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A Comprehensive In Vitro Comparison of Preparation Techniques for Fat Grafting

Streit, Libor M.D., Ph.D.; Jaros, Josef Ph.D.; Sedlakova, Veronika M.D.; Sedlackova, Miroslava M.D., Ph.D.; Drazan, Lubos M.D., Ph.D.; Svoboda, Michal B.Sc.; Pospisil, Jakub M.Sc.; Vyska, Tomas M.D.; Vesely, Jiri M.D., Ph.D.; Hampl, Ales D.V.M., Ph.D.

Plastic & Reconstructive Surgery: March 2017 - Volume 139 - Issue 3 - p 670e–682e
doi: 10.1097/PRS.0000000000003124
Experimental: Original Articles
Discussion

Background: Lipomodeling is a technique that uses the patient’s own fat for tissue regeneration and augmentation. The extent of regenerative effect is reported to be determined by the numbers of adipose-derived stem cells and the viability of cells in processed adipose tissue which, together with other factors, influence the degree of graft retention. This study addresses whether differences exist in properties of fat graft obtained by three commonly used techniques.

Methods: Adipose tissue harvested from the hypogastric regions of 14 patients was processed by decantation, centrifugation, and membrane-based tissue filtration. The morphology of each preparation was assessed by electron microscopy and overall cell viability was assessed by live/dead assay. The number of adipose-derived stem cells was determined and their stem cell character was assessed by the presence of cell surface molecules (i.e., CD105, CD90, CD31, and CD45) and by their capacity to differentiate into adipogenic and osteogenic lineages.

Results: First, morphologies of processed fat samples obtained by individual procedures differed, but no preparation caused obvious damage to cellular or acellular components. Second, although the highest numbers of adipose-derived stem cells were contained in the upper fraction of centrifuged lipoaspirates, the difference between preparations was marginal. Third, the maximal concentration of adipose fraction (removal of watery component) of lipoaspirate was achieved by membrane-based tissue filtration. Finally, no significant differences in overall viability were detected.

Conclusions: Properties of processed lipoaspirate were influenced by the preparation procedure. However, the differences were not dramatic; both centrifugation and membrane-based filtration are methods of choice whose selection depends on other criteria (e.g., practicality) for individual surgical settings.

Brno, Czech Republic

From the Department of Plastic and Aesthetic Surgery and the International Clinical Research Center, St. Anne’s University Hospital Brno; and the Department of Histology and Embryology, Faculty of Medicine, and the Institute of Biostatistics and Analysis, Masaryk University.

Received for publication January 5, 2016; accepted June 21, 2016.

Drs. Streit and Jaros are co–first authors.

Presented at XXXVI National Congress of Plastic Surgery, in Prague, Czech Republic, September 24 through 26, 2015; the Fourth Annual Research Council Meeting of the European Association of Plastic Surgeons, in Edinburgh, United Kingdom, May 27 through 28, 2015; the 12th Annual Meeting of the International Society for Stem Cell Research, in Vancouver, British Columbia, Canada, June 18 through 21, 2014; and the 11th Congress and Consensus Conference of the International Committee for Quality Assurance and Medical Technologies and Devices in Plastic Surgery, in Budapest, Hungary, April 10 through 13, 2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

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Libor Streit, M.D., Department of Plastic and Aesthetic Surgery, St. Anne’s University Hospital, Berkova 34, 612 00 Brno, Czech Republic, liborstreit@gmail.com

©2017American Society of Plastic Surgeons