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Platelet-Rich Plasma Mixed-Fat Grafting: A Reasonable Prosurvival Strategy for Fat GraftS?

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Abstract

Background

One of the most interesting developments in practical applications of fat grafting in recent years is the use of prosurvival strategies to improve maintenance of volume. Platelet-rich plasma (PRP) plays a decisive role in the repair and regeneration of different tissues via the activation and secretion of a great variety of growth factors and other cytokines stored in the alpha-granules of the platelets. This review aimed to assess the efficacy of PRP mixed-fat grafting as a prosurvival strategy for fat grafts.

Methods

Online searches of the Cochrane Library and MEDLINE until January 2014 were conducted. The review included studies with at least one clinical end point in which the effect of PRP on the absorption and viability of the fat graft could be assessed.

Results

The review comprised 6 preclinical studies with a control group and 9 clinical studies of humans. It also included comparative studies performed with other prosurvival strategies for fat grafts, such as combination with the stromal vascular fraction and second-generation PRP, also called “platelet-rich fibrin.” The results indicate that PRP may have a dose-dependent positive effect on fat grafts and suggest low complication rates.

Conclusions

The development of new growth factor delivery systems or cell therapies to enrich fat grafts is an area that merits further research.

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References

  1. Illouz YG (1983) Body contouring by lipolysis: a 5-year experience with over 3,000 cases. Plast Reconstr Surg 72:591–597

    Article  PubMed  CAS  Google Scholar 

  2. Coleman SR (1998) Structural fat grafting. Aesthet Surg J 18:386, 388

    Article  PubMed  Google Scholar 

  3. Tabit CJ, Slack GC, Fan K et al (2012) Fat grafting versus adipose-derived stem cell therapy: distinguishing indications, techniques, and outcomes. Aesthetic Plast Surg 36:704–713

    Article  PubMed  Google Scholar 

  4. Newman RE, Yoo D, LeRoux MA et al (2009) Treatment of inflammatory diseases with mesenchymal stem cells. Inflamm Allergy Drug Targets 8:110–123

    Article  PubMed  CAS  Google Scholar 

  5. Rigotti G, Marchi A, Galie M et al (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 119:1409–1422 discussion 1423–1424

    Article  PubMed  CAS  Google Scholar 

  6. Serra-Renom JM, Muñoz-Olmo JL, Serra-Mestre JM (2010) Fat grafting in postmastectomy breast reconstruction with expanders and prostheses in patients who have received radiotherapy: formation of new subcutaneous tissue. Plast Reconstr Surg 125:12–18

    Article  PubMed  CAS  Google Scholar 

  7. Phulpin B, Gangloff P, Tran N et al (2009) Rehabilitation of irradiated head and neck tissues by autologous fat transplantation. Plast Reconstr Surg 123:1187–1197

    Article  PubMed  CAS  Google Scholar 

  8. Gir P, Brown SA, Oni G et al (2012) Fat grafting: evidence-based review on autologous fat harvesting, processing, reinjection, and storage. Plast Reconstr Surg 130:249–258

    Article  PubMed  CAS  Google Scholar 

  9. Yoshimura K, Sato K, Aoi N et al (2008) Cell-assisted lipotransfer for cosmetic breast augmentation: Supportive use of adipose-derived stem/stromal cells. Aesthet Plast Surg 32:48–55 discussion 56–57

    Article  Google Scholar 

  10. Hamed S, Egozi D, Kruchevsky D et al (2010) Erythropoietin improves the survival of fat tissue after its transplantation in nude mice. PLoS ONE 5:e13986

    Article  PubMed  PubMed Central  Google Scholar 

  11. Yuksel E, Weinfeld AB, Cleek R et al (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 105:1712–1720

    Article  PubMed  CAS  Google Scholar 

  12. Shoshani O, Livne E, Armoni M et al (2005) The effect of interleukin-8 on the viability of injected adipose tissue in nude mice. Plast Reconstr Surg 115:853–859

    Article  PubMed  CAS  Google Scholar 

  13. Marx R, Carlson E, Eichstaedt R et al (1998) Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:638–646

    Article  PubMed  CAS  Google Scholar 

  14. Pierce GF, Mustoe TA, Altrock BW et al (1991) Role of platelet-derived growth factor in wound healing. J Cell Biochem 45:319–326

    Article  PubMed  CAS  Google Scholar 

  15. Eppley BL, Pietrzak WS, Blanton M (2006) Platelet-rich plasma: a review of biology and applications in plastic surgery. Plast Reconstr Surg 118:147

    Article  Google Scholar 

  16. Pires Fraga FM, Nishio RT, Ishikawa RS et al (2010) Increased survival of free fat grafts with platelet-rich plasma in rabbits. J Plast Reconstr Aesthet Surg 63:e818–e822

    Article  PubMed  Google Scholar 

  17. Oh DS, Cheon YW, Jeon YR et al (2011) Activated platelet-rich plasma improves fat graft survival in nude mice: a pilot study. Dermatol Surg 37:619–625

    Article  PubMed  CAS  Google Scholar 

  18. Nakamura S, Ishihara M, Takikawa M et al (2010) Platelet-rich plasma (PRP) promotes survival of fat grafts in rats. Ann Plast Surg 65:101–106

    Article  PubMed  CAS  Google Scholar 

  19. Rodriguez-Flores J, Palomar-Gallego MA, Enguita-Valls AB et al (2011) Influence of platelet-rich plasma on the histologic characteristics of the autologous fat graft to the upper lip of rabbits. Aesthetic Plast Surg 35:480–486

    Article  PubMed  Google Scholar 

  20. Por YC, Yeow VK, Louri N et al (2009) Platelet-rich plasma has no effect on increasing free fat graft survival in the nude mouse. J Plast Reconstr Aesthet Surg 62:1030–1034

    Article  PubMed  Google Scholar 

  21. Liu B, Tan XY, Liu YP et al (2013) The adjuvant use of stromal vascular fraction and platelet-rich fibrin for autologous adipose tissue transplantation. Tissue Eng Part C Methods 19:1–14

    Article  PubMed  Google Scholar 

  22. Serra-Renom JM, Muñoz del Olmo JL, Gonzalo Caballero C (2006) Use of fat grafts enriched with platelet growth factors for facial lipofiling in ritidectomy. Cir Plas Iberlatinoam 32:191–198

    Google Scholar 

  23. Cervelli V, Gentile P, Scioli MG et al (2009) Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods 15:625–634

    Article  PubMed  CAS  Google Scholar 

  24. Salgarello M, Visconti G, Rusciani A (2011) Breast fat grafting with platelet-rich plasma: a comparative clinical study and current state of the art. Plast Reconstr Surg 127:2176–2185

    Article  PubMed  CAS  Google Scholar 

  25. Gentile P, Orlandi A, Scioli MG et al (2012) A comparative translational study: the combined use of enhanced stromal vascular fraction and platelet-rich plasma improves fat grafting maintenance in breast reconstruction. Stem Cells Transl Med 1:341–351

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  26. Gentile P, Di Pasquali C, Bocchini I et al (2013) Breast reconstruction with autologous fat graft mixed with platelet-rich plasma. Surg Innov 20:370–376

    Article  PubMed  Google Scholar 

  27. Fiaschetti V, Pistolese CA, Fornari M et al (2013) Magnetic resonance imaging and ultrasound evaluation after breast autologous fat grafting combined with platelet-rich plasma. Plast Reconstr Surg 132:498e–509e

    Article  PubMed  CAS  Google Scholar 

  28. Keyhan SO, Hemmat S, Badri AA et al (2013) Use of platelet-rich fibrin and platelet-rich plasma in combination with fat graft: Which is more effective during facial lipostructure? J Oral Maxillofac Surg 71:610–621

    Article  PubMed  Google Scholar 

  29. Cervelli V, Bocchini I, Di Pasquali C et al (2013) P R L platelet-rich lipotransfert: our experience and current state of art in the combined use of fat and PRP. Biomed Res Int 2013:434191

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  30. Gentile P, De Angelis B, Pasin M et al (2014) Adipose-derived stromal vascular fraction cells and platelet-rich plasma: basic and clinical evaluation for cell-based therapies in patients with scars on the face. J Craniofac Surg 25:267–272

    Article  PubMed  Google Scholar 

  31. Bennett NT, Schultz GS (1993) Growth factors and wound healing: biochemical properties of growth factors and their receptors. Am J Surg 165:728–737

    Article  PubMed  CAS  Google Scholar 

  32. Sanchez AR, Sheridan PJ, Kupp LI (2003) Is platelet-rich plasma the perfect enhancement factor? a current review. Int J Oral Maxillofac Implants 18:93–103

    PubMed  Google Scholar 

  33. Anitua E, Andia I, Ardanza B et al (2004) Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 91:4–15

    PubMed  CAS  Google Scholar 

  34. Fernandez-Barbero JE, Galindo-Moreno P, Avila-Ortiz G et al (2006) Flow cytometric and morphological characterization of platelet-rich plasma gel. Clin Oral Implants Res 17:687–693

    Article  PubMed  Google Scholar 

  35. El-Sharkawy H, Kantarci A, Deady J et al (2007) Platelet-rich plasma: growth factors and pro- and antiinflammatory properties. J Periodontol 78:661–669

    Article  PubMed  CAS  Google Scholar 

  36. Eppley BL, Woodell JE, Higgins J (2004) Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg 114:1502–1508

    Article  PubMed  Google Scholar 

  37. Sommer B, Sattler G (2000) Current concepts of fat graft survival: histology of aspirated adipose tissue and review of the literature. Dermatol Surg 26:1159–1166

    Article  PubMed  CAS  Google Scholar 

  38. Yuksel E, Weinfeld AB, Cleek R et al (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 105:1712–1720

    Article  PubMed  CAS  Google Scholar 

  39. Rophael JA, Craft RO, Palmer JA et al (2007) Angiogenic growth factor synergism in a murine tissue engineering model of angiogenesis and adipogenesis. Am J Pathol 171:2048–2057

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  40. Craft RO, Rophael J, Morrison WA et al (2009) Effect of local long-term delivery of platelet-derived growth factor (PDGF) on injected fat graft survival in severe combined immunodeficient (SCID) mice. J Plast Reconstr Aesthet Surg 62:235–243

    Article  PubMed  Google Scholar 

  41. Moya ML, Cheng MH, Huang JJ et al (2010) The effect of FGF-1 loaded alginate microbeads on neovascularization and adipogenesis in a vascular pedicle model of adipose tissue engineering. Biomaterials 31:2816–2826

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  42. Zhang J, Middleton KK, Fu FH et al (2013) HGF mediates the antiinflammatory effects of PRP on injured tendons. PLoS ONE 8:e67303

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  43. Randelli PS, Arrigoni P, Cabitza P et al (2008) Autologous platelet rich plasma for arthroscopic rotator cuff repair: a pilot study. Disabil Rehabil 30:1584–1589

    Article  PubMed  Google Scholar 

  44. Mishra A, Pavelko T (2006) Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 34:1774–1778

    Article  PubMed  Google Scholar 

  45. Peerbooms JC, Sluimer J, Bruijn DJ et al (2010) Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 38:255–262

    Article  PubMed  Google Scholar 

  46. Everts PA, Devilee RJ, Brown Mahoney C et al (2006) Platelet gel and fibrin sealant reduce allogeneic blood transfusions in total knee arthroplasty. Acta Anaesthesiol Scand 50:593–599

    Article  PubMed  CAS  Google Scholar 

  47. Sanchez M, Anitua E, Azofra J et al (2007) Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med 35:245–251

    Article  PubMed  Google Scholar 

  48. Middleton KK, Barro V, Muller B et al (2012) Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthop J 32:150–163

    PubMed  PubMed Central  Google Scholar 

  49. Kakudo N, Minakata T, Mitsui T et al (2008) Proliferation promoting effect of platelet-rich plasma on human adipose-derived stem cells and human dermal fibroblasts. Plast Reconstr Surg 122:1352–1360

    Article  PubMed  CAS  Google Scholar 

  50. Anitua E, Sanchez M, Nurden AT et al (2006) New insights into and novel applications for platelet-rich fibrin therapies. Trends Biotechnol 24:227–234

    Article  PubMed  CAS  Google Scholar 

  51. Kang YH, Jeon SH, Park JY et al (2011) Platelet-rich fibrin is a bioscaffold and reservoir of growth factors for tissue regeneration. Tissue Eng Part A 17:349–359

    Article  PubMed  CAS  Google Scholar 

  52. Wu W, Zhang J, Dong Q et al (2009) Platelet-rich plasma: a promising cell carrier for micro-invasive articular cartilage repair. Med Hypotheses 72:455–457

    Article  PubMed  Google Scholar 

  53. Eppley BL, Pietrzak WS, Blanton M (2006) Platelet-rich plasma: a review of biology and applications in plastic surgery. Plast Reconstr Surg 118:147e–159e

    Article  PubMed  CAS  Google Scholar 

  54. Marx RE (2004) Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 62:489–496

    Article  PubMed  Google Scholar 

  55. He L, Lin Y, Hu X et al (2009) A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:707–713

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Plastic and Reconstructive Surgery Department, Second University of Naples, Via S. Maria di Costantinopoli 104, Naples, Italy

    José Maria Serra-Mestre, Aurora Almadori & Francesco D’Andrea

  2. Plastic and Reconstructive Surgery Department, Quirón Hospital, Universitat Internacional de Catalunya, Barcelona, Spain

    José Maria Serra-Renom & Lourdes Martinez

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  1. José Maria Serra-Mestre
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  2. José Maria Serra-Renom
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  3. Lourdes Martinez
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  4. Aurora Almadori
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  5. Francesco D’Andrea
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Correspondence to José Maria Serra-Mestre.

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Serra-Mestre, J.M., Serra-Renom, J.M., Martinez, L. et al. Platelet-Rich Plasma Mixed-Fat Grafting: A Reasonable Prosurvival Strategy for Fat GraftS?. Aesth Plast Surg 38, 1041–1049 (2014). https://doi.org/10.1007/s00266-014-0374-7

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