BACKGROUND: Lipomodeling is a technique that uses the patient's own fat for tissue regeneration and augmentation. The extent of regenerative effect is reported to be determined by the numbers of adipose-derived stem cells and the viability of cells in processed adipose tissue which, together with other factors, influence the degree of graft retention. This study addresses whether differences exist in properties of fat graft obtained by three commonly used techniques. METHODS: Adipose tissue harvested from the hypogastric regions of 14 patients was processed by decantation, centrifugation, and membrane-based tissue filtration. The morphology of each preparation was assessed by electron microscopy and overall cell viability was assessed by live/dead assay. The number of adipose-derived stem cells was determined and their stem cell character was assessed by the presence of cell surface molecules (i.e., CD105, CD90, CD31, and CD45) and by their capacity to differentiate into adipogenic and osteogenic lineages. RESULTS: First, morphologies of processed fat samples obtained by individual procedures differed, but no preparation caused obvious damage to cellular or acellular components. Second, although the highest numbers of adipose-derived stem cells were contained in the upper fraction of centrifuged lipoaspirates, the difference between preparations was marginal. Third, the maximal concentration of adipose fraction (removal of watery component) of lipoaspirate was achieved by membrane-based tissue filtration. Finally, no significant differences in overall viability were detected. CONCLUSIONS: Properties of processed lipoaspirate were influenced by the preparation procedure. However, the differences were not dramatic; both centrifugation and membrane-based filtration are methods of choice whose selection depends on other criteria (e.g., practicality) for individual surgical settings.

Brno Czech Republic

From the Department of Plastic and Aesthetic Surgery and the International Clinical Research Center St Anne's University Hospital Brno; and the Department of Histology and Embryology Faculty of Medicine and the Institute of Biostatistics and Analysis Masaryk University

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Plast Reconstr Surg. 2017 Mar;139(3):683e-684e. doi: 10.1097/PRS.0000000000003132. PubMed

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Illouz YGThe fat cell “graft”: A new technique to fill depressions.Plast Reconstr Surg198678122123

Bircoll MCosmetic breast augmentation utilizing autologous fat and liposuction techniques.Plast Reconstr Surg198779267271

Bircoll M, Novack BHAutologous fat transplantation employing liposuction techniques.Ann Plast Surg198718327329

Bircoll MAutologous fat transplantation to the breast.Plast Reconstr Surg198882361362

Coleman SRLong-term survival of fat transplants: Controlled demonstrations.Aesthetic Plast Surg199519421425

Coleman SRFacial recontouring with lipostructure.Clin Plast Surg199724347367

Coleman SRStructural fat grafting: More than a permanent filler.Plast Reconstr Surg2006118Suppl108S120S

Rigotti G, Marchi A, Galiè M, et al.Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: A healing process mediated by adipose-derived adult stem cells.Plast Reconstr Surg200711914091422; discussion 1423

Van RL, Bayliss CE, Roncari DACytological and enzymological characterization of adult human adipocyte precursors in culture.J Clin Invest197658699704

Zuk PA, Zhu M, Mizuno H, et al.Multilineage cells from human adipose tissue: Implications for cell-based therapies.Tissue Eng20017211228

Zuk PA, Zhu M, Ashjian P, et al.Human adipose tissue is a source of multipotent stem cells.Mol Biol Cell20021342794295

Erickson GR, Gimble JM, Franklin DM, Rice HE, Awad H, Guilak FChondrogenic potential of adipose tissue-derived stromal cells in vitro and in vivo.Biochem Biophys Res Commun2002290763769

Awad HA, Halvorsen YD, Gimble JM, Guilak FEffects of transforming growth factor beta1 and dexamethasone on the growth and chondrogenic differentiation of adipose-derived stromal cells.Tissue Eng2003913011312

Huang JI, Zuk PA, Jones NF, et al.Chondrogenic potential of multipotential cells from human adipose tissue.Plast Reconstr Surg2004113585594

Dragoo JL, Samimi B, Zhu M, et al.Tissue-engineered cartilage and bone using stem cells from human infrapatellar fat pads.J Bone Joint Surg Br200385740747

Cowan CM, Shi YY, Aalami OO, et al.Adipose-derived adult stromal cells heal critical-size mouse calvarial defects.Nat Biotechnol200422560567

Mizuno H, Zuk PA, Zhu M, Lorenz HP, Benhaim P, Hedrick MHMyogenic differentiation by human processed lipoaspirate cells.Plast Reconstr Surg2002109199209; discussion 210

Planat-Bénard V, Menard C, André M, et al.Spontaneous cardiomyocyte differentiation from adipose tissue stroma cells.Circ Res200494223229

Ashjian PH, Elbarbary AS, Edmonds B, et al.In vitro differentiation of human processed lipoaspirate cells into early neural progenitors.Plast Reconstr Surg200311119221931

Miranville A, Heeschen C, Sengenès C, Curat CA, Busse R, Bouloumié AImprovement of postnatal neovascularization by human adipose tissue-derived stem cells.Circulation2004110349355

Rehman J, Traktuev D, Li J, et al.Secretion of angiogenic and antiapoptotic factors by human adipose stromal cells.Circulation200410912921298

Seo MJ, Suh SY, Bae YC, Jung JSDifferentiation of human adipose stromal cells into hepatic lineage in vitro and in vivo.Biochem Biophys Res Commun2005328258264

Rohrich RJ, Sorokin ES, Brown SAIn search of improved fat transfer viability: A quantitative analysis of the role of centrifugation and harvest site.Plast Reconstr Surg2004113391395; discussion 396

Niechajev I, Sevćuk OLong-term results of fat transplantation: Clinical and histologic studies.Plast Reconstr Surg199494496506

Moore JH Jr, Kolaczynski JW, Morales LM, et al.Viability of fat obtained by syringe suction lipectomy: Effects of local anesthesia with lidocaine.Aesthetic Plast Surg199519335339

Lu F, Li J, Gao J, et al.Improvement of the survival of human autologous fat transplantation by using VEGF-transfected adipose-derived stem cells.Plast Reconstr Surg200912414371446

Zhu M, Zhou Z, Chen Y, et al.Supplementation of fat grafts with adipose-derived regenerative cells improves long-term graft retention.Ann Plast Surg201064222228

Gir P, Brown SA, Oni G, Kashefi N, Mojallal A, Rohrich RJFat grafting: Evidence-based review on autologous fat harvesting, processing, reinjection, and storage.Plast Reconstr Surg2012130249258

Gerth DJ, King B, Rabach L, Glasgold RA, Glasgold MJLong-term volumetric retention of autologous fat grafting processed with closed-membrane filtration.Aesthet Surg J201434985994

Botti G, Pascali M, Botti C, Bodog F, Cervelli VA clinical trial in facial fat grafting: Filtered and washed versus centrifuged fat.Plast Reconstr Surg201112724642473

Mestak O, Sukop A, Hsueh YS, et al.Centrifugation versus PureGraft for fatgrafting to the breast after breast-conserving therapy.World J Surg Oncol201412178

Kurita M, Matsumoto D, Shigeura T, et al.Influences of centrifugation on cells and tissues in liposuction aspirates: Optimized centrifugation for lipotransfer and cell isolation.Plast Reconstr Surg200812110331041; discussion 1042

Ferraro GA, De Francesco F, Tirino V, et al.Effects of a new centrifugation method on adipose cell viability for autologous fat grafting.Aesthetic Plast Surg201135341348

Zhu M, Cohen SR, Hicok KC, et al.Comparison of three different fat graft preparation methods: Gravity separation, centrifugation, and simultaneous washing with filtration in a closed system.Plast Reconstr Surg2013131873880

Smith P, Adams WP Jr, Lipschitz AH, et al.Autologous human fat grafting: Effect of harvesting and preparation techniques on adipocyte graft survival.Plast Reconstr Surg200611718361844

Xie Y, Zheng D, Li Q, Chen Y, Lei H, Pu LLThe effect of centrifugation on viability of fat grafts: An evaluation with the glucose transport test.J Plast Reconstr Aesthet Surg201063482487

Xiao Y, Yuan T, Yao W, Liao K3T3-L1 adipocyte apoptosis induced by thiazolidinediones is peroxisome proliferator-activated receptor-gamma-dependent and mediated by the caspase-3-dependent apoptotic pathway.FEBS J2010277687696

Palumbo P, Melchiorre E, La Torre C, et al.Effects of phosphatidylcholine and sodium deoxycholate on human primary adipocytes and fresh human adipose tissue.Int J Immunopathol Pharmacol201023481489

Pu LL, Coleman SR, Cui X, Ferguson RE Jr, Vasconez HCAutologous fat grafts harvested and refined by the Coleman technique: A comparative study.Plast Reconstr Surg2008122932937

Hoareau L, Bencharif K, Girard AC, et al.Effect of centrifugation and washing on adipose graft viability: A new method to improve graft efficiency.J Plast Reconstr Aesthet Surg201366712719

Rubino C, Mazzarello V, Faenza M, Montella A, Santanelli F, Farace FA scanning electron microscope study and statistical analysis of adipocyte morphology in lipofilling: Comparing the effects of harvesting and purification procedures with 2 different techniques.Ann Plast Surg201574718721

Gattazzo F, Urciuolo A, Bonaldo PExtracellular matrix: A dynamic microenvironment for stem cell niche.Biochim Biophys Acta2014184025062519

Yoshimura K, Suga H, Eto HAdipose-derived stem/progenitor cells: Roles in adipose tissue remodeling and potential use for soft tissue augmentation.Regen Med20094265273

Dominici M, Le Blanc K, Mueller I, et al.Minimal criteria for defining multipotent mesenchymal stromal cells: The International Society for Cellular Therapy position statement.Cytotherapy20068315317

Yoshimura K, Shigeura T, Matsumoto D, et al.Characterization of freshly isolated and cultured cells derived from the fatty and fluid portions of liposuction aspirates.J Cell Physiol20062086476

Condé-Green A, de Amorim NF, Pitanguy IInfluence of decantation, washing and centrifugation on adipocyte and mesenchymal stem cell content of aspirated adipose tissue: A comparative study.J Plast Reconstr Aesthet Surg20106313751381

Yang XF, He X, He J, et al.High efficient isolation and systematic identification of human adipose-derived mesenchymal stem cells.J Biomed Sci20111859

Mitchell JB, McIntosh K, Zvonic S, et al.Immunophenotype of human adipose-derived cells: Temporal changes in stromal-associated and stem cell-associated markers.Stem Cells200624376385

Baer PCAdipose-derived mesenchymal stromal/stem cells: An update on their phenotype in vivo and in vitro.World J Stem Cells20146256265

Bourin P, Bunnell BA, Casteilla L, 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).Cytotherapy201315641648

Allen RJ Jr, Canizares O Jr, Scharf C, et al.Grading lipoaspirate: Is there an optimal density for fat grafting?Plast Reconstr Surg20131313845

Condé-Green A, Baptista LS, de Amorin NF, et al.Effects of centrifugation on cell composition and viability of aspirated adipose tissue processed for transplantation.Aesthet Surg J201030249255

Kaufman MR, Bradley JP, Dickinson B, et al.Autologous fat transfer national consensus survey: Trends in techniques for harvest, preparation, and application, and perception of short- and long-term results.Plast Reconstr Surg2007119323331

Butterwick KJ, Nootheti PK, Hsu JW, Goldman MPAutologous fat transfer: An in-depth look at varying concepts and techniques.Facial Plast Surg Clin North Am20071599111, viii

Mineda K, Kuno S, Kato H, et al.Chronic inflammation and progressive calcification as a result of fat necrosis: The worst outcome in fat grafting.Plast Reconstr Surg201413310641072

Condé-Green A, Wu I, Graham I, et al.Comparison of 3 techniques of fat grafting and cell-supplemented lipotransfer in athymic rats: A pilot study.Aesthet Surg J201333713721

Ibatici A, Caviggioli F, Valeriano V, et al.Comparison of cell number, viability, phenotypic profile, clonogenic, and proliferative potential of adipose-derived stem cell populations between centrifuged and noncentrifuged fat.Aesthetic Plast Surg201438985993

Butterwick KJLipoaugmentation for aging hands: A comparison of the longevity and aesthetic results of centrifuged versus noncentrifuged fat.Dermatol Surg200228987991

Yoshimura K, Shigeura T, Matsumoto D, et al.Characterization of freshly isolated and cultured cells derived from the fatty and fluid portions of liposuction aspirates.J Cell Physiol20062086476

Condé-Green A, Wu I, Graham I, et al.Comparison of 3 techniques of fat grafting and cell-supplemented lipotransfer in athymic rats: A pilot study.Aesthet Surg J201333713721

Salinas HM, Broelsch GF, Fernandes JR, et al.Comparative analysis of processing methods in fat grafting.Plast Reconstr Surg2014134675683

Palumbo P, Miconi G, Cinque B, et al.In vitro evaluation of different methods of handling human liposuction aspirate and their effect on adipocytes and adipose derived stem cells.J Cell Physiol201523019741981

Cleveland EC, Albano NJ, Hazen ARoll, spin, wash, or filter? Processing of lipoaspirate for autologous fat grafting: An updated, evidence-based review of the literature.Plast Reconstr Surg2015136706713

Strong AL, Cederna PS, Rubin JP, Coleman SR, Levi BThe current state of fat grafting: A review of harvesting, processing, and injection techniques.Plast Reconstr Surg2015136897912

Tuin AJ, Domerchie PN, Schepers RH, et al.What is the current optimal fat grafting processing technique? A systematic review.J Craniomaxillofac Surg2016444555

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