The Adjuvant Use of Stromal Vascular Fraction and Platelet-Rich Fibrin for Autologous Adipose Tissue Transplantation

Abstract

Autologous adipose transplantation is rapidly gaining popularity for the restoration of soft tissue defects and lipoatrophy as well as for aesthetic improvements (e.g., facial reconstruction and rejuvenation). However, the current technique is crude that suffers from serious demerits, particularly the long-term unpredictability of volume maintenance due to resorption of the grafted adipose tissue and limited adipogenesis. We hypothesized that the adjuvant use of patient-derived adipose stromal vascular fraction (SVF) and platelet-rich fibrin (PRF) may enhance the overall outcome of autologous fat grafting in plastic and reconstructive surgery. Autologous SVF, with a mean cell number of (4.8±3.79)×10⁷ cells/mL and a mean cell viability of 71.8%, and autologous PRF, with sustained release of multiple angiogenic growth factors, were created before surgical use. The following adipose tissue implants were injected subcutaneously into a rabbit ear's auricula according to the following study design: 2 mL adipose granules and 0.2 mL normal saline solution (AG+NS group), 2 mL adipose granules and 0.2 mL SVF (AG+SVF group), 2 mL adipose granules and 0.2 mL PRF (AG+PRF group), or 2 mL adipose granules combined with 0.1 mL SVF and 0.1 mL PRF (AG+SVF+PRF group). Histological examinations showed that the implanted adipose granules were well engrafted in the AG+SVF+PRF group, with a higher microvessel density 4 weeks postimplantation compared with the other three groups (p<0.01). Twenty-four weeks postimplantation, the resorption rates of implanted tissue in each group were 49.39%±9.47%, 27.25%±4.37%, 36.41%±8.47%, and 17.37%±6.22%, respectively, and were significantly different (p<0.01). The results demonstrated that the efficacy of adipose tissue implantation can be enhanced by using autologous PRF and SVF as therapeutic adjuvants, offering a clinically translatable strategy for soft tissue augmentation and reconstruction.

Application of Platelet-Rich Plasma and Platelet-Rich Fibrin in Fat Grafting: Basic Science and Literature Review

“…Several studies confirmed the gradual release of PDGF and TGF for 28 days from PRF, comparing the burst release of PRP within 1 day. 50,51 A possible explanation is that PRF polymerizes with 3D architecture progressively, slowly, and naturally during centrifugation, which helps to entrap cytokines released from platelets with the fibrin polymer. In contrast, PRP is activated with a high concentration of thrombin, which makes the polymerization rapid, followed by strong contraction of the clots, from which fluids will expel.…”

“…Liu et al studied the effect of autologous PRF and/or SVF on fat graft survival. 50 They implanted a mixture of fat graft with PRF alone, SVF alone, or PRF with SVF on the rabbit ear. After 4 weeks, there was higher microvessel density and remaining adipose tissue area in the PRF + SVF + fat graft group compared to the other groups.…”

Lineage depletion of stromal vascular fractions isolated from human adipose tissue: a novel approach towards cell enrichment technology

“…cells. Thus, the efficacy of linpopulation might be correlated with its use in specific treatment of mesodermal related disorders such as bone and cartilage dysfunctions, soft tissue augmentation, muscular disorders and so on (Vieira et al 2008;Liu et al 2012;Lendeckel et al 2004). On the other hand, the efficacy of lin?…”

Mesenchymal Stem Cells of Adipose Tissue: A Modern View, the Relevance and Prospects of Application in Plastic Surgery

“…3. Результаты экспериментальных исследований использования СВКФ и плазмы, обогащенной факторами роста, для приживления жировой ткани: 1) гистологическая картина; 2) визуальная оценка на кроликах [28]. Fig.…”