Aesthetic Plastic Surgery

, Volume 42, Issue 1, pp 1–8 | Cite as

The Effects of Platelet-Rich Plasma and Adipose-Derived Stem Cells on Neovascularization and Fat Graft Survival

  • Bing-Jun Xiong
  • Qiu-Wen Tan
  • Yu-Juan Chen
  • Yi Zhang
  • Di Zhang
  • Shen-Li Tang
  • Shu Zhang
  • Qing LvEmail author
Original Article Basic Science/Experimental



Adipose-derived stem cell (ADSCs)-assisted and platelet-rich plasma (PRP)-assisted lipofilling aim to enhance angiogenesis and cell proliferation and are promising techniques for lipofilling. This study aimed to compare the outcomes of ADSCs-assisted and PRP-assisted lipofilling.


Adipose tissue and human venous blood were obtained from women with early breast cancer. Human ADSCs were isolated and amplified in vitro. PRP was extracted through double centrifugation. The effect of PRP on ADSCs proliferation was evaluated. In the in vivo study, 1 ml of adipose tissue with saline (control group), PRP (PRP group), or ADSCs (ADSCs group) was injected subcutaneously into the dorsum of nude mice. At 2, 4, 8, and 12 weeks after injection, tissues were assessed for volume retention and ultrasound abnormality. For histological assessment, hematoxylin and eosin staining were performed.


Cytokines in PRP and blood were comparable. Regarding the in vitro assay, PRP significantly improved ADSCs proliferation, and the effect was dose-dependent. Concerning the in vivo study, for each time point, ADSCs-assisted lipofilling showed superior volume maintenance. Similarly, the PRP group showed improved angiogenesis and fat survival, as compared with the control group. The angiogenic effect of PRP was inferior to that of ADSCs at most time points. No significant difference was observed at 12 weeks after lipofilling. Complication rates were comparable between the PRP group and ADSCs group.


PRP-assisted and ADSCs-assisted lipofilling can significantly improve the cosmetic results of grafted fat. PRP-assisted lipofilling, which is considered convenient and clinically available, is a promising technique to improve neovascularization and fat survival.

No Level Assigned

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


Lipofilling Fat graft Adipose-derived stem cells Platelet-rich plasma 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration Helsinki and its later amendments or comparable ethical standards. All applicable institutional and/or national guidelines for the care and use of animals were followed.

Informed Consent

Informed consent was obtained from all tissue donors.


  1. 1.
    Alexander D, Bucky LP (2011) Breast augmentation using pre-expansion and autologous fat transplantation—a clinical radiological study. Plast Reconstr Surg 127:2451–2452CrossRefGoogle Scholar
  2. 2.
    Spear SL, Pittman T (2014) A prospective study on lipoaugmentation of the breast. Aesthet Surg J 34:400CrossRefPubMedGoogle Scholar
  3. 3.
    Yoshimura K, Sato K, Aoi N, Kurita M, Hirohi T, Harii K (2008) Cell-assisted lipotransfer for cosmetic breast augmentation: supportive use of adipose-derived stem/stromal cells. Aesthet Plast Surg 32:48–55CrossRefGoogle Scholar
  4. 4.
    Yoshimura K, Sato K, Aoi N, Kurita M, Inoue K, Suga H, Eto H, Kato H, Hirohi T, Harii K (2008) Cell-assisted lipotransfer for facial lipoatrophy: efficacy of clinical use of adipose-derived stem cells. Dermatol Surg 34:1178–1185PubMedGoogle Scholar
  5. 5.
    Chung CW, Marra KG, Li H, Leung AS, Ward DH, Tan H, Kelmendi-Doko A, Rubin JP (2012) VEGF microsphere technology to enhance vascularization in fat grafting. Ann Plast Surg 69:213–219CrossRefPubMedGoogle Scholar
  6. 6.
    Yuksel E, Weinfeld AB, Cleek R, Wamsley S, Jensen J, Boutros S, Waugh JM, Shenaq SM, Spira M (2000) Increased free fat-graft survival with the long-term, local delivery of insulin, insulin-like growth factor-I, and basic fibroblast growth factor by PLGA/PEG microspheres. Plast Reconstr Surg 105:1712–1720CrossRefPubMedGoogle Scholar
  7. 7.
    Hamed S, Egozi D, Kruchevsky D, Teot L, Gilhar A, Ullmann Y (2010) Erythropoietin improves the survival of fat tissue after its transplantation in nude mice. PLoS ONE 5:e13986CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Zhu M, Zhou Z, Chen Y, Schreiber R, Ransom JT, Fraser JK, Hedrick MH, Pinkernell K, Kuo HC (2010) Supplementation of fat grafts with adipose-derived regenerative cells improves long-term graft retention. Ann Plast Surg 64:222–228CrossRefPubMedGoogle Scholar
  9. 9.
    Kølle SF, Fischer-Nielsen A, Mathiasen AB, Elberg JJ, Oliveri RS, Glovinski PV, Kastrup J, Kirchhoff M, Rasmussen BS, Talman ML, Thomsen C, Dickmeiss E, Drzewiecki KT (2013) Enrichment of autologous fat grafts with ex vivo expanded adipose tissue-derived stem cells for graft survival: a randomised placebo-controlled trial. Lancet 382:1113–1120CrossRefPubMedGoogle Scholar
  10. 10.
    Schweizer R, Tsuji W, Gorantla VS, Marra KG, Rubin JP, Plock JA (2015) The role of adipose-derived stem cells in breast cancer progression and metastasis. Stem Cells Int 2015:120949CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Wong RSY (2011) Mesenchymal stem cells: angels or demons? Biomed Res Int 2011:459510Google Scholar
  12. 12.
    Strassburg S, Nienhueser H, Björn SG, Finkenzeller G, Torio-Padron N (2016) Co-culture of adipose-derived stem cells and endothelial cells in fibrin induces angiogenesis and vasculogenesis in a chorioallantoic membrane model. J Tissue Eng Regen Med 10:496–506CrossRefPubMedGoogle Scholar
  13. 13.
    Merfeldclauss S, Gollahalli N, March KL, Traktuev DO (2010) Adipose tissue progenitor cells directly interact with endothelial cells to induce vascular network formation. Tissue Eng Part A 16:2953–2966CrossRefGoogle Scholar
  14. 14.
    Tian CX, Fan XJ, Chen XH, Deng L, Qin TW, Luo JC, Li XQ, Lv Q (2012) Preparation and biocompatibility of porcine skeletal muscle acellular matrix for adipose tissue engineering. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 26:749–754PubMedGoogle Scholar
  15. 15.
    Landesberg R, Roy M, Glickman RS (2000) Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg 58:297–300CrossRefPubMedGoogle Scholar
  16. 16.
    Matsumoto D, Sato K, Gonda K, Takaki Y, Shigeura T, Sato T, Aiba-Kojima E, Iizuka F, Inoue K, Suga H, Yoshimura K (2006) Cell-assisted lipotransfer: supportive use of human adipose-derived cells for soft tissue augmentation with lipoinjection. Tissue Eng 12:3375–3382CrossRefPubMedGoogle Scholar
  17. 17.
    Miranville A, Heeschen C, Sengenès C, Curat CA, Busse R, Bouloumié A (2004) Improvement of postnatal neovascularization by human adipose tissue-derived stem cells. Circulation 110:349–355CrossRefPubMedGoogle Scholar
  18. 18.
    Suga H, Eto H, Shigeura T, Inoue K, Aoi N, Kato H, Nishimura S, Manabe I, Gonda K, Yoshimura K (2009) IFATS collection: fibroblast growth factor-2-induced hepatocyte growth factor secretion by adipose-derived stromal cells inhibits postinjury fibrogenesis through a c-Jun N-terminal kinase-dependent mechanism. Stem Cells 27:238–249CrossRefPubMedGoogle Scholar
  19. 19.
    Rehman J, Traktuev D, Li J, Merfeld-Clauss S, Temm-Grove CJ, Bovenkerk JE, Pell CL, Johnstone BH, Considine RV, March KL (2004) Secretion of angiogenic and antiapoptotic factors by human adipose stromal cells. Circulation 109:1292–1298CrossRefPubMedGoogle Scholar
  20. 20.
    Barret JP, Sarobe N, Grande N, Vila D, Palacin JM (2009) Maximizing results for lipofilling in facial reconstruction. Clin Plast Surg 36:487–492CrossRefPubMedGoogle Scholar
  21. 21.
    Francis MP, Sachs PC, Elmore LW, Holt SE (2010) Isolating adipose-derived mesenchymal stem cells from lipoaspirate blood and saline fraction. Organogenesis 6:11–14CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    O’Halloran N, Courtney D, Kerin MJ, Lowery AJ (2017) Adipose-derived stem cells in novel approaches to breast reconstruction: their suitability for tissue engineering and oncological safety. Breast Cancer 11:1–18Google Scholar
  23. 23.
    Ryu H, Oh JE, Rhee KJ, Baik SK, Kim J, Kang SJ, Sohn JH, Choi E, Shin HC, Kim YM, Kim HS, Bae KS, Eom YW (2014) Adipose tissue-derived mesenchymal stem cells cultured at high density express IFN-β and suppress the growth of MCF-7 human breast cancer cells. Cancer Lett 352:220–227CrossRefPubMedGoogle Scholar
  24. 24.
    Dirat B, Bochet L, Dabek M, Daviaud D, Dauvillier S, Majed B, Wang YY, Meulle A, Salles B, Le Gomidec S, Garrido I, Escourrou G, Valet P, Muller C (2011) Cancer-associated adipocytes exhibit an activated phenotype and contribute to breast cancer invasion. Cancer Res 71:2455–2465CrossRefPubMedGoogle Scholar
  25. 25.
    Tan SS, Loh W (2017) The utility of adipose-derived stem cells and stromal vascular fraction for oncologic soft tissue reconstruction: is it safe? A matter for debate. Surgeon 15:186–189CrossRefPubMedGoogle Scholar
  26. 26.
    Petit JY, Maisonneuve P, Rotmensz N, Bertolini F, Clough KB, Sarfati I, Gale KL, Macmillan RD, Rey P, Benyahi D, Rietjens M (2015) Safety of lipofilling in patients with breast cancer. Clin Plast Surg 42:339–344CrossRefPubMedGoogle Scholar
  27. 27.
    Choi J, Minn KW, Chang H (2012) The efficacy and safety of platelet-rich plasma and adipose-derived stem cells: an update. Arch Plast Surg 39:585–592CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Luiz C, Gontijo-de-Amorim NF, Takiya CM, Radovan B, Donatella B, Paolo B, Andrea S, Gino R (2017) Effect of use of platelet-rich plasma (PRP) in skin with intrinsic aging process. Aesthet Surg J. Google Scholar
  29. 29.
    Smith OJ, Kanapathy M, Khajuria A, Prokopenko M, Hachach-Haram N, Mann H, Mosahebi A (2017) Protocol for a systematic review of the efficacy of fat grafting and platelet-rich plasma for wound healing. Syst Rev 6:111CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Blanton MW, Hadad I, Johnstone BH, Mund JA, Rogers PI, Eppley BL, March KL (2009) Adipose stromal cells and platelet-rich plasma therapies synergistically increase revascularization during wound healing. Plast Reconstr Surg 123:56S–64SCrossRefPubMedGoogle Scholar
  31. 31.
    LiaoHT Marra KG, Rubin JP (2014) Application of platelet-rich plasma and platelet-rich fibrin in fat grafting: basic science and literature review. Tissue Eng Part B Rev 20:267–276CrossRefGoogle Scholar
  32. 32.
    Chignonsicard B, Kouidhi M, Xi Y, Audrey DA, Villageois P, Peraldi P, Ferrari P, Rival Y, Piwnica D, Aubert J, Dani C (2017) Platelet-rich plasma respectively reduces and promotes adipogenic and myofibroblastic differentiation of human adipose-derived stromal cells via the TGFβ signalling pathway. Sci Rep 7:2954CrossRefGoogle Scholar
  33. 33.
    Li F, Guo W, Li K, Yu M, Tang W, Wang H, Tian WD (2015) Improved fat graft survival by different volume fractions of platelet-rich plasma and adipose-derived stem cells. Aesthet Surg J 35:319CrossRefPubMedGoogle Scholar
  34. 34.
    Feng L, Huang SB, Zhao S, Deng H (2017) Effects of platelet-rich plasma on proliferation and adipogenic differentiation of adipose-derived stem cells in vitro. J Wenzhou Med Univ 7–13Google Scholar
  35. 35.
    Felthaus O, Prantl L, Skaff-Schwarze M, Klein S, Anker A, Ranieri M, Kuehlmann B (2017) Effects of different concentrations of platelet-rich plasma and platelet-poor plasma on vitality and differentiation of autologous adipose tissue-derived stem cells. Clin Hemorheol Microcirc 66:1–9CrossRefGoogle Scholar
  36. 36.
    Khouri RK, Rigotti G, Cardoso E, Khouri RK, Biggs TM (2014) Megavolume autologous fat transfer: part I. Theory and principles. Plast Reconstr Surg 133:1369–1377CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  • Bing-Jun Xiong
    • 1
  • Qiu-Wen Tan
    • 1
    • 2
  • Yu-Juan Chen
    • 1
  • Yi Zhang
    • 2
  • Di Zhang
    • 1
  • Shen-Li Tang
    • 1
  • Shu Zhang
    • 1
  • Qing Lv
    • 1
    Email author
  1. 1.Department of Breast SurgeryWest China Hospital, Sichuan UniversityChengduChina
  2. 2.Laboratory of Stem Cell and Tissue EngineeringWest China Hospital, Sichuan UniversityChengduChina

Personalised recommendations