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The Combination of Tissue Dissection and External Volume Expansion Generates Large Volumes of Adipose Tissue

He, Yunfan M.D.; Dong, Ziqing M.D.; Xie, Gan M.D.; Zhou, Tao M.D.; Lu, Feng M.D., Ph.D.

Plastic and Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 888e–899e
doi: 10.1097/PRS.0000000000003212
Experimental: Original Articles

Background: Noninvasive external volume expansion device has been applied to stimulate nonsurgical breast enlargement in clinical settings. Although previous results demonstrate the capacity of external volume expansion to increase the number of adipocytes, this strategy alone is insufficient to reconstruct soft-tissue defects or increase breast mass. The authors combined a minimally invasive tissue dissection method with external volume expansion to generate large volumes of adipose tissue.

Method: In vitro, various densities of adipose-derived stem cells were prepared to evaluate relations between cell contacts and cell proliferation. In vivo, dorsal adipose tissue of rabbits was thoroughly dissected and the external volume expansion device was applied to maintain the released state. External volume expansion without tissue dissection served as the control.

Results: In the dissection group, the generated adipose tissue volume was much larger than that in the control group at all time points. A larger number of proliferating cells appeared in the dissection samples than in the control samples at the early stage after tissue dissection. At low cell density, adipose-derived stem cells displayed an increasing proliferation rate compared to high cell density. Protein expression analysis revealed that cell proliferation was mediated by a similar mechanism both in vivo and in vitro, involving the release of cell contact inhibition and Hippo/Yes-associated protein pathway activation.

Conclusions: Adipose tissue dissection releases cell-to-cell contacts and induces adipose-derived stem cell proliferation. Preexpanded adipose-derived stem cells undergo adipogenesis under the adipogenic environment created by external volume expansion, leading to better adipose regeneration compared with the control.

Supplemental Digital Content is available in the text.

Guangzhou, Guangdong, People’s Republic of China

From the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University.

Received for publication May 16, 2016; accepted August 3, 2016.

The first two authors contributed equally and should be considered co–first authors.

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

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Feng Lu, M.D., Ph.D., Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515 People’s Republic of China,

©2017American Society of Plastic Surgeons