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Strategies to Improve AFT Volume Retention After Fat Grafting

  • Original Article
  • Fat Injection
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Autologous fat grafting has gained increasing popularity used in plastic surgery as a strategy to improve functional and aesthetic outcome. However, variable augmentation results have concerned surgeons in that volume loss of grafted fat reported fluctuates unsteadily.

Aim

An optimal technique that clinically maximizes the long-term survival rate of transplantation is in urgent need to be identified.

Method

The PubMed/MEDLINE database was queried to search for animal and human studies published through March of 2022 with search terms related to adipose grafting encompassing liposuction, adipose graft viability, processing technique, adipose-derived stem cell, SVF and others.

Results

45 in vivo studies met inclusion criteria. The principal of ideal processing technique is effective purification of fat and protection of tissue viability, such as gauze rolling and washing-filtration devices. Cell-assisted lipotransfer including SVF, SVF-gel and ADSCs significantly promotes graft retention via differentiation potential and paracrine manner. ADSCs induce polarization of macrophages to regulate inflammatory response, mediate extracellular matrix remodeling and promote endothelial cell migration and sprouting, and differentiate into adipocytes to replace necrotic cells, providing powerful evidence for the benefits and efficacy of cell-assisted lipotransfer.

Conclusion

Based on the current evidence, the best strategy can not be decided. Cell-assisted lipotransfer has great potential for use in regenerative medicine. But so far mechanically prepared SVF-gel is conducive to clinical promotion. PRP as endogenous growth factor sustained-release material shows great feasibility.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Data Availability

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

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Acknowledgements

This work was supported by the Scientific Research Staring Foundation for the Returned Overseas Chinese Scholars, Peking University Third Hospital (No. BYSYLXHG2019001) and Innovation Transformation Fund, Peking University Third Hospital (No. BYSYZHKC2020101)

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  1. Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China

    Meiling Liu, Yujia Shang, Na Liu, Yonghuan Zhen & Yang An

  2. College of Traditional Chinese Materia Medica, Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China

    Yujia Shang & Na Liu

  3. Department of Plastic and Reconstructive Surgery, Chinese PLA General Hospital, Beijing, 100853, China

    Youbai Chen

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Liu, M., Shang, Y., Liu, N. et al. Strategies to Improve AFT Volume Retention After Fat Grafting. Aesth Plast Surg 47, 808–824 (2023). https://doi.org/10.1007/s00266-022-03088-y

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