Physical, Biochemical, and Biologic Properties of Fat Graft Processed via Different Methods

Abstract

Background: Clinical use of autologous fat for correction of soft-tissue defects in cosmetic and reconstructive procedures has grown in popularity. Graft processing is implicated as one of the variable factors affecting quality, viability, and subsequent graft survival. This study analyzed the in vitro physical and biologic characteristics of lipoaspirate processed using different techniques. Methods: Fresh lipoaspirates from patients with informed consent were processed by 4 methods: decantation, centrifugation, the REVOLVE System, and PureGraft. Processed fat grafts were analyzed for yield, composition, tissue particle size and morphology, and viability and function of adipocytes and stem cells. Fat tissue harvested from waste containers of REVOLVE and PureGraft and trapped on REVOLVE paddles was also evaluated. Results: Grafts produced by the filtration systems contained the highest percentage of fat tissue, whereas those from decantation contained the lowest percentage, although they have the highest volume yield. In addition, grafts from REVOLVE and PureGraft showed more large-sized particles (>1000 μm) than those from decantation or centrifugation. REVOLVE also preserved significantly higher populations of viable and functional adipocytes and stromal vascular fraction cells when compared with other processing methods. Tissue particles in waste containers of REVOLVE and PureGraft were mostly (>85%) <300 μm and demonstrated a minimal number of viable adipocytes and stem cells. Fat tissues trapped on REVOLVE paddles contained a higher percentage of noninjectable and fibrous collagen bundles. Conclusion: Different processing methods result in fat grafts with varying physical and biologic properties, which may contribute to fat graft viability and retention in vivo.

Autologous Lipoaugmentation Long‐Term Clinical Outcomes: A Systematic Review

“…51 In fact, their study found that centrifugation resulted in higher fat tissue content, though this did not translate into improved lipolysis activity. 51 Translation of these in vitro findings to in vivo fat retention has yet to be comparatively evaluated. Ultimately, based on prevailing theories on fat grafting, the aim of fat processing is to maximize the concentration of injected viable adipocytes during lipoaugmentation and/or activate adipose-derived stem cells to remodel the adipose tissue.…”

“…Translation of this single study to VF lipoaugmentation is unclear but suggests that fat can survive such centrifugation, though reported speeds and durations varied. A comparative review of adipocyte viability in vitro using various processing techniques supports similar viability with centrifugation compared to decantation and commercial processing kits 51 . In fact, their study found that centrifugation resulted in higher fat tissue content, though this did not translate into improved lipolysis activity 51 .…”

“…A comparative review of adipocyte viability in vitro using various processing techniques supports similar viability with centrifugation compared to decantation and commercial processing kits 51 . In fact, their study found that centrifugation resulted in higher fat tissue content, though this did not translate into improved lipolysis activity 51 . Translation of these in vitro findings to in vivo fat retention has yet to be comparatively evaluated.…”

Comparative Analysis of a New Automatic System and Four Existing Techniques for Autologous Fat Grafting

“…32,33 Firstly, the results we obtained allow us to confirm results from several previous studies, namely that simple decantation of the tissue leads to inferior results to all other techniques tested. 24,27,30,34,35 Indeed, in this technique, the liquid represents up to 30% of the volume, 17 which may explain the poor grafting efficiency of about 60% (Fig. 4).…”

Stem Cells in Autologous Microfragmented Adipose Tissue: Current Perspectives in Osteoarthritis Disease

“…The PureGraft technology is based on the filtration of adipose tissue through a particular membrane, an equally rapid procedure (15 min). In addition, grafts from PureGraft displayed larger particles (>1000 μm) and were able to operate a “dialysis” of the adipose tissue without resorting to other, more destructive methods such as centrifugation [ 95 ]. The main use of these technologies is in the field of fat grafting for breast volumes [ 96 ].…”