Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine

Abstract

The results of transplantation of free autologous fat obtained by blunt syringe suction lipectomy are unpredictable. We examined if adipose tissue viability is compromised by using syringe suction lipectomy and by infiltration of the tissue with local anesthetics. As reference, we used adipose tissue samples excised during elective surgery. Fat obtained intraoperatively and by lipectomy was digested with collagenase to isolate adipocytes. The mechanical damage associated with sample handling and cell isolation in both procedures was similar and did not exceed 6% of the total cell mass. In addition, cells isolated from intraoperative and lipectomy samples did not differ functionally, responded similarly to insulin stimulation of glucose transport and epinephrine-stimulated lipolysis, and retained the same growth pattern in culture. Since during fat transplantation the graft is exposed to local anesthetics at both the donor and the recipient sites, we reexamined adipocyte function in the presence of lidocaine. Lidocaine potently inhibited glucose transport and lipolysis in adipocytes and their growth in culture. That effect, however, persisted only as long as lidocaine was present; after washing, the cells were able to fully regain their function and growth regardless of whether the exposure was as short as 30 minutes or as long as 10 days. These results indicate that adipose tissue obtained by syringe lipectomy consists of fully viable and functional adipocytes, but local anesthetics may halt their metabolism and growth.

Adipose-derived stem cells: Isolation, expansion and differentiation☆

“…The procedure generates finely minced tissue fragments whose size depends on the cannula's dimensions. Independent studies have determined that liposuction aspiration alone does not significantly alter the viability of isolated SVF cells [29][30][31]. Indeed, adherent stromal cells with characteristics of adipocyte progenitors can be found directly within the liposuction aspiration fluid, as well as in SVF derived from the tissue fragment digests [32].…”

Fat graft – the natural choice for reconstructive, regenerative and aesthetic surgery

“…Few studies related to the effects of infiltration have not shown adverse effects of local anesthetics or epinephrine on fat graft survival [50,51]. However, Keck et al [52] reported moderate effect of mepivacaine and ropivacaine and severe unfavorable influence of articaine/epinephrine and lidocaine on preadipocyte viability.…”

Autologous Fat Grafting - Factors of Influence on the Therapeutic Results

“…In 1995 Jr. Moore published the results of a profound analysis stating no negative influence of the adrenalin on fat cells survival (Moore, 1995). On the contrary, lidocain leaded to inhibition of glucose transport, lipolysis and growth of adipocytes but the effect was irreversible after cease of contact.…”

“…This technique combines the advantages of machine liposuction and surgical excision and in the same time it does not have the burden of their disadvantages -respectively adipocytes destruction due to the high negative pressure and disfiguring cicatrices (Novaes et al, 1998;MacRae et al, 2003;. Manual lipoaspiration is noninvasive and as atraumatic towards adipose cells as surgical excision (Moore et al, 1995;Lalikos et al, 1997) which makes it an optimal method for fat harvesting.…”

“…The new concepts were built on attempts to avoid excessive pressure changes during harvesting and reimplantation, improving the means of purification from potential local inflammation promotors, and application in a fashion that assures sufficient nutritional sources Shiffman, Mirrafati, 2001). Though none of the newly invented techniques is considered optimal a consensus has been reached on some stages of the technical implementation of autologous fat grafting such as manual syringe lipoaspiration and threedimensional reimplantation (Niechajev, Sevcuk, 1994;Coleman, 2001;Jauffret et al, 1994;Lalikos et al, 1997;Moore et al, 1995;Novaes et al, 1995). To date the optimal method of transplant purification still remains unclear as well as the impact on the therapeutic results of factors as combination with other interventions, intraoperative extent of correction and the need of numerous transplantations as methods counteracting the postoperative resorption.…”