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Autologous fat grafting: A comparative study of four current commercial protocols

  • Vincent Hivernaud
    Correspondence
    Corresponding author. INSERM, LIOAD, UMR-S 791, Nantes, France.
    Affiliations
    INSERM, LIOAD, UMR-S 791, Nantes, France

    Université de Nantes, UMR-S 791, LIOAD, UFR Odontologie, Nantes, France

    ONIRIS, UMR-S 791, LIOAD, Nantes, France
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  • Bruno Lefourn
    Affiliations
    Clinique Bretéché, Département de Chirurgie Plastique et Reconstructive, Nantes, France
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  • Myriam Robard
    Affiliations
    Cellular and Tissular Imaging Core Facility of Nantes University (MicroPICell), Structure Fédérative de Recherche François Bonamy, Université de Nantes, Nantes, France
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  • Jérôme Guicheux
    Affiliations
    INSERM, LIOAD, UMR-S 791, Nantes, France

    Université de Nantes, UMR-S 791, LIOAD, UFR Odontologie, Nantes, France

    ONIRIS, UMR-S 791, LIOAD, Nantes, France

    CHU Nantes, PHU 4 OTONN, Nantes, France
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  • Pierre Weiss
    Affiliations
    INSERM, LIOAD, UMR-S 791, Nantes, France

    Université de Nantes, UMR-S 791, LIOAD, UFR Odontologie, Nantes, France

    ONIRIS, UMR-S 791, LIOAD, Nantes, France

    CHU Nantes, PHU 4 OTONN, Nantes, France
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Published:December 13, 2016DOI:https://doi.org/10.1016/j.bjps.2016.11.022

      Summary

      Background

      Autologous fat grafting is a widely used technique that gives natural results when treating soft tissue deficiencies. However, there is no consensus on which is the best procedure to use, leading to unpredictable results because of fat graft resorption.

      Objectives

      This study compared four commercial lipotransfer devices by analyzing the behavior of the processed adipose tissue and outcome of the adipose graft in an in vivo model.

      Methods

      Four different protocols that used manual, power-assisted or water-assisted lipoaspiration and then decantation, centrifugation, or filtration were used on each of eight patients to process lipoaspirate. Harvested adipose tissue was assessed in vitro for tissue resorption, oil formation, and cytokine secretion. Graft resorption rate was calculated and histological analyses were performed after subcutaneously injecting the harvested adipose tissue in a murine model.

      Results

      All protocols resulted in very low oil formation and histologically healthy grafts. The tissue volume was significantly greater after 2 days in culture when using manual lipoaspiration and soft centrifugations/washing steps (Microfill®/Macrofill®) compared to Water-Assisted Lipoaspiration/Decantation (BodyJet®) and Power-Assisted Lipoaspiration/Filtration (PAL® + PureGraft®). These results were confirmed in mice 1 month after subcutaneous injection, with greater efficiency obtained with protocols that used (A) manual aspiration, (B) soft centrifugations, and (C) washing steps.

      Conclusions

      We confirmed that the choice of technique used to process adipose tissue during lipotransfer surgery can highly influence fat grafting efficacy. In our study, the use of manual aspiration combined with soft centrifugations led to the best results in the selected models.

      Keywords

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