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Quality and Vitality of Autologous Fat Grafts Harvested Via Different Techniques: A Clinical Comparison Study.

BACKGROUND
The unpredictable outcome in autologous fat grafting due to reabsorption processes is a major challenge for health care providers and patients. A higher number of viable adipocytes is considered relevant for a higher volume retained. While various impairing variables have already been extensively researched, other potential parameters are less investigated or even neglected.


OBJECTIVE
The present project targets the harvesting process of adipose tissue as the primary cause of cell damage and aims at determining risk factors associated with low cell survival.


METHODS
Thirty-nine male and female subjects undergoing planned elective liposuction or abdominoplasty were enrolled. Forty-seven lipoaspirates harvested via different liposuction techniques were analyzed. RNA isolation and real-time polymerase chain reaction (PCR) was performed to elucidate differences in the expression of various adipocyte markers. Furthermore, scanning electron microscopy was performed in various samples to elicit the cell damage in different techniques.


RESULTS
A statistically significant lower peroxisome proliferator-activated receptor gamma (PPARG) expression was detected in subjects with a higher BMI. A trend towards a lower expression of perilipin 1 (PLIN1) in lipoaspirates harvested via the super wet + ultrasound technique (SWU), compared to the dry and the super wet (SW) technique was shown. The lowest level of cell damage in scanning electron microscopy images was detected in lipoaspirates harvested with the SWU technique, whereby differences to other techniques were statistically significant.


CONCLUSIONS
Optimization of the outcome in autologous fat grafting may be feasible via targeting and optimizing the harvesting process as a main risk factor for impaired adipocyte viability. The ultrasound assisted liposuction might be considered a suitable harvesting technique.