Concentrated Deoiled Fat: A Novel Method of Fat Processing to Improve Fat Graft Survival-A Basic Research.

Centrifugation Concentrated deoiled fat Flocculation Inflammation Volume retention

Journal

Aesthetic plastic surgery
ISSN: 1432-5241
Titre abrégé: Aesthetic Plast Surg
Pays: United States
ID NLM: 7701756

Informations de publication

Date de publication:
16 Jul 2024
Historique:
received: 10 10 2023
accepted: 21 05 2024
medline: 17 7 2024
pubmed: 17 7 2024
entrez: 16 7 2024
Statut: aheadofprint

Résumé

Oil compromises graft outcomes via inflammation, which accounts for the unpredictability of volume retention rates as low as 20%. Existing techniques for oil removal are relatively inefficient. In this study, a novel approach was taken to prepare concentrated deoiled fat (CDF) by utilizing flocculation and centrifugation to remove the oil. The hypothesis put forward in this study was that CDF would exhibit improved volume retention and quality by enhancing purification efficiency and reducing inflammation. This basic research involved both in vitro and in vivo experiments using samples obtained from women who underwent abdominal liposuction. The CDF was prepared by flocculation and centrifugation. In the vitro experiments, the microstructure of fat was assessed using Calcein acetoxymethyl ester (AM) staining for living cells and propidium iodide (PI) staining for dead nuclei in two groups: Coleman fat group and CDF group. Additionally, the glucose uptake capacity of these two groups was evaluated using the glucose transport test (GTT). In the vivo experiments, the study included three groups: two experimental groups (low-volume concentrated deoiled fat, LCDF; high-volume concentrated deoiled fat, HCDF) and one control group (Coleman fat), with 10 healthy female BALB/c nude mice in each group, 1ml of the graft was injected subcutaneously to each mouse. After 8 weeks, the fat grafts were harvested and subjected to volume evaluation, HE staining and immunostaining for perilipin to assess graft outcomes. In the vitro experiments, the concentration rate of the CDF was found to be 79.6% that of Coleman fat, with 15.1% more oil separated. Cell viability, as assessed by AM/PI staining, did not show a significant difference between the two grafts, but the results of the GTT showed that the tissue viability of the CDF was higher than that of Coleman fat. In the vivo experiments, the CDF had higher volume retention than Coleman fat, as measured by water displacement. Histopathologic scoring indicated that HCDF group and LCDF group had a more intact fat structure with fewer vacuoles, inflammation, and fibrosis compared to Coleman fat. Additionally, the percentages of perilipin-positive area in the LCDF group and HCDF group were higher than in the Coleman group, indicating improved graft quality and outcome with the use of concentrated deoiled fat. "Concentrated deoiled fat" refers to an autologous fat graft from which oil has been removed by flocculation and centrifugation. This process increases volume retention and viable cells and decreases infiltrated inflammatory cells. 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 .

Sections du résumé

BACKGROUND BACKGROUND
Oil compromises graft outcomes via inflammation, which accounts for the unpredictability of volume retention rates as low as 20%. Existing techniques for oil removal are relatively inefficient. In this study, a novel approach was taken to prepare concentrated deoiled fat (CDF) by utilizing flocculation and centrifugation to remove the oil. The hypothesis put forward in this study was that CDF would exhibit improved volume retention and quality by enhancing purification efficiency and reducing inflammation.
METHODS METHODS
This basic research involved both in vitro and in vivo experiments using samples obtained from women who underwent abdominal liposuction. The CDF was prepared by flocculation and centrifugation. In the vitro experiments, the microstructure of fat was assessed using Calcein acetoxymethyl ester (AM) staining for living cells and propidium iodide (PI) staining for dead nuclei in two groups: Coleman fat group and CDF group. Additionally, the glucose uptake capacity of these two groups was evaluated using the glucose transport test (GTT). In the vivo experiments, the study included three groups: two experimental groups (low-volume concentrated deoiled fat, LCDF; high-volume concentrated deoiled fat, HCDF) and one control group (Coleman fat), with 10 healthy female BALB/c nude mice in each group, 1ml of the graft was injected subcutaneously to each mouse. After 8 weeks, the fat grafts were harvested and subjected to volume evaluation, HE staining and immunostaining for perilipin to assess graft outcomes.
RESULTS RESULTS
In the vitro experiments, the concentration rate of the CDF was found to be 79.6% that of Coleman fat, with 15.1% more oil separated. Cell viability, as assessed by AM/PI staining, did not show a significant difference between the two grafts, but the results of the GTT showed that the tissue viability of the CDF was higher than that of Coleman fat. In the vivo experiments, the CDF had higher volume retention than Coleman fat, as measured by water displacement. Histopathologic scoring indicated that HCDF group and LCDF group had a more intact fat structure with fewer vacuoles, inflammation, and fibrosis compared to Coleman fat. Additionally, the percentages of perilipin-positive area in the LCDF group and HCDF group were higher than in the Coleman group, indicating improved graft quality and outcome with the use of concentrated deoiled fat.
CONCLUSIONS CONCLUSIONS
"Concentrated deoiled fat" refers to an autologous fat graft from which oil has been removed by flocculation and centrifugation. This process increases volume retention and viable cells and decreases infiltrated inflammatory cells.
LEVEL OF EVIDENCE V METHODS
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 .

Identifiants

pubmed: 39014232
doi: 10.1007/s00266-024-04159-y
pii: 10.1007/s00266-024-04159-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : The Program of the Young Doctor Incubation at Army Medical University Xinqiao Hospital
ID : 2022YQB084

Informations de copyright

© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.

Références

Khouri RK, Khouri RK (2017) Current clinical applications of fat grafting. Plast Reconstr Surg 140:466e
doi: 10.1097/PRS.0000000000003648 pubmed: 28582333
Strong AL, Cederna PS, Rubin JP, Coleman SR, Levi B (2015) The current state of fat grafting: a review of harvesting, processing, and injection techniques. Plast Reconstr Surg 136:897–912
doi: 10.1097/PRS.0000000000001590 pubmed: 26086386 pmcid: 4833505
Cai JR, Feng JW, Liu KY, Zhou SL, Lu F (2018) Early macrophage infiltration improves fat graft survival by inducing angiogenesis and hematopoietic stem cell recruitment. Plast Reconstr Surg 141:376–386
doi: 10.1097/PRS.0000000000004028 pubmed: 29036027
Yamaguchi M, Matsumoto F, Bujo H, Shibasaki M, Takahashi K, Yoshimoto S, Ichinose M, Saitom Y (2005) Revascularization determines volume retention and gene expression by fat grafts in mice. Exp Biol Med 230:742–748
doi: 10.1177/153537020523001007
Stillaert F, Depypere B, Doornaert M, Creytens D, Clercq HD, Cornelissen R, Monstrey S, Blondeel P (2016) Autologous plasma and its supporting role in fat graft survival: a relevant vector to counteract resorption in lipofilling. J Plast Reconstr Aesthet Surg 69:952–958
doi: 10.1016/j.bjps.2016.03.014 pubmed: 27117776
Canizares OJ, Thomson JE, Allen RJJ, Davidson EH, Tutela JP, Saadeh PB, Warren SM, Hazen A (2017) The effect of processing technique on fat graft survival. Plast Reconstr Surg 140:933–943
doi: 10.1097/PRS.0000000000003812 pubmed: 29068928
Lin JY, Song P, Pu LLQ (2018) management of fat necrosis after autologous fat transplantation for breast augmentation. Plast Reconstr Surg 142:665e–673e
doi: 10.1097/PRS.0000000000004898 pubmed: 30511971
Kato H, Mineda K, Eto H, Doi K, Kuno S, Kinoshita K, Kanayama K, Yoshimura KN (2014) Degeneration, regeneration, and cicatrization after fat grafting dynamic total tissue remodeling during the first 3 months. Plast Reconstr Surg 133:303–313
doi: 10.1097/PRS.0000000000000066
Wu WZ, Bi X, Zhao J, Lin ZS, Lu F, Dong ZQ, Li Y (2023) Ultra-condensed fat: a novel fat product for volume augmentation. Aesthetic Plast Surg 47:2074–2083
doi: 10.1007/s00266-023-03383-2 pubmed: 37227488
Yao Y, Dong ZQ, Liao YJ, Zhang P, Ma JJ, Gao JH, Lu F (2017) Adipose extracellular matrix/stromal vascular fraction gel: a novel adipose tissue-derived injectable for stem cell therapy. Plast Reconstr Surg 139:867–879
doi: 10.1097/PRS.0000000000003214 pubmed: 28002250
Yang ZB, Jin SY, He Y, Zhang XY, Han XF, Li FC (2021) Comparison of microfat, nanofat and extracellular matrix/stromal vascular fraction gel for skin rejuvenation: basic research and clinical applications. Aesthet Surg J 41:NP1557–NP1570
doi: 10.1093/asj/sjab033 pubmed: 33507247
Coleman SR (2002) Hand rejuvenation with structural fat grafting. Plast Reconstr Surg 110:1731–1744; discussion 1745–1747
Xie Y, Zheng DN, Li QF, Chen Y, Lei H, Pu LLQ (2009) The effect of centrifugation on viability of fat grafts: an evaluation with the glucose transport test. J Plast Reconstr Aesthet Surg 63:482–487
doi: 10.1016/j.bjps.2008.11.056 pubmed: 19129016
Lee JH, Kirkham JC, McCormack MC, Nicholls AM, Randolph MA, Austen WG Jr (2013) The effect of pressure and shear on autologous fat grafting. Plast Reconstr Surg 131:1125–1136
doi: 10.1097/PRS.0b013e3182879f4a pubmed: 23385989
Jin SY, Yang ZB, Han XF, Li FC (2021) Blood impairs viability of fat grafts and adipose stem cells: importance of washing in fat processing. Aesthet Surg J 41:86–97
doi: 10.1093/asj/sjaa170 pubmed: 32564062
Kuno S, Yoshimura K (2015) Condensation of tissue and stem cells for fat grafting. Clin Plast Surg 42:191–197
doi: 10.1016/j.cps.2014.12.006 pubmed: 25827563
Kurita M, Matsumoto D, Shigeura T, Sato K, Gonda K, Harii K, Yoshimura K (2008) Influences of centrifugation on cells and tissues in liposuction aspirates: optimized centrifugation for lipotransfer and cell isolation. Plast Reconstr Surg 121:1033–1041
doi: 10.1097/01.prs.0000299384.53131.87 pubmed: 18317153
Condé-Green A, de Amorim NF, Pitanguy I (2010) Influence of decantation, washing and centrifugation on adipocyte and mesenchymal stem cell content of aspirated adipose tissue: a comparative study. J Plast Reconstr Aesthet Surg 63:1375–1381
doi: 10.1016/j.bjps.2009.07.018 pubmed: 19679523
Condé-Green A, Wu I, Graham I, Chae JJ, Drachenberg CB, Singh DP, Holton L 3rd, Slezak S, Elisseeff J (2013) Comparison of 3 techniques of fat grafting and cell-supplemented lipotransfer in athymic rats: a pilot study. Aesthet Surg J 33:713–721
doi: 10.1177/1090820X13487371 pubmed: 23718980
Wang GH, Zhao JF, Xue HY, Li D (2019) Facial aesthetic fat graft retention rates after filtration, centrifugation, or sedimentation processing techniques measured using three-dimensional surface imaging devices. Chin Med J (Engl) 132:69–77
doi: 10.1097/CM9.0000000000000016 pubmed: 30628961
He JZ, Chen FZ, Zhang YX, Tan PC, Li QF, Cheng C (2023) Concentrated ultrasound-processed fat (CUPF): more than a mechanically emulsified graft. J Plast Reconstr Aesthet Surg 83:198–206
doi: 10.1016/j.bjps.2023.04.073 pubmed: 37279632
He Y, Zhang XY, Han XF, Li FC (2022) the importance of protecting the structure and viability of adipose tissue for fat grafting. Plast Reconstr Surg 149:1357–1368
doi: 10.1097/PRS.0000000000009139 pubmed: 35404340
Liu ML, Shang YJ, Liu N, Zhen YH, Chen YB, An Y (2022) Strategies to improve AFT volume retention after fat grafting. Aesthetic Plast Surg 47:808–824
doi: 10.1007/s00266-022-03088-y pubmed: 36316460
Sheng LL, Yu ZY, Li SL, Cao WG (2022) Long-term volume retention after fat processing with cotton gauze rolling and centrifugation: a comparative study in nude mice. J Plast Reconstr Aesthet Surg 75:4290–4296
doi: 10.1016/j.bjps.2022.08.023 pubmed: 36175330
Fisher C, Grahovac TL, Schafer ME, Shippert RD, Marra KG, Rubin JP (2013) Comparison of harvest and processing techniques for fat grafting and adipose stem cell isolation. Plast Reconstr Surg 132:351–361
doi: 10.1097/PRS.0b013e3182958796 pubmed: 23584621
Egro FM, Roy E, Rubin JP, Coleman SR (2022) Evolution of the Coleman technique. Plast Reconstr Surg 150:329e–336e
doi: 10.1097/PRS.0000000000009355 pubmed: 35666154
Pensato R, Al-Amer R, La Padula S (2023) Effect of platelet-rich fibrin on fat grafting in animal models: a meta-analysis. Aesthetic Plast Surg 18, Epub ahead of print
Schipper JAM, Vriend L, Tuin AJ, Dijkstra PU, Schepers RH, van der Lei B, Jansma J, Harmsen MC (2022) supplementation of facial fat grafting to increase volume retention: a systematic review. Aesthet Surg J 42:NP711–NP727
doi: 10.1093/asj/sjac122 pubmed: 35576617 pmcid: 9750673
Atashi F, André-Lévigne D, Colin DJ, Germain S, Pittet-Cuénod B, Modarressi A (2019) Does non-activated platelet-rich plasma (PRP) enhance fat graft outcome? An assessment with 3D CT-scan in mice. J Plast Reconstr Aesthet Surg 72:669–675
doi: 10.1016/j.bjps.2018.12.039 pubmed: 30658950
Rigotti G, Charles-de-Sá L, Gontijo-de-Amorim NF, Takiya CM, Amable PR, Borojevic R, Benati D, Bernardi P, Sbarbati A (2016) Expanded stem cells, stromal-vascular fraction, and platelet-rich plasma enriched fat: comparing results of different facial rejuvenation approaches in a clinical trial. Aesthet Surg J 36:261–270
doi: 10.1093/asj/sjv231 pubmed: 26879294 pmcid: 5127465
Yoshimura K, Shigeura T, Matsumoto D, Sato T, Takaki Y, Aiba-Kojima E, Sato K, Inoue K, Nagase T, Koshima I, Gonda K (2006) Characterization of freshly isolated and cultured cells derived from the fatty and fluid portions of liposuction aspirates. J Cell Physiol 208:64–76
doi: 10.1002/jcp.20636 pubmed: 16557516
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. Aesthetic Plast Surg 32:48–55; discussion 56–77
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 34:1178–1185
pubmed: 18513295
Eisenstein M (2016) Regulation: rewriting the regenerative rulebook. Nature 540:S64–S67
doi: 10.1038/540S63a pubmed: 27926695
van Dongen JA, Stevens HP, Parvizi M, van der Lei B, Harmsen MC (2016) The fractionation of adipose tissue procedure to obtain stromal vascular fractions for regenerative purposes. Wound Repair Regen 24:994–1003
doi: 10.1111/wrr.12482 pubmed: 27717133
Shen SR, Huo HS, Ren H, Shao Y (2023) comparative efficacy and safety of cell-assisted and conventional lipotransfer in facial filling: a systematic review and meta-analysis. Aesthetic Plast Surg 48:1444 (Epub ahead of print)
doi: 10.1007/s00266-023-03650-2 pubmed: 37794201
Laloze J, Varin A, Gilhodes J, Bertheuil N, Grolleau JL, Brie J, Usseglio J, Sensebe L, Filleron T, Chaput B (2018) Cell-assisted lipotransfer: friend or foe in fat grafting? Systematic review and meta-analysis. J Tissue Eng Regen Med 12:e1237–e1250
doi: 10.1002/term.2524 pubmed: 28719946
Chen A, Zhang L, Chen PH, Zhang CY, Tang SJ, Chen XS (2021) Comparison of the efficacy and safety of cell-assisted lipotransfer and platelet-rich plasma assisted lipotransfer: what should we expect from a systematic review with meta-analysis? Cell Transplant 30:963689721989607
doi: 10.1177/0963689721989607 pubmed: 33845642

Auteurs

Zhibin Yang (Z)

Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China.

Shengyang Jin (S)

Center of Scar and Wound Treatment, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33, Badachu Road, Shijingshan District, Beijing, 100000, China.

Shuqing Huang (S)

Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China.

Rongshuai Yan (R)

Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China.

Zeyuan Lei (Z)

Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China. leizeyuan0854@163.com.

Classifications MeSH