The search for appropriate filler, which can be used for aesthetic and reconstructive operations is currently one of challenges for plastic surgery. The application of absorbable and permanent artificial fillers may cause adverse events. Thus, autologous fat grafting can be a safe alternative. Moreover, fat tissue is rich in adipose-derived stem cells (ASC), which can be successfully used for regenerative procedures. The paper reviews reports on fat grafting procedures, which indicate risks and their possible prophylactic.
Adipose tissue is a much more prolific source of ASCs than bone marrow. Basically, ASC are characterized by a spectrum of markers: CD11b-CD45-CD13+CD73+CD90+, which can be widened by CD36+CD-106-CD10+CD26+CD49d+CD49e+CD3-D49f -PODXL- to improve phenotyping. It is suggested to use at least two negative markers and two positive markers during the same phenotyping analysis. Fat transfer requires appropriate approach, planning and technique to make it clinically successful.
Fat grafting fulfills the expectations for ideal injectable agent, which can be used for aesthetic and reconstructive surgery. To improve the survival of fat graft, careful decisions on donor site, local anesthetic administration, liposuction method, processing and placement methods need to be made. Moreover, fat is the source of adipose-derived stem cells which can be used for regenerative procedures. A proper transformation and identification of those cells is required to improve clinical effects.
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1. O’Neill AC Zhong T Hofer SOP. Implications of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) for Breast Cancer Reconstruction: An Update for Surgical Oncologists. Ann Surg Oncol. 2017; doi: 10.1245/s10434-017-6014-0.
2. Lourith N Kanlayavattanakul M. Biopolymeric agents for skin wrinkle treatment. J Cosmet Laser Ther. 2016;18(5):301.
3. Lee SK Kim HS. Correction of horizontal neck lines: Our preliminary experience with hyaluronic acid fillers. J Cosmet Dermatol. 2017; doi: 10.1111/jocd.12382.
4. Peters W Fornasier V. Complications from injectable materials used for breast augmentation. Can J Plast Surg. 2009;17(3):89.
5. Lee J II Kang SJ Sun H. Skin Necrosis with Oculomotor Nerve Palsy Due to a Hyaluronic Acid Filler Injection. Arch Plast Surg. 2017;44:340.
6. Lafaille P Benedetto A. Fillers: contraindications side effects and precautions. J Cutan Aesthet Surg. 2010;3(1):16.
7. Lowe NJ Maxwell CA Patnaik R. Adverse reactions to dermal fillers: Review. Dermatol Surg. 2005;31:1616.
9. Saththianathan M Johani K Taylor A Hu H Vickery K Callan P Deva AK. The Role of Bacterial Biofilm in Adverse Soft-Tissue Filler Reactions: A Combined Laboratory and Clinical Study. Plast Reconstr Surg. 2017;139(3):613.
25. Zuk PA Zhu M Mizuno H Huang J Futrell JW Katz AJ et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7(2):211.
26. Crisan M Yap S Casteilla L Chen CW Corselli M Park TS. et al. A perivascular origin for mesenchymal stem cells in multiple human organs. Cell Stem Cell. 2008;3(3):301.
27. Bourin P Bunnell BA Casteilla L Dominici M Katz AJ March KL et al. Stromal cells from the adipose tissue-derived stromal vascular fraction and culture expanded adipose tissue-derived stromal/stem cells: a joint statement of the International Federation for Adipose Therapeutics and Science (IFATS) and the International Society for Cellular Therapy (ISCT). Cytotherapy. 2013; 15(6):641.
28. Aust L Devlin B Foster SJ Halvorsen YD Hicok K du Laney T et al. Yield of human adipose-derived adult stem cells from liposuction aspirates. Cytotherapy. 2004;6:7.
29. Zhu Y Liu T Song K Fan X Ma X Cui Z. Adipose-derived stem cell: a better stem cell than BMSC. Cell Biochem Funct 2008;26:664.
30. Pittenger MF Mackay AM Beck SC Jaiswal RK Douglas R Mosca JD et al. Multilineage potential of adult human mesenchymal stem cells. Science 1999;284:143.
31. Katsha AM Ohkouchi S Xin H Kanehira M Sun R Nukiwa T et al. Paracrine factors of multipotent stromal cells ameliorate lung injury in an elastase-induced emphysema model. Mol Ther. 2011;19(1):196.
32. Shigemura N Okumura M Mizuno S Imanishi Y Nakamura T Sawa Y. Autologous transplantation of adipose tissue-derived stromal cells ameliorates pulmonary emphysema. Am J Transplant. 2006;6(11):2592.
33. Palpant NJ Metzger JM. Aesthetic Cardiology: Adipose-Derived Stem Cells for Myocardial Repair. Curr Stem Cell Res Ther. 2010;5(2):145.
34. Cui G-H Wang YY Li Ch-J Shi Ch-H Wang W-S. Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: A meta-analysis. Exp Ther Med. 2016;12(5):3390.
35. Paek HJ Kim C Williams SK. Adipose stem cell-based regenerative medicine for reversal of diabetic hyperglycemia. World J Diabetes. 2014;5(3):235.
36. Siniscalco D Bradstreet JJ Sych N Antonucci N. Mesenchymal stem cells in treating autism: Novel insights. World J Stem Cells. 2014;6(2):173.
37. Panes J. Stem Cell Therapy for Perianal Fistulas in Crohn’s Disease. Gastroenterol Hepatol (N Y). 2016;12(10):637.
38. Stepien A Dabrowska NL Maciagowska M Piusinska-Macoch R Zolocinska A Mazur S et al. Clinical Application of Autologous Adipose Stem Cells in Patients with Multiple Sclerosis: Preliminary Results. Mediators Inflamm. 2016;2016:5302120.
39. Choi HS Kim HJ Oh JH Park HG Ra JC Chang KA et al. Therapeutic potentials of human adipose-derived stem cells on the mouse model of Parkinson’s disease. Neurobiol Aging. 2015;36(10):2885.
40. Mead B Berry M Logan A Scott RA Leadbeater W Scheven BA. Stem cell treatment of degenerative eye disease. Stem Cell Res. 2015;14(3):243.
41. Lin G Wang G Banie L Ning H Shindel AW Fandel TM et al. Treatment of Stress Urinary Incontinence with Adipose Tissue-Derived Stem Cells. Cytotherapy. 2010;12(1):88.
42. Lin JY Wang C Pu LL. Can we standardize the techniques for fat grafting? Clin Plast Surg. 2015;42(2):99.
43. Cohen SR. Fat Grafting in the Face: Standardization of Harvest Processing Cell Enrichment and a New Facial Component Analysis Scale. Plastic Reconstr Surg. 2011; 128(4S): 8.
44. Gabriel A Champaneria MC Maxwell GP. Fat grafting and breast reconstruction: tips for ensuring predictability. Gland Surg. 2015;4(3):232.
45. Padoin AV Braga-Silva J Martins P Rezende K Rezende AR Grechi B et al. Sources of processed lipoaspirate cells: influence of donor site on cell concentration. Plast Reconstr Surg. 2008;122:614.
46. Matsumoto D Sato K Gonda K Takaki Y Shigeura T Sato T et al. Cell-assisted lipotransfer: supportive use of human adipose-derived cells for soft tissue augmentation with lipoinjection. Tissue Eng. 2006;12(12):3375.
47. Yoshimura K Suga H Eto H. Adipose-derived stem/progenitor cells: roles in adipose tissue remodeling and potential use for soft tissue augmentation. Regen Med. 2009;4:265.
48. Rohrich RJ Sorokin ES Brown SA. In search of improved fat transfer viability: a quantitative analysis of the role of centrifugation and harvest site. Plast Reconstr Surg. 2004; 113(1):391.
49. Small K Choi M Petruolo O Lee C Karp N. Is there an ideal donor site of fat for secondary breast reconstruction? Aesthet Surg J. 2014;34(4):545.
50. Moore JH Jr Kolaczynski JW Morales LM Considine RV Pietrzkowski Z Noto PF et al. Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Aesthetic Plast Surg. 1995;19(4):335.
51. Kim IH Yang JD Lee DG Chung HY Cho BC. Evaluation of centrifugation technique and effect of epinephrine on fat cell viability in autologous fat injection. Aesthet Surg J. 2009; 29(1):35.
52. Keck M Zeyda M Gollinger K Burjak S Kamolz LP Frey M et al. Local anesthetics have a major impact on viability of preadipocytes and their differentiation into adipocytes. Plast Reconstr Surg. 2010;126(5):1500.
53. Khouri RK Rigotti G Cardoso E Khouri RK Jr Biggs TM. Megavolume autologous fat transfer: part II. Practice and techniques. Plast Reconstr Surg. 2014;133:1369.
54. Cheriyan T Kao HK Qiao X Guo L. Low harvest pressure enhances autologous fat graft viability. Plast Reconstr Surg. 2014; 133(6):1365.
55. Kling RE Mehrara BJ Pusic AL Young VL Hume KM Crotty CA et al. Trends in autologous fat grafting to the breast: a national survey of the american society of plastic surgeons. Plast Reconstr Surg. 2013;132(1):35.
56. Ozsoy Z Kul Z Bilir A. The role of cannula diameter in improved adipocyte viability: a quantitative analysis. Aesthet Surg J. 2006;26(3):287.
57. Erdim M Tezel E Numanoglu A Sav A. The effects of the size of liposuction cannula on adipocyte survival and the optimum temperature for fat graft storage: an experimental study. J Plast Reconstr Aesthet Surg. 2009;62(9):1210.