Grading Lipoaspirate

Allen, Robert J.; Cañizares, Orlando; Scharf, Carrie; Nguyen, Phuong D.; Thanik, Vishal; Saadeh, Pierre B.; Coleman, Sydney R.; Hazen, Alexes

doi:10.1097/prs.0b013e3182729cc6

Cited by 67 publications

(27 citation statements)

References 17 publications

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“…36,60 Furthermore, injection of high-density fat into FVB/NJ immunocompetent mice resulted in the largest fat graft 2 and 10 weeks after transplantation. 61 Histologic assessment of the fat graft formed with high-density fat demonstrated an increased number endothelial cells, a reduced number of collagen bands, and decreased fibrosis. These results correlated with increased expression of angiogenic factors such as vascular endothelial growth factor, stromal derived factor 1-alpha, platelet-derived growth factor, and adiponectin.…”

Section: Density Of Processed Tissuementioning

confidence: 95%

The Current State of Fat Grafting

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Cederna

Rubin

et al. 2015

Plastic and Reconstructive Surgery

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129

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Background Interest in and acceptance of autologous fat grafting for use in contour abnormalities, breast reconstruction, and cosmetic procedures have increased. However, there are many procedural variations that alter the effectiveness of the procedure and may account for the unpredictable resorption rates observed. Methods The authors highlighted studies investigating the effects of harvesting procedures, processing techniques, and reinjection methods on the survival of fat grafts. This review focused on the impact different techniques have on outcomes observed in the following: in vitro analyses, in vivo animal experiments, and human studies. Results This systemic review revealed the current state of the literature. There was no significant difference in the outcomes of grafted fat obtained from different donor sites, different donor-site preparations, harvest technique, fat harvesting cannula size, or centrifugation speed, when tumescent solution was used. Gauze rolling was found to enhance the volume of grafted fat, and no significant difference in retention was observed following centrifugation, filtration, or sedimentation in animal experiments. In contrast, clinical studies in patients found more favorable outcomes with fat processed by centrifugation compared with sedimentation. In addition, higher retention was observed with slower reinjection speed and when introduced into less mobile areas. Conclusions There has been a substantial increase in research interest to identify methodologies for optimizing fat graft survival. Despite some differences in harvest and implantation technique in the laboratory, these findings have not translated into a universal protocol for fat grafting. Therefore, additional human studies are necessary to aid in the development of a universal protocol for clinical practice.

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Section: Density Of Processed Tissuementioning

confidence: 95%

The Current State of Fat Grafting

Strong

Cederna

Rubin

et al. 2015

Plastic and Reconstructive Surgery

Self Cite

356

129

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“…After harvesting, the lipoaspirate was enriched with stem cells through centrifugation. Our group and others have demonstrated that centrifugation at 3000rpm for 3 mins of the adipose tissue enriches fat with ADSC’s in the distal portion of the lipoaspirate [27–29]. The proximal lipoaspirate graft was discarded along with the free oil and blood segments and only the distal lipoaspirate graft was used for injections.…”

Section: Methodsmentioning

confidence: 99%

Stem cell enriched lipotransfer reverses the effects of fibrosis in systemic sclerosis

et al. 2019

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Oro-facial fibrosis in systemic sclerosis (Scleroderma;SSc) has a major impact on mouth function, facial appearance, and patient quality of life. Lipotransfer is a method of reconstruction that can be used in the treatment of oro-facial fibrosis. The effect of this treatment not only restores oro-facial volume but has also been found to reverse the effects of oro-facial fibrosis. Adipose derived stem cells (ADSCs) within the engrafted adipose tissue have been shown to be anti-fibrotic in SSc and are proposed as the mechanism of the anti-fibrotic effect of lipotransfer. A cohort of 62 SSc patients with oro-facial fibrosis were assessed before and after stem cell enriched lipotransfer treatment. Clinical evaluation included assessment of mouth function using a validated assessment tool (Mouth Handicap in Systemic Sclerosis Scale-MHISS), validated psychological measurements and pre and post-operative volumetric assessment. In addition, to understand the mechanism by which the anti-fibrotic effect of ADSCs occur, SSc derived fibroblasts and ADSCs from this cohort of patients were co-cultured in direct and indirect culture systems and compared to monoculture controls. Cell viability, DNA content, protein secretion of known fibrotic mediators including growth factor- β1 (TGF β-1) and connective tissue growth factor (CTGF) using ELISA analysis and fibrosis gene expression using a fibrosis pathway specific qPCR array were evaluated. Mouth function (MHISS) was significantly improved (6.85±5.07) (p<0.0001) after treatment. All psychological measures were significantly improved: DAS 24 (12.1±9.5) (p<0.0001); HADS-anxiety (2.8±3.2) (p<0.0001), HADS-depression (2.0±3.1) (p<0.0001); BFNE (2.9 ± 4.3) (p<0.0001); VAS (3.56±4.1) (p<0.0001). Multiple treatments further improved mouth function (p<0.05), DAS (p<0.0001) and VAS (p = 0.01) scores. SSc fibroblast viability and proliferation was significantly reduced in co-culture compared to monoculture via a paracrine effect over 14 days (p < 0.0001). Protein secretion of transforming growth factor (TGF-β1) and connective tissue growth factor (CTGF) was significantly reduced in co-culture compared to monoculture (p < 0.0001). Multiple fibrosis associated genes were down regulated in SSc co-culture compared to monoculture after 14 days including Matrix metalloproteinase-8 (MMMP-8), Platelet derived growth factor-β (PDGF-β) and Integrin Subunit Beta 6 (ITG-β6). Autologous stem cell enriched lipotransfer significantly improved the effects of oro-facial fibrosis in SSc in this open cohort study. Lipotransfer may reduce dermal fibrosis through the suppression of fibroblast proliferation and key regulators of fibrogenesis including TG-β1 and CTGF. Our findings warrant further investigation in a randomised controlled trial.

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“…5.5 A graded density of fat can be obtained by centrifuging the products of liposuction using standard Coleman technology ( Allen et al, 2013 ). Compared with the fat in the upper liposuction, the fat in the lower liposuction contains more ECM and ASCs, and higher concentrations of anti-inflammatory and fat angiogenesis factors ( Qiu et al, 2016 ; De Francesco et al, 2017 ).…”

Section: Clinical Avoidance Of Poor Extracellular Matrix Remodeling After Graftingmentioning

confidence: 99%

Recent Developments in Extracellular Matrix Remodeling for Fat Grafting

Dong

et al. 2021

Front. Cell Dev. Biol.

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Remodeling of the extracellular matrix (ECM), which provides structural and biochemical support for surrounding cells, is vital for adipose tissue regeneration after autologous fat grafting. Rapid and high-quality ECM remodeling can improve the retention rate after fat grafting by promoting neovascularization, regulating stem cells differentiation, and suppressing chronic inflammation. The degradation and deposition of ECM are regulated by various factors, including hypoxia, blood supply, inflammation, and stem cells. By contrast, ECM remodeling alters these regulatory factors, resulting in a dynamic relationship between them. Although researchers have attempted to identify the cellular sources of factors associated with tissue regeneration and regulation of the microenvironment, the factors and mechanisms that affect adipose tissue ECM remodeling remain incompletely understood. This review describes the process of adipose ECM remodeling after grafting and summarizes the factors that affect ECM reconstruction. Also, this review provides an overview of the clinical methods to avoid poor ECM remodeling. These findings may provide new ideas for improving the retention of adipose tissue after fat transplantation.

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Grading Lipoaspirate

Cited by 67 publications

References 17 publications

The Current State of Fat Grafting

The Current State of Fat Grafting

Stem cell enriched lipotransfer reverses the effects of fibrosis in systemic sclerosis

Recent Developments in Extracellular Matrix Remodeling for Fat Grafting

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