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Studies in Fat Grafting: Part I. Effects of Injection Technique on In Vitro Fat Viability and In Vivo Volume Retention

Chung, Michael T. B.S.; Paik, Kevin J. B.S.; Atashroo, David A. M.D.; Hyun, Jeong S. M.D.; McArdle, Adrian M.B., B.A.O., B.Ch.; Senarath-Yapa, Kshemendra M.B., B.Ch.; Zielins, Elizabeth R. M.D.; Tevlin, Ruth M.B., B.A.O., B.Ch.; Duldulao, Chris B.S.; Hu, Michael S. M.D.; Walmsley, Graham G. B.A.; Parisi-Amon, Andreina Ph.D.; Momeni, Arash M.D.; Rimsa, Joe R. B.S.; Commons, George W. M.D.; Gurtner, Geoffrey C. M.D.; Wan, Derrick C. M.D.; Longaker, Michael T. M.D., M.B.A.

Plastic and Reconstructive Surgery: July 2014 - Volume 134 - Issue 1 - p 29–38
doi: 10.1097/PRS.0000000000000290
Cosmetic: Original Articles

Background: Fat grafting has become increasingly popular for the correction of soft-tissue deficits at many sites throughout the body. Long-term outcomes, however, depend on delivery of fat in the least traumatic fashion to optimize viability of the transplanted tissue. In this study, the authors compare the biological properties of fat following injection using two methods.

Methods: Lipoaspiration samples were obtained from five female donors, and cellular viability, proliferation, and lipolysis were evaluated following injection using either a modified Coleman technique or an automated, low-shear device. Comparisons were made to minimally processed, uninjected fat. Volume retention was also measured over 12 weeks after injection of fat under the scalp of immunodeficient mice using either the modified Coleman technique or the Adipose Tissue Injector. Finally, fat grafts were analyzed histologically.

Results: Fat viability and cellular proliferation were both significantly greater with the Adipose Tissue Injector relative to injection with the modified Coleman technique. In contrast, significantly less lipolysis was noted using the automated device. In vivo fat volume retention was significantly greater than with the modified Coleman technique at the 4-, 6-, 8-, and 12-week time points. This corresponded to significantly greater histologic scores for healthy fat and lower scores for injury following injection with the device.

Conclusion: Biological properties of injected tissues reflect how disruptive and harmful techniques for placement of fat may be, and the authors’ in vitro and in vivo data both support the use of the automated, low-shear devices compared with the modified Coleman technique.

Stanford, Menlo Park, and Palo Alto, Calif.

From the Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Plastic and Reconstructive Surgery Division, and the Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine; the Department of Bioengineering, Stanford University School of Medicine and Engineering; the TauTona Group; and the Plastic Surgery Center of Palo Alto.

Received for publication October 12, 2013; accepted December 2, 2013.

The first two authors contributed equally to this article.

Disclosure: Mr. Rimsa is the vice president of research and development and chief operating officer at Tau Tona Group. Dr. Gurtner and Dr. Longaker have equity in the TauTona Group. Dr. Longaker coauthored this article while on sabbatical from Stanford University. The other authors have no f inancial interest to declare in relation to the content of this article.

Michael T. Longaker, M.D., M.B.A., Department of Surgery, Stanford University School of Medicine, 257 Campus Drive, Stanford, Calif. 94305,, Derrick C. Wan, M.D., Department of Surgery, Stanford University School of Medicine, 257 Campus Drive, Stanford, Calif. 94305,

©2014American Society of Plastic Surgeons