Justinas Grasys1, Bong-Sung Kim1, Norbert Pallua1. 1. From the Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Abstract
BACKGROUND: Although fat grafting has emerged as a major force in plastic, reconstructive, and aesthetic surgery, some questions regarding its reliability and regenerative potential remain unanswered. OBJECTIVES: The authors examined the influence of three anatomic areas on various lipoaspirate properties to identify the most appropriate harvest site for fat-grafting procedures. METHODS: Lipoaspirates from 25 healthy patients were harvested from the abdomen, inner thigh, and knee. The authors measured the content of soluble factors in the lipoaspirate followed by the assessment of the yield, adipogenic differentiation, proliferation of stromal vascular fraction (SVF) cells, and the percentage of adipose-derived stem cells (ASC) in the SVF. The results also were correlated with the age and body mass index of the donors. RESULTS: Lipoaspirates from the abdomen showed significantly higher concentrations of matrix metalloproteinase (MMP)-9 compared with the knee. The content of basic fibroblast growth factor (b-FGF), platelet-derived growth factor (PDGF)-BB, and insulin-like growth factor (IGF)-1 tended to be highest in the abdomen but did not reach statistical significance. Vascular endothelial growth factor (VEGF)-A and bFGF-2 contents both correlated negatively with age in lipoaspirates from at least two different anatomic areas. CONCLUSIONS: The authors' results indicate that the abdomen may be a slight favorite over the inner thigh and knee because of its richer content of soluble factors. However, because only the difference of MMP-9 content actually reached statistical significance and because no differences in SVF characteristics were observed, a decision primarily based on other criteria appears to be justifiable.
BACKGROUND: Although fat grafting has emerged as a major force in plastic, reconstructive, and aesthetic surgery, some questions regarding its reliability and regenerative potential remain unanswered. OBJECTIVES: The authors examined the influence of three anatomic areas on various lipoaspirate properties to identify the most appropriate harvest site for fat-grafting procedures. METHODS: Lipoaspirates from 25 healthy patients were harvested from the abdomen, inner thigh, and knee. The authors measured the content of soluble factors in the lipoaspirate followed by the assessment of the yield, adipogenic differentiation, proliferation of stromal vascular fraction (SVF) cells, and the percentage of adipose-derived stem cells (ASC) in the SVF. The results also were correlated with the age and body mass index of the donors. RESULTS: Lipoaspirates from the abdomen showed significantly higher concentrations of matrix metalloproteinase (MMP)-9 compared with the knee. The content of basic fibroblast growth factor (b-FGF), platelet-derived growth factor (PDGF)-BB, and insulin-like growth factor (IGF)-1 tended to be highest in the abdomen but did not reach statistical significance. Vascular endothelial growth factor (VEGF)-A and bFGF-2 contents both correlated negatively with age in lipoaspirates from at least two different anatomic areas. CONCLUSIONS: The authors' results indicate that the abdomen may be a slight favorite over the inner thigh and knee because of its richer content of soluble factors. However, because only the difference of MMP-9 content actually reached statistical significance and because no differences in SVF characteristics were observed, a decision primarily based on other criteria appears to be justifiable.
Authors: Glenn E Winnier; Nick Valenzuela; Jennifer Peters-Hall; Joshua Kellner; Christopher Alt; Eckhard U Alt Journal: PLoS One Date: 2019-09-03 Impact factor: 3.240