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Autologe Fettgewebstransplantation

Neueste Erkenntnisse und klinische Relevanz

Autologous adipose tissue transplantation

Latest knowledge and clinical relevance

  • Übersichten
  • Published:
Journal für Ästhetische Chirurgie Aims and scope

Zusammenfassung

Hintergrund

Das Verfahren des autologen Fetttransfers wurde 1893 erstmals durch den deutschen Chirurgen Gustav Neuber beschrieben. Heutzutage gilt der US-Amerikaner Sydney Coleman als Wiederentdecker der Fettgewebstransplantation, da er diese Methode maßgeblich mit seinem dazu ausgearbeiteten Protokoll prägte. Das Fettgewebe ist wegen seiner volumetrischen und regenerativen Eigenschaften ein anerkannter autologer Filler in der regenerativen plastischen Chirurgie und erfreut sich zunehmender Beliebtheit.

Fragestellung

Neueste Entwicklungen in der autologen Fettgewebstransplantation und deren klinische Anwendung werden zusammengefasst.

Material und Methode

Es wird eine kurze Übersicht über die Bestandteile des Fetttransplantats präsentiert. Im Hauptteil werden die aktuellen Entwicklungen des autologen Fetttransfers dargestellt. Dazu wurden aktuelle Studien analysiert.

Ergebnisse

Fett ist ein dynamisches Gewebe, das eine Vielzahl verschiedener Zellen enthält. Hierbei spielen insbesondere die enthaltenen Stammzellen, die „adipose-derived stem cells“ (ASC), eine wichtige Rolle. Zudem werden im Fettgewebe Wachstumsfaktoren produziert, wodurch v. a. die Angiogenese gesichert wird. Im Laufe der Zeit wurde das von Coleman entwickelte Protokoll mehrfach modifiziert, und verschiedenste Techniken zur Verbesserung der Fetttransplantation wurden entwickelt.

Schlussfolgerung

Der autologe Fetttransfer hat in der regenerativen, plastischen Chirurgie zunehmend an Bedeutung gewonnen. Aktuell besteht noch kein Konsens zur optimalen Vorgehensweise hinsichtlich des Liposuktions‑, Prozessierungs- und Injektionsverfahren, was jedoch durch kontinuierliche Forschung verbessert wird.

Abstract

Background

The method of autologous fat transfer was first described in 1893 by the German surgeon Gustav Neuber. This technique has been decisively influenced by the American plastic surgeon Sydney Coleman who developed a standardized protocol. Fat tissue is an appreciated autologous filler in regenerative plastic surgery due to its volumetric and regenerative properties.

Objective

Recent developments in autologous fat graft and their clinical applications are summarized.

Methods

A brief overview of the components of fat grafting as well as the latest development in autologous fat transfers are provided based on the analysis of recent studies.

Results

Adipose tissue is a dynamic organ and includes a multitude of different cells of which the adipose tissue stem cells, so-called adipose-derived stem cells (ASC), play an important role. Growth factors are produced and secreted by adipose tissue inducing proliferation, differentiation, and angiogenesis. Over time the protocol developed by Coleman has been modified several times and various techniques for improving fat transplantation procedures have been developed.

Conclusion

The autologous fat transfer has gained importance in regenerative plastic surgery. Currently, there is no consensus on the optimal approach in terms of liposuction, processing and injection procedures, which require further research.

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Authors and Affiliations

  1. Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland

    N. Pallua,  B. S. Kim &  B. Schäfer

  2. Privatpraxis, Königsallee 20, 40212, Düsseldorf, Deutschland

    N. Pallua

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  1. N. Pallua
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Correspondence to N. Pallua.

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N. Pallua, B.S. Kim und B. Schäfer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

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Pallua, N., Kim, B.S. & Schäfer, B. Autologe Fettgewebstransplantation. J Ästhet Chir 11, 13–18 (2018). https://doi.org/10.1007/s12631-018-0117-8

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  • DOI: https://doi.org/10.1007/s12631-018-0117-8

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