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Autologous Human Fat Grafting: Effect of Harvesting and Preparation Techniques on Adipocyte Graft Survival

Smith, Paul M.D.; Adams, William P. Jr M.D.; Lipschitz, Avron H. M.D.; Chau, Brandon M.D.; Sorokin, Evan M.D.; Rohrich, Rod J. M.D.; Brown, Spencer A. Ph.D.

Plastic & Reconstructive Surgery: May 2006 - Volume 117 - Issue 6 - pp 1836-1844
doi: 10.1097/01.prs.0000218825.77014.78
Experimental: Original Articles

Background: Autogenous fat transfer with lipoinjection for soft-tissue augmentation is a commonly used technique without a universally accepted approach. The high percentage and variable amount of fat resorption reduce the clinical efficacy of this procedure and often result in the need for further grafting. The purposes of this study were to evaluate the effect of different harvesting and preparation techniques on human fat tissue viability and to determine fat tissue viability rates among the different fat preparations transplanted into a severe combined immune deficiency mouse model at 3 months.

Methods: Using standard liposuction and syringe aspiration, fat was removed from patients (n = 3) undergoing elective body contouring. Tissue was prepared by six different combinations of centrifugation and/or washing the cells with lactated Ringer's solution or normal saline. Metabolic activities of fat cell viability were monitored to assess overall cell viability. To analyze viability over 3 months, freshly harvested tissue specimens (minimum n = 5) were prepared by a combination of various procedures (wash, centrifugation, and different solutions) and subsequently injected under the dorsal flank skin of severe combined immune deficiency mice in two experiments. Mice were monitored for 12 weeks and the fat xenografts were removed for mass and histological evaluations.

Results: Metabolic analyses showed improved cell viability in tissue specimens undergoing minimal manipulation. No significant differences in fat cell viability, as assessed by graft weight maintenance or histologic evaluations, were observed with regard to harvesting or preparation techniques.

Conclusions: Improved viability of freshly harvested but untreated fat specimens may be expected as compared with grafts that have undergone additional manipulations. No unique combination of preparation or harvesting techniques appeared to be more advantageous on transplanted fat grafts at 3 months. This study also demonstrated a reliable animal model for future investigation into examining novel applications for augmenting fat graft survival.

Dallas, Texas

From the Department of Plastic Surgery, Nancy Lee and Perry R. Bass Advanced Wound Healing Laboratory, University of Texas Southwestern Medical Center.

Received for publication February 27, 2004; revised May 28, 2004.

Presented at the 48th Annual Meeting of the Plastic Surgery Research Council, in Las Vegas, Nevada, April 23 to 26, 2003.

Spencer A. Brown, Ph.D., Department of Plastic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9132, spencer.brown@utsouthwestern.edu

©2006American Society of Plastic Surgeons