in body weights and BMIs after VAL in both females (4.73 ± 4.73 kg) and males (3.39 ± 4.27 kg) (p < 0.001). However, no correlation was observed between the decrease in body weights and BMIs after VAL and gender, age, aspirate volume, and fat volume.

CONCLUSION

Although there was a decrease in mean body weight and mean BMI in both males and females one month after VAL, no associations were observed between weight drop after VAL and gender, age, aspiration volume, and fat volume. 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 .

Male Pectoralis Major Muscle Augmentation with Autologous Fat Transplantation Using VASER Lipoaspirate: Evaluation with MRI

The popularity of autologous fat grafts has increased for the reshaping, contouring, and augmentation of the male breast tissue. However, long-term maintenance of tissue viability and the ways for assessment serve as hot-spot topics in the field. This study was designed to evaluate the viability of fat grafts obtained by a vibration amplification of sound energy at resonance (VASER)-assisted lipoaspiration procedure using a magnetic resonance imaging-based approach.

Methods

This is a prospective examination of 20 male patients (40 breasts) who underwent VASER-assisted liposuction and fat grafting surgery, and long-term fat graft viability was evaluated by magnetic resonance imaging scans.

Results

Participants had an average age of 34.85 ± 7.37 years with a mean BMI of 26.73 ± 2.63 kg/m². The mean fat graft volume injected was 542.63 ± 144.78 mL on the right, and 548.95 ± 140.36 mL on the left side. On the magnetic resonance imaging follow-up, the mean intrapectoral adipose tissue thickness was 20.34 ± 6.31 mm on the right, and 18.94 ± 8.27 mm on the left sides and tissue viability was preserved in all cases. The mean follow-up duration was 22 ± 9.8 (range 14-44) months.

Conclusion

VASER-assisted lipoaspiration and autologous fat grafting of the major pectoralis muscle provide a satisfactory outcome and long-term maintenance of the grafted adipose tissue.

The Short-Term Effect of VASER Assisted Liposuction on Lipid Profile

OBJECTIVE

The presence of obesity with dyslipidemia is a worldwide health problem and one of the major risks for cardiovascular diseases. The metabolic effects of liposuction are being investigated in terms of insulin resistance and reducing cholesterol levels. We aimed to examine the metabolic effects of Vibration Amplification of Sound Energy at Resonance (VASER^®)-assisted liposuction on the lipid profiles of overweight patients.

METHODS

Eighteen patients who underwent VASER^®-assisted liposuction were investigated in terms of changes in lipid profiles. The total cholesterol (Total-C), triglycerides (TGs), Low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels were measured enzymatically. We also calculated Non-HDL Cholesterol levels and Total Cholesterol/HDL Cholesterol ratios.

RESULTS

We observed that Total-C (p ≤ 0.0001), LDL-C (p ≤ 0.0001), TGs (p = 0.0004), Non-HDL-C levels (p ≤ 0.0001) and Total-C/HDL-C ratios (p ≤ 0.0001) decreased on the third month after VASER^®-assisted liposuction.

CONCLUSION

We conclude that VASER^®-assisted liposuction could be beneficial to regulate lipid metabolism. Especially, decrements of Non-HDL Cholesterol and Total-C/HDL-C ratio could be protective against cardiovascular diseases.

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 .