Deciphering the Emerging Roles of Adipocytes and Adipose-Derived Stem Cells in Fat Transplantation

Abstract

Autologous fat transplantation is widely regarded as an increasingly popular method for augmentation or reshaping applications in soft tissue defects. Although the fat transplantation is of simple applicability, low donor site morbidity and excellent biocompatibility, the clinical unpredictability and high resorption rates of the fat grafts remain an inevitable problem. In the sites of fat transplantation, the most essential components are the adipocyte and adipose-derived stem cells (ADSCs). The survival of adipocytes is the direct factor determining fat retention. The efficacy of fat transplantation is reduced by fat absorption and fibrosis due to the inadequate blood flow, adipocyte apoptosis and fat necrosis. ADSCs, a heterogeneous mixture of cells in adipose tissue, are closely related to tissue survival. ADSCs exhibit the ability of multilineage differentiation and remarkable paracrine activity, which is crucial for graft survival. This article will review the recent existing research on the mechanisms of adipocytes and ADSCs in fat transplantation, especially including adipocyte apoptosis, mature adipocyte dedifferentiation, adipocyte browning, ADSCs adipogenic differentiation and ADSCs angiogenesis. The in-depth understanding of the survival mechanism will be extremely valuable for achieving the desired filling effects.

The Application and Efficacy Evaluation of Autologous Fat Transplantation in Antiaging of the Face: Systematic Review and Meta-Analysis

“…For antiaging of relevant documents, collection of adjustment values, and convergence of relevant values into system evaluation, according to the quantitative meta-analysis method, STATA/se15 statistics are used to summarize the performance indicators. Efficacy indicators include patient satisfaction, operator satisfaction, average number of operations, incidence of complications, fat survival rate, and biopsy index [ 24 ].…”

Macrophage‐mediated extracellular matrix remodeling after fat grafting in nude mice

“…The majority of cells after fat grafting inevitably undergo apoptosis and necrosis due to exposure to ischemia, hypoxia, or excessive stress in the survival environment. 14,15 Moreover, although cryopreserved fat loses up to 92.7% of cellular metabolic activity and contains massive cell necrosis, 16 the volume and morphology of the grafts after the transplantation of cryopreserved fat are similar to those of transplanted fresh fat grafts. 17 This suggests that the effect of ECM on grafted fat retention should not be ignored.…”

“…Current studies have focused on cellular events, and little research has been done on the role of extracellular matrix (ECM) in fat grafting. The majority of cells after fat grafting inevitably undergo apoptosis and necrosis due to exposure to ischemia, hypoxia, or excessive stress in the survival environment 14,15 . Moreover, although cryopreserved fat loses up to 92.7% of cellular metabolic activity and contains massive cell necrosis, 16 the volume and morphology of the grafts after the transplantation of cryopreserved fat are similar to those of transplanted fresh fat grafts 17 .…”

The protective role of FTY720 in promoting survival of allograft fat in mice

“…Although adipose tissue is considered an ideal soft‐tissue filling material, the results of fat grafting can be unpredictable. After fat grafting, ischemia, hypoxia, or excessive stress in the survival environment induce apoptosis and necrosis in a few adipocytes 5 . Adipocyte survival is the direct factor that determines fat graft retention for further application of fat grafting.…”

“…After fat grafting, ischemia, hypoxia, or excessive stress in the survival environment induce apoptosis and necrosis in a few adipocytes. 5 Adipocyte survival is the direct factor that determines fat graft retention for further application of fat grafting. Therefore, acquiring sufficient highly-viable adipocytes and improvement of vascularization, are key to improving the odds of survival of the fat graft.…”