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Shikanai A, Furukawa S, Jiang S, Fujimura S, Kutomi G, Saito M, Tanaka R. Novel breast reconstruction technique using ex vivo mononuclear (RE-01) cells and adipose-derived mesenchymal stem cells. Regen Ther 2025; 29:271-281. [PMID: 40230355 PMCID: PMC11994943 DOI: 10.1016/j.reth.2025.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 03/01/2025] [Accepted: 03/23/2025] [Indexed: 04/16/2025] Open
Abstract
Introduction Breast reconstruction using fat grafts presents challenges; for example, fat necrosis owing to inadequate blood flow results in reduced engraftment rates. Supplementation of adipose tissue with adipose-derived mesenchymal stem cells (ADSCs) to promote the rapid vascularization of transplanted tissue has been investigated. However, the vascularization of fat-grafted tissues using only ADSC transplantation is limited. Ex vivo cultured mononuclear cells (RE-01) are a cell population with highly vascular and tissue-regenerative properties. This study aimed to evaluate the effect of combining RE-01 cells and ADSCs on the engraftment rate of fat grafts and explore the potential of this approach as a new option for breast reconstruction surgery. We hypothesized that combining RE-01 with ADSCs might promote angiogenesis and improve the fat grafting rate, consequently reducing the number of ADSCs required. Methods ADSCs cultured from human adipose tissue discarded during liposuction were co-cultured with RE-01 cells produced from the peripheral blood of healthy volunteers. In vitro vascular regeneration and adipogenic differentiation potential were analyzed. In addition, fat grafting experiments were conducted using nude mice to verify the fat grafting efficacy of ADSCs after co-cultivation with RE-01. Results ADSCs co-cultured with RE-01 cells promoted angiogenesis and adipogenesis in vitro. This was evidenced by a significant increase in the expression of adipogenic markers FABP4 and PPARγ, as well as enhanced lipid droplet formation observed through Oil Red O staining. The in vivo results demonstrated that the fat engraftment rate was significantly improved in the mixed group of ADSCs co-cultured with RE-01 cells. The number of blood vessels and fat quality of the transplanted adipose tissue were also increased in this group, suggesting that ADSCs co-cultured with RE-01 cells were highly effective in fat transplantation. Conclusions ADSCs co-cultured with RE-01 cells may be useful for improving the engraftment rate of fat grafts. However, further studies are required to verify the mechanisms.
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Affiliation(s)
- Ayana Shikanai
- Division of Regenerative Therapy, Juntendo University Graduates School of Medicine, Tokyo, Japan
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Satomi Furukawa
- Division of Regenerative Therapy, Juntendo University Graduates School of Medicine, Tokyo, Japan
- Center for Genomic and Regenerative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- ReEir. Inc., Tokyo, Japan
| | - Sen Jiang
- Division of Regenerative Therapy, Juntendo University Graduates School of Medicine, Tokyo, Japan
- Intractable Disease Research Center, Juntendo University Graduates School of Medicine, Tokyo, Japan
| | - Satoshi Fujimura
- Division of Regenerative Therapy, Juntendo University Graduates School of Medicine, Tokyo, Japan
- Intractable Disease Research Center, Juntendo University Graduates School of Medicine, Tokyo, Japan
- ReEir. Inc., Tokyo, Japan
| | - Goro Kutomi
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Rica Tanaka
- Division of Regenerative Therapy, Juntendo University Graduates School of Medicine, Tokyo, Japan
- Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan
- Center for Genomic and Regenerative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Intractable Disease Research Center, Juntendo University Graduates School of Medicine, Tokyo, Japan
- ReEir. Inc., Tokyo, Japan
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Eigenberger A, Felthaus O, Bartsch A, Schimanski T, Utpatel K, Prantl L. The Influence of Sedimentation on the Composition of the Lipoaspirate and the Effects on Further Mechanical Processing. Cells 2025; 14:601. [PMID: 40277926 DOI: 10.3390/cells14080601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 04/02/2025] [Accepted: 04/08/2025] [Indexed: 04/26/2025] Open
Abstract
Manual processing of lipoaspirate can enhance stem cell concentration, thereby improving the take rate, which still represents a major challenge in autologous fat transfer. However, since the preparation consists of many manual steps that are difficult to standardize, we investigated the influence of residual tumescent solution on the macroscopic and microscopic outcome of the mechanically processed lipoaspirate. Additionally, we investigated whether sedimentation followed by vacuum filtration of the aqueous phase could accelerate processing by replacing the initial centrifugation step. Samples with more than 5% remaining aqueous phase show no clearly defined oil phase, preventing any volume reduction. In contrast, all centrifuged samples produced a clear oil phase. The remaining tissue, as confirmed by both histology and viability assays, was superior to nanofat. Although sedimentation and filtration in the LipoCollector did not sufficiently separate enough aqueous phase from the lipoaspirate, tissue viability was significantly higher compared to our control container. Our findings indicate that centrifugation remains essential for effective aqueous phase separation and further mechanical processing, while the automatic filtration may enhance processing efficiency. These results indicate that further work is needed to simplify mechanical processing, as the outcome can be significantly influenced by parameters such as tumescent impurities.
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Affiliation(s)
- Andreas Eigenberger
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Medical Device Lab, Regensburg Center of Biomedical Engineering (RCBE), Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg, 93053 Regensburg, Germany
| | - Oliver Felthaus
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Alexander Bartsch
- Medical Device Lab, Regensburg Center of Biomedical Engineering (RCBE), Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg, 93053 Regensburg, Germany
| | - Tom Schimanski
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Kirsten Utpatel
- Institute of Pathology, University of Regensburg, 93053 Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
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Schipper JAM, Tuin AJ, Loonen TGJ, Dijkstra PU, Spijkervet FKL, Schepers RH, Jansma J. Volume and patient satisfaction, 5 years of follow up after facial fat grafting. J Plast Reconstr Aesthet Surg 2025; 102:231-237. [PMID: 39938464 DOI: 10.1016/j.bjps.2025.01.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 12/06/2024] [Accepted: 01/24/2025] [Indexed: 02/14/2025]
Abstract
BACKGROUND Autologous facial fat grafting is used to restore volume loss in the facial region. The volume retention after grafting is not stable over time. OBJECTIVES The aim of this study was to assess long-term visible volume retention measured with 3-dimensional surface imaging and long-term patient-reported satisfaction 5 years after facial fat grafting. METHODS Twelve patients were included for 3-dimensional analysis and satisfaction measurements with 5 years of follow-up. Volume was measured with a validated automatic algorithm using three-dimensional surface imaging and patient satisfaction was recorded with the FACE-Q questionnaire. RESULTS After 5 years, the face volume increase was associated with the weight gain of the person and not with the injected volume. Weight gain beta (95% confidence interval) = 1.40 (0.37; 2.42), p = 0.013. Injected volume beta (95% confidence interval) = 0.30 (-0.28; 0.88), p = 0.268. Satisfaction returned to pre-operative levels (facial appearance score pre-operative) median 45.0 (IQR 25.5; 47.3); after 5 years median 39.0 (IQR 28.0; 57.0). CONCLUSION After 5 years of facial fat grafting, volume retention was related to weight gain. Patient satisfaction returned to pre-operative levels. An increase in volume due to weight gain does not lead to increased patient satisfaction. Repeated fat grafting is necessary which will potentially increase satisfaction in the long term. Weight change as a confounder complicates long-term studies of volume retention.
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Affiliation(s)
- J A M Schipper
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, the Netherlands.
| | - A J Tuin
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, the Netherlands
| | - T G J Loonen
- Radboudumc 3D-Lab, Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - P U Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, 14 Arunamarin Road, Bangkoknoi, Bangkok 10700, Thailand
| | - F K L Spijkervet
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, the Netherlands
| | - R H Schepers
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, the Netherlands; Martini Hospital, Department of Oral and Maxillofacial Surgery, Groningen, the Netherlands
| | - J Jansma
- University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, the Netherlands; Martini Hospital, Department of Oral and Maxillofacial Surgery, Groningen, the Netherlands
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Camargo CP, Barbosa EF, Chammas MC, Silveira HB, Santos DLDS, Furuya TK, Alves MJF, Uno M, Altran SC, Gemperli R. Enrichment of Fat Graft with Association of ASC and Nanofat in an Animal Model. Aesthetic Plast Surg 2025; 49:908-916. [PMID: 39402194 DOI: 10.1007/s00266-024-04322-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 08/08/2024] [Indexed: 01/06/2025]
Abstract
INTRODUCTION Fat graft (FG) absorption rate varies from 20 to 80% in two years. Recently, several bioengineering techniques were applied to improve FG retention rate. Numerous studies investigated the use of adipocyte-derived stem cells (ASC) as FG enrichment. However, ASC production is costly, complex, and time-consuming. In contrast, Nanofat, a combination of lipids, stem cells and growth factors, offers a faster, simpler, and more cost-effective alternative for FG enrichment. OBJECTIVE This study aims to compare the effects of ASC with those of Nanofat, as a viable option in FG enrichment. MATERIAL AND METHODS Animals were allocated in three groups: Control group (1 mL fat), ASC group (1 mL fat +1x106 ASC), and NnF group (1 mL of fat + 0.3mL NnF). These groups were subdivided in three subgroups (4, 8, and 12 weeks, n = 6/group). We performed ultrasound and macroscopic measurements for FG volume, histology and expression of healing and inflammation genes. RESULTS At week 12, ASC and NnF groups showed a higher retention of FG when compared to the Control group (51%, 46%, 12% respectively, p < 0.01). Fibrosis was similar in ASC and Nanofat groups. The Nanofat group showed a higher vascular density then the Control group (p < 0.05). Il-10 gene expression was higher, and Mmp9 was lower in the Nanofat group when compared to the ASC and Control groups. CONCLUSION This study indicates that enriching FG with both ASC and Nanofat led to an increased retention rate of the FG, suggesting that Nanofat might be a promising alternative for FG enrichment. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .
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Affiliation(s)
- Cristina Pires Camargo
- Microsurgery and Plastic Surgery Laboratory (LIM-04), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Emily Freire Barbosa
- Microsurgery and Plastic Surgery Laboratory (LIM-04), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Cristina Chammas
- Radiology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Henrique Brito Silveira
- Microsurgery and Plastic Surgery Laboratory (LIM-04), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Deborah Luisa de Sousa Santos
- Multiprofessional Residency Program in Oncology Care for Adults (COREMU), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Tatiane Katsue Furuya
- Center for Translational Research in Oncology (LIM24), Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
- Comprehensive Center for Precision Oncology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria José Ferreira Alves
- Center for Translational Research in Oncology (LIM24), Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
- Comprehensive Center for Precision Oncology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Miyuki Uno
- Center for Translational Research in Oncology (LIM24), Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
- Comprehensive Center for Precision Oncology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Silvana Cereijido Altran
- Microsurgery and Plastic Surgery Laboratory (LIM-04), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rolf Gemperli
- Microsurgery and Plastic Surgery Laboratory (LIM-04), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Wang Y, Zhou Y, Li K. The role of lncRNA in the differentiation of adipose-derived stem cells: from functions to mechanism. J Mol Med (Berl) 2025; 103:125-135. [PMID: 39708157 DOI: 10.1007/s00109-024-02507-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 12/04/2024] [Accepted: 12/10/2024] [Indexed: 12/23/2024]
Abstract
Adipose-derived stem cells (ADSCs) have become one of the best seed cells widely studied and concerned in tissue engineering because of their rich sources and excellent multi-directional differentiation ability, which are expected to play a practical application role in tissue defect, osteoporosis, plastic surgery, and other fields. However, the differentiation direction of ADSCs is regulated by complex factors. Long non-coding RNAs (lncRNAs) are RNA molecules longer than 500 nucleotides that do not encode proteins and can act as signaling RNAs in response to intracellular and extracellular stimuli. Recently, accumulating evidence has revealed that lncRNAs could regulate the cell cycle and differentiation direction of ADSCs through various mechanisms, including histone modification, binding to RNA-binding proteins, and regulating the expression of miRNAs. Therefore, enriching and elucidating its mechanism of action as well as targeting lncRNAs to regulate ADSCs differentiation have potential prospects in tissue regeneration applications such as bone, blood vessels, and adipose. In this review, we summarize the role and mechanism of lncRNAs and its complexes in the multi-directional differentiation of ADSCs and discuss some potential approaches that can exert therapeutic effects on tissue defects by modulating the expression level of lncRNAs in ADSCs. Our work might provide some new research directions for the clinical applications of tissue engineering.
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Affiliation(s)
- Yujing Wang
- Department of Oral & Maxillofacial Surgery, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Central South University, Changsha, 410000, China
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Yuxi Zhou
- Department of Oral & Maxillofacial Surgery, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Central South University, Changsha, 410000, China
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Kun Li
- Department of Oral & Maxillofacial Surgery, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Central South University, Changsha, 410000, China.
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China.
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Sterodimas A. Helium Plasma Effect on Breast Stromal-Enriched Lipograft: A Case Report. Aesthet Surg J Open Forum 2024; 6:ojae087. [PMID: 40007601 PMCID: PMC11852245 DOI: 10.1093/asjof/ojae087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2025] Open
Abstract
Autologous fat transfer for large volume augmentation, reconstructive, and cosmetic purposes has become more popular due to the inherent biocompatibility, accessibility, and low cost. For volume augmentation, the retention of grafted fat is unpredictable. Several approaches to autologous fat transfer have prepared the donor fat and/or the recipient-site increase fat graft retention as well as the predictability of the retention. This study is the first clinical report on the combination of radiofrequency helium plasma pretreatment of the recipient site and a cell-assisted lipotransfer technique for enhanced fat graft retention. One patient underwent autologous breast augmentation using the stromal-enriched lipograft technique to process the fat prior to injection. Only the right breast received pretreatment using radiofrequency helium plasma after infiltration. The processed fat was injected using a droplet style injector. The patient was followed for 2 years and underwent breast MRI examinations for measurement of the graft volume. The overall fat graft survival after 12 months for the stromal-enriched lipograft was 63%, whereas the survival for the stromal-enriched lipograft in combination with radiofrequency helium plasma was 89%. The addition of biostimulatory techniques to prepare the recipient site for breast augmentation enhanced the fat graft retention. Further clinical studies using radiofrequency helium plasma are required to justify using this modality as a recipient-site preparation technique. Level of Evidence 5 Therapeutic
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Affiliation(s)
- Aris Sterodimas
- Corresponding Author: Dr Aris Sterodimas, 264 Mesogion Avenue, GR-15562 Athens, Greece. E-mail:
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Uyulmaz S, Fontein D, Sarvan M, Grünherz L, Giovanoli P, Lindenblatt N. Management of Delayed Vascular Occlusion in Free Flap Breast Reconstruction: A Systematic Review of Literature and Case Report. Ann Plast Surg 2024; 93:713-721. [PMID: 39526818 DOI: 10.1097/sap.0000000000004146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
INTRODUCTION Free flap surgery is a reliable and safe procedure for breast reconstruction. The survival of free flaps depends on their vascular pedicle initially, but neovascularization can sustain their blood supply after a while. Management of late pedicle occlusion in free flap breast reconstruction and potential implications of late pedicle occlusion on the transferred tissue are controversial. METHODS AND MATERIALS We systematically reviewed current literature focusing on articles that reported on late pedicle occlusion in free flaps for breast reconstruction. We aimed to analyze incidences of late pedicle occlusion, the existing evidence for the most appropriate management strategy for late pedicle occlusion, and its implications on overall outcomes. In support of the review, we present a clinical case of a salvage of a deep inferior epigastric artery perforator flap following late arterial thrombosis 12 days postoperatively. RESULTS The literature is limited to a few case reports on pedicle occlusion in free flap breast reconstruction and a few heterogeneous retrospective reviews reporting on late pedicle occlusion in general. Despite the heterogeneity of articles and approaches to salvage flaps with late pedicle occlusion, we found no convincing evidence that surgery is the best choice to salvage flaps in breast reconstruction that appear to have late pedicle occlusion. Our case demonstrates that a conservative approach may be justified more than initially deemed necessary. CONCLUSIONS Late pedicle occlusion is a rare but serious event in free flap breast reconstruction. Surgery does not seem to be the most appropriate approach in every case. Decisions should be based on clinical dynamics and imaging findings such as indocyanine-green angiography. A carefully carried out conservative approach may lead to flap salvage.
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Affiliation(s)
- Semra Uyulmaz
- From then Department of Plastic and Hand Surgery, University Hospital Zurich, Switzerland
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Vania R, Sanjaya IGPH, Hamid ARRH, Sudarsa SD, Dewi IGASM, Niryana IW, Martadiani ED. Early activation of macrophage-2 with IL-4 in stromal vascular fraction increases VEGF levels and adipocyte count and maintains volume of fat graft in Wistar rats ( Rattus norvegicus). NARRA J 2024; 4:e1080. [PMID: 39816080 PMCID: PMC11731649 DOI: 10.52225/narra.v4i3.1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 09/04/2024] [Indexed: 01/18/2025]
Abstract
Several previous studies have demonstrated the benefits of early macrophage 2 activation fat grafts supplemented with macrophage culture. However, this approach is considered impractical in clinical settings because of intraperitoneal induction use. The aim of this study was to investigate the effect of early stromal vascular fraction (SVF) macrophage-2 activation with IL-4 on fat graft survival compared to SVF alone using an animal model for better fat graft viability. This experimental study included inguinal fat harvesting, isolated with collagenases to retrieve the SVF, and then injected with a combination of fat graft and SVF (0.3 mL) into the scalp region. The intervention group received an IL-4 intralesional injection on the third day, and the fat grafts were biopsied on days 7, 14, and The primary outcomes were the final volume of the fat graft, vascular endothelial growth factor (VEGF) expression, and the adipocyte cell count using perilipin staining on immunohistochemistry examination. The group receiving IL-4 exhibited significantly higher VEGF on days 7, 14, and 30 (p = 0.009, 0.009, and 0.021, respectively). Similarly, the IL-4 treatment significantly increased the perilipin concentration on days 7, 14, and 30 (p = 0.008, 0.008, and 0.029, respectively). In this group, VEGF concentration was significantly increased on day 14 as compared to day 7 (p = 0.009), while no significant difference was observed in the control group (p = 0.090). Additionally, the IL-4 group displayed significantly less reduction of fat graft volume than the control group, as observed on days 7, 14, and 30 (p = 0.009, 0.009, and 0.021, respectively). Overall, the study underscores the potential benefits of early M2 polarization in fat grafting, as well as providing practical advantages for improving fat graft volume retention.
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Affiliation(s)
- Rachel Vania
- Division of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
| | - I GPH. Sanjaya
- Division of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
| | - Agus RRH. Hamid
- Division of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
| | - Shita D. Sudarsa
- Division of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
| | - I GASM. Dewi
- Department of Pathological Anatomy, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
| | - I W. Niryana
- Department of Neurosurgery, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
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Qin Z, Chen G, Wang N, Long J, Yang M, Wang J, Gao B, Zhang Z, Zhang Z. Biomechanics of Negative-Pressure-Assisted Liposuction and Their Influence on Fat Regeneration. TISSUE ENGINEERING. PART B, REVIEWS 2024. [PMID: 39587950 DOI: 10.1089/ten.teb.2024.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Abstract
Autologous fat grafting has been widely adopted in cosmetic and reconstructive procedures recently. With the emerging of negative-pressure-assisted liposuction system, the harvesting process of fat grafting is more standardized, controllable, and efficient. Each component in the system could influence the biomechanical environment of lipoaspirate. Several reviews have studied the impact of negative pressure on fat regeneration. As the initial part of the harvesting system, cannulas possess their unique mechanical parameters and their influence on lipoaspirate biomechanical characters, biological behaviors, and regeneration patterns remains unclear. Basic in vivo and in vitro studies have been performed to determine the possible mechanisms. Instant in vivo studies focus on adipocytes, stromal vascular fraction cells, fat particles, and growth factors, while in vivo grafting experiments analyze the graft retention rate and histology. Understanding the different regeneration patterns of lipoaspirate and the mechanisms behind may facilitate the choice of harvesting cannulas in clinical practice.
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Affiliation(s)
- Zijin Qin
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Guo Chen
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Na Wang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Jie Long
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Minli Yang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Juan Wang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Botao Gao
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Zhaoxiang Zhang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Ziang Zhang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
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Melfa F, McCarthy A, Aguilera SB, van Loghem J, Gennai A. Guided SEFFI and CaHA: A Retrospective Observational Study of an Innovative Protocol for Regenerative Aesthetics. J Clin Med 2024; 13:4381. [PMID: 39124647 PMCID: PMC11313436 DOI: 10.3390/jcm13154381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: This retrospective observational study sought to determine the efficacy and safety of an innovative combined treatment protocol using guided Superficial Enhanced Fluid Fat Injection (SEFFI) and calcium hydroxylapatite (CaHA) in facial rejuvenation. Methods: A total of 158 patients (149 females and 9 males) underwent the combined treatment of guided SEFFI and diluted/hyperdiluted CaHA. The study evaluated treatment outcomes at 30, 90, and 150 days post-treatment using the Global Aesthetic Improvement Scale (GAIS) and three-dimensional photogrammetric analysis. Results: The combined treatment demonstrated consistent enhancement in skin quality and facial volume across temporal, malar, zygomatic, and jawline regions. At 90 days post-treatment, substantial improvements were observed, with the GAIS scores reflecting significant enhancements in both skin quality and volume, which were sustained or slightly improved by 150 days. Minor complications, predominantly ecchymosis at the injection sites, resolved within a week, confirming the treatments' safety. Conclusions: The integration of guided SEFFI and CaHA resulted in significant improvements in skin quality and facial volume with minimal complications. Further research is recommended to consolidate these findings and explore long-term outcomes.
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Affiliation(s)
| | | | - Shino Bay Aguilera
- Shino Bay Cosmetic Dermatology & Laser Institute, Fort Lauderdale, FL 33301, USA
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Paramo R, Barmettler A. Dermal Fillers in the Oculoplastics Office: Applications and Strategies for Complication Prevention and Treatment. Int Ophthalmol Clin 2024; 64:23-28. [PMID: 38910502 DOI: 10.1097/iio.0000000000000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Affiliation(s)
- Ricky Paramo
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, NY
| | - Anne Barmettler
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, NY
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12
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Chen X, Chen W, Xu H, Tian Y, Wang X, Chen X, Li J, Luo S, Hao L. Disulfiram Improves Fat Graft Retention by Modulating Macrophage Polarization With Inhibition of NLRP3 Inflammasome-Mediated Pyroptosis. Aesthet Surg J 2024; 44:NP501-NP518. [PMID: 38567442 PMCID: PMC11177556 DOI: 10.1093/asj/sjae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Macrophage-mediated inflammatory response in the early post-grafting period restricts fat graft retention. Pyroptosis is a novel type of programmed cell death that extensively participates in inflammatory pathologies. OBJECTIVES This study sought to determine whether macrophage pyroptosis was activated during the inflammatory phase after fat grafting and to investigate the efficacy of a pyroptosis inhibitor, disulfiram (DSF), in fat graft retention. METHODS We established a C57BL/6 mice fat grafting model and then analyzed macrophage pyroptosis. DSF (50 mg/kg, every other day) was intraperitoneally injected starting 1 hour before fat grafting and continued for 14 days. An in vitro co-culture system was established in which mouse RAW264.7 macrophages were co-cultured with apoptotic adipocytes to further validate the findings of the in vivo studies and to explore the underlying mechanisms. RESULTS Here we reported that macrophage pyroptosis was activated in both fat grafts and in vitro co-culture models. DSF was found to be a potent pyroptosis inhibitor, promoting M2 macrophage polarization. In addition, DSF was demonstrated to enhance vascularization and graft retention. CONCLUSIONS Our results suggested that pyroptosis plays a crucial role in the inflammatory cascade within fat grafts. DSF, being a clinically available drug, could be translated into a clinically effective drug for improving fat graft survival by inhibiting macrophage pyroptosis, therefore inducing M2 macrophage polarization and promoting neovascularization.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lijun Hao
- Corresponding Author: Dr Lijun Hao, No. 23 Youzheng Street, Nangang District, Harbin, Heilongjiang, 150000 P. R. China. E-mail:
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13
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Ruff PG, Sterodimas A. Enhanced Fat Graft Viability and Remodeling Using a Helium-based Radiofrequency Device to Prepare the Recipient Site. Aesthetic Plast Surg 2024; 48:612-620. [PMID: 38097690 PMCID: PMC10954941 DOI: 10.1007/s00266-023-03749-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/25/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Improvements to autologous fat grafting for soft tissue augmentation are needed to overcome the unpredictable volume retention. Approaches such as fat harvesting and processing, injection technique, preparation of the recipient site, and supplemental biologics are topics of ongoing research. Here, an energy-based device was investigated as a stimulatory tool for recipient site preparation for improving fat graft retention. OBJECTIVE The objective was to measure the stimulatory responses in fat grafts after 4 weeks when using a helium-based radiofrequency device to pretreat the recipient tissue. METHODS Using an autologous fat grafting mouse model, the inguinal fat pad was grafted in a small cranial pocket after either a saline injection alone (control) or a saline injection followed by pretreatment (treated). The fat pad was resected after 4 weeks, sectioned and stained with immunofluorescence markers to investigate tissue remodeling. RESULTS Pretreatment resulted in higher viability of adipocytes, a higher concentration of viable ASCs in areas of adipose tissue regeneration, and localized macrophages in the areas of regeneration when compared to the control. There was no observable difference in vascularity or angiogenesis. The staining for ASCs was higher in the pretreated group in comparison with the control group (5.0% vs. 3.3%, p=0.36) when using a pixel classifier in QuPath in the viable adipose tissue regions. CONCLUSIONS The use of a helium-based radiofrequency device as a pretreatment tool appears to increase the viability of the adipose tissue likely due to higher concentration of ASCs. The apparent increase in viable ASCs may be due to enhanced proliferation or paracrine recruitment of these cells in response to the helium-based radiofrequency treatment. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 . Bullet List of Important Points: Pretreatment of the fat graft recipient site increases the viability of the adipose tissue after 4 weeks in comparison with the control grafts. The increased viability is likely due to the observed increase in adipose-derived stem cells in the pretreated group. Pretreatment enhanced the adipose tissue remodeling as colocalization of adipose-derived stem cells and macrophages showed an active remodeling, whereas the control group exhibited more necrotic and fibrotic tissue.
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Affiliation(s)
- Paul G Ruff
- West End Plastic Surgery, MedStar Georgetown University, Washington, DC, USA
| | - Aris Sterodimas
- Department of Plastic and Reconstructive Surgery, Metropolitan General Hospital, Athens, Greece.
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14
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Xining Z, Sai L. The Evolving Function of Vasculature and Pro-angiogenic Therapy in Fat Grafting. Cell Transplant 2024; 33:9636897241264976. [PMID: 39056562 PMCID: PMC11282510 DOI: 10.1177/09636897241264976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 07/28/2024] Open
Abstract
Autologous fat grating is a widely-accepted method to correct soft tissue deficiency. Although fat transplantation shows excellent biocompatibility and simple applicability, the relatively low retention rate caused by fat necrosis is still a challenge. The vasculature is integral after fat grafting, serving multiple crucial functions. Rapid and effective angiogenesis within grafts is essential for supplying oxygen necessary for adipocytes' survival. It facilitates the influx of inflammatory cells to remove necrotic adipocytes and aids in the delivery of regenerative cells for adipose tissue regeneration in fat grafts. The vasculature also provides a niche for interaction between adipose progenitor cells and vascular progenitor cells, enhancing angiogenesis and adipogenesis in grafts. Various methods, such as enriching grafts with diverse pro-angiogenic cells or utilizing cell-free approaches, have been employed to enhance angiogenesis. Beige and dedifferentiated adipocytes in grafts could increase vessel density. This review aims to outline the function of vasculature in fat grafting and discuss different cell or cell-free approaches that can enhance angiogenesis following fat grafting.
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Affiliation(s)
- Zhang Xining
- The Plastic and Aesthetic Center, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Luo Sai
- The Plastic and Aesthetic Center, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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15
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Jordao A, Cléret D, Dhayer M, Le Rest M, Cao S, Rech A, Azaroual N, Drucbert AS, Maboudou P, Dekiouk S, Germain N, Payen J, Guerreschi P, Marchetti P. Engineering 3D-Printed Bioresorbable Scaffold to Improve Non-Vascularized Fat Grafting: A Proof-of-Concept Study. Biomedicines 2023; 11:3337. [PMID: 38137558 PMCID: PMC10741522 DOI: 10.3390/biomedicines11123337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Autologous fat grafting is the gold standard for treatment in patients with soft-tissue defects. However, the technique has a major limitation of unpredictable fat resorption due to insufficient blood supply in the initial phase after transplantation. To overcome this problem, we investigated the capability of a medical-grade poly L-lactide-co-poly ε-caprolactone (PLCL) scaffold to support adipose tissue and vascular regeneration. Deploying FDM 3D-printing, we produced a bioresorbable porous scaffold with interconnected pore networks to facilitate nutrient and oxygen diffusion. The compressive modulus of printed scaffold mimicked the mechanical properties of native adipose tissue. In vitro assays demonstrated that PLCL scaffolds or their degradation products supported differentiation of preadipocytes into viable mature adipocytes under appropriate induction. Interestingly, the chorioallantoic membrane assay revealed vascular invasion inside the porous scaffold, which represented a guiding structure for ingrowing blood vessels. Then, lipoaspirate-seeded scaffolds were transplanted subcutaneously into the dorsal region of immunocompetent rats (n = 16) for 1 or 2 months. The volume of adipose tissue was maintained inside the scaffold over time. Histomorphometric evaluation discovered small- and normal-sized perilipin+ adipocytes (no hypertrophy) classically organized into lobular structures inside the scaffold. Adipose tissue was surrounded by discrete layers of fibrous connective tissue associated with CD68+ macrophage patches around the scaffold filaments. Adipocyte viability, assessed via TUNEL staining, was sustained by the presence of a high number of CD31-positive vessels inside the scaffold, confirming the CAM results. Overall, our study provides proof that 3D-printed PLCL scaffolds can be used to improve fat graft volume preservation and vascularization, paving the way for new therapeutic options for soft-tissue defects.
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Affiliation(s)
- Amélia Jordao
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Damien Cléret
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Mélanie Dhayer
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
| | - Mégann Le Rest
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Shengheng Cao
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Alexandre Rech
- University of Lille, Faculté de Pharmacie, Plateau RMN, UFR3S, F-59000 Lille, France
| | - Nathalie Azaroual
- University of Lille, ULR 7365–GRITA–Groupe de Recherche Sur Les Formes Injectables Et Les Technologies Associées, F-59000 Lille, France;
| | - Anne-Sophie Drucbert
- U 1008 Controlled Drug Delivery Systems and Biomaterials, Inserm, F-59000 Lille, France
| | | | - Salim Dekiouk
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Centre de Bio-Pathologie, Banque de Tissus, CHU Lille, F-59000 Lille, France
| | - Nicolas Germain
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Centre de Bio-Pathologie, Banque de Tissus, CHU Lille, F-59000 Lille, France
| | - Julien Payen
- Lattice Medical, 80 rue du Docteur Yersin, F-59120 Loos, France
| | - Pierre Guerreschi
- U 1008 Controlled Drug Delivery Systems and Biomaterials, Inserm, F-59000 Lille, France
- Service de Chirurgie Plastique, CHU Lille, F-59000 Lille, France
| | - Philippe Marchetti
- UMR9020–UMR-S 1277–Canther–Cancer Heterogeneity, Plasticity and Resistance to Therapies, CNRS, Inserm, CHU Lille, Oncolille, University Lille, F-59000 Lille, France; (A.J.); (N.G.)
- Centre de Bio-Pathologie, Banque de Tissus, CHU Lille, F-59000 Lille, France
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Sharp O, Johal KS, Morgan M, Ramakrishnan VV. Primary lipofilling as an adjunct in transverse upper gracilis flap breast reconstruction. J Plast Reconstr Aesthet Surg 2023; 86:1-7. [PMID: 37634487 DOI: 10.1016/j.bjps.2023.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/18/2023] [Indexed: 08/29/2023]
Abstract
In many centres, the myocutaneous transverse upper gracilis (TUG) flap represents an alternative choice in autologous breast reconstruction when abdominal tissue is unavailable. However, a single TUG flap may be volume deficient, particularly in the upper pole. We describe the application of simultaneous lipofilling to the pectoralis major muscle at the index procedure and present our decision-making algorithm, technique and outcomes. A retrospective review of all TUG flaps between January 2011 and May 2021 was conducted. Patient demographics, volume of primary and any subsequent fat grafting and complications were recorded. A total of 183 patients (242 TUG flaps) were included in this study. Of these; 130 patients were reconstructed with single TUG flaps, 16 patients received a single TUG flap with immediate lipofilling, and 37 patients underwent stacked, double TUG flap reconstructions. Of the 242 flaps, there were 2 flap losses (<1%), neither of which occurred in the immediate lipofilling cohort. Among the 130 single TUG patients, 28 (21.5%) required a cumulative total of 40, and a mean of 1.4, secondary lipofilling procedures. The immediate lipofilling patients were injected with a mean of 42 ml fat (range: 20-80 ml). In this group, only 2 of 16 patients required secondary lipofilling. The mean follow-up was 67 months (17-141). Primary lipofilling may reduce the need for secondary revisional procedures and appears safe at the index operation, adds little operative time and has negligible donor site morbidity. In patients where a second (stacked) flap would add unnecessary volume and complexity, it can be considered a useful adjunct.
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Affiliation(s)
- O Sharp
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, United Kingdom.
| | - K S Johal
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, United Kingdom
| | - M Morgan
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, United Kingdom
| | - V V Ramakrishnan
- St Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, United Kingdom
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17
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Oskarsdotter K, Nordgård CT, Apelgren P, Säljö K, Solbu AA, Eliasson E, Sämfors S, Sætrang HEM, Asdahl LC, Thompson EM, Troedsson C, Simonsson S, Strand BL, Gatenholm P, Kölby L. Injectable In Situ Crosslinking Hydrogel for Autologous Fat Grafting. Gels 2023; 9:813. [PMID: 37888386 PMCID: PMC10606883 DOI: 10.3390/gels9100813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Autologous fat grafting is hampered by unpredictable outcomes due to high tissue resorption. Hydrogels based on enzymatically pretreated tunicate nanocellulose (ETC) and alginate (ALG) are biocompatible, safe, and present physiochemical properties capable of promoting cell survival. Here, we compared in situ and ex situ crosslinking of ETC/ALG hydrogels combined with lipoaspirate human adipose tissue (LAT) to generate an injectable formulation capable of retaining dimensional stability in vivo. We performed in situ crosslinking using two different approaches; inducing Ca2+ release from CaCO3 microparticles (CMPs) and physiologically available Ca2+ in vivo. Additionally, we generated ex situ-crosslinked, 3D-bioprinted hydrogel-fat grafts. We found that in vitro optimization generated a CMP-crosslinking system with comparable stiffness to ex situ-crosslinked gels. Comparison of outcomes following in vivo injection of each respective crosslinked hydrogel revealed that after 30 days, in situ crosslinking generated fat grafts with less shape retention than 3D-bioprinted constructs that had undergone ex situ crosslinking. However, CMP addition improved fat-cell distribution and cell survival relative to grafts dependent on physiological Ca2+ alone. These findings suggested that in situ crosslinking using CMP might promote the dimensional stability of injectable fat-hydrogel grafts, although 3D bioprinting with ex situ crosslinking more effectively ensured proper shape stability in vivo.
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Affiliation(s)
- Kristin Oskarsdotter
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Catherine T. Nordgård
- Department of Biotechnology and Food Science, Norwegian Biopolymer Laboratory (NOBIPOL), Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Peter Apelgren
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
- Department of Plastic Surgery, Region Västra Götaland, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Karin Säljö
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
- Department of Plastic Surgery, Region Västra Götaland, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Anita A. Solbu
- Department of Biotechnology and Food Science, Norwegian Biopolymer Laboratory (NOBIPOL), Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Edwin Eliasson
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, 412 96 Gothenburg, Sweden
| | - Sanna Sämfors
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, 412 96 Gothenburg, Sweden
| | | | - Lise Cathrine Asdahl
- DuPont Nutrition Norge AS d/b/a NovaMatrix, Postboks 223, 1377 Billingstad, Norway
| | - Eric M. Thompson
- Ocean TuniCell AS, 5258 Blomsterdalen, Norway
- Department of Biological Sciences, University of Bergen, 5006 Bergen, Norway
| | | | - Stina Simonsson
- Department of Medicinal Chemistry & Cell Biology, Institution of Biomedicine, Sahlgrenska University Hospital, 405 30 Gothenburg, Sweden
| | - Berit L. Strand
- Department of Biotechnology and Food Science, Norwegian Biopolymer Laboratory (NOBIPOL), Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | | | - Lars Kölby
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
- Department of Plastic Surgery, Region Västra Götaland, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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18
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Vesole AS, Shapiro SB, Samy RN, Pensak ML, Breen JT. Quantification of Fat Graft Retention in the Translabyrinthine Approach Using Magnetic Resonance Imaging Volumetric Analysis. Otol Neurotol 2023; 44:e428-e434. [PMID: 37315233 DOI: 10.1097/mao.0000000000003916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To characterize the viability and volume of autologous free fat grafts over time, determine clinical/patient factors that may affect free fat graft survival and assess the clinical impact of free fat graft survival on patient outcomes in the translabyrinthine approach for lateral skull base tumor resection. STUDY DESIGN Retrospective chart review. SETTING Tertiary neurotologic referral center. PATIENTS Forty-two adult patients who underwent translabyrinthine craniotomy for resection of a lateral skull base tumor with the mastoid defect filled by autologous abdominal fat graft and subsequently underwent more than one postoperative magnetic resonance imaging (MRI) scans of the brain. INTERVENTIONS Mastoid obliteration with abdominal fat after craniotomy, postoperative MRI. MAIN OUTCOME MEASURES Rate of fat graft volume loss, fraction retention of original fat graft volume, initial fat graft volume, time to steady-state fat graft retention, rate of postoperative cerebrospinal fluid (CSF) leak, and/or pseudomeningocele formation. RESULTS Patients were followed postoperatively with MRI for a mean of 31.6 months with a mean of 3.2 postoperative MRIs per patient. Initial graft size was a mean of 18.7 cm3 with a steady-state fat graft retention of 35.5%. Steady-state graft retention (<5% loss per year) was achieved at a mean of 24.96 months postoperatively. No significant association was found in multivariate regression analysis of clinical factors impact on fat graft retention and CSF leak/pseudomeningocele formation. CONCLUSIONS In the use of autologous abdominal free fat graft for filling mastoid defects after translabyrinthine craniotomy, there is a logarithmic decline in fat graft volume over time, reaching steady state in 2 years. Rates of CSF leak or pseudomeningocele formation were not significantly affected by initial volume of the fat graft, rate of fat graft resorption, nor the fraction of original fat graft volume at steady state. In addition, no analyzed clinical factors significantly influenced fat graft retention over time.
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Affiliation(s)
- Adam S Vesole
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Scott B Shapiro
- Department of Otolaryngology-Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ravi N Samy
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Myles L Pensak
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Joseph T Breen
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Jacksonville, Jacksonville, Florida
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19
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Aso M, Yamamoto TT, Kuroda M, Wada J, Kubota Y, Ishikawa K, Maezawa Y, Teramoto N, Tawada A, Asada S, Aoyagi Y, Kirinashizawa M, Onitake A, Matsuura Y, Yasunaga K, Konno SI, Nishino K, Yamamoto M, Miyoshi J, Kobayashi N, Tanio M, Ikeuchi T, Igari H, Mitsukawa N, Hanaoka H, Yokote K, Saito Y. First-in-human autologous implantation of genetically modified adipocytes expressing LCAT for the treatment of familial LCAT deficiency. Heliyon 2022; 8:e11271. [PMID: 36387451 PMCID: PMC9663876 DOI: 10.1016/j.heliyon.2022.e11271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/21/2022] [Accepted: 10/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Familial lecithin: cholesterol acyltransferase (LCAT) deficiency (FLD) is a severe inherited disease without effective treatment. Patients with FLD develop severe low HDL, corneal opacity, hemolytic anemia, and renal injury. Objective We developed genetically modified adipocytes (GMAC) secreting LCAT (LCAT-GMAC) for ex vivo gene therapy. GMACs were prepared from the patient’s adipocytes to express LCAT by retroviral gene transduction to secrete functional enzymes. This study aimed to evaluate the safety and efficacy of LCAT-GMAC implantation in an FLD patient. Methods Proliferative preadipocytes were obtained from a patient using a ceiling culture and retrovirally transduced with LCAT. After obtaining enough cells by expansion culture of the transduced cells, the resulting LCAT-GMACs were implanted into a patient with FLD. To evaluate the safety and efficacy, we analyzed the outcome of the autologous implantation for 24 weeks of observation and subsequent 240 weeks of the follow-up periods. Results This first-in-human autologous implantation of LCAT-GMACs was shown to be safe by evaluating adverse events. The LCAT-GMAC implantation increased serum LCAT activity by approximately 50% of the baseline and sustained over three years. Consistent with increased LCAT activity, intermediate-density lipoprotein (IDL) and free cholesterol levels of the small and very small HDL fractions decreased. We found the hemoglobin/haptoglobin complex in the hemolyzed pre-implantation sera of the patient. After one week of the implantation, the hemoglobin/haptoglobin complex almost disappeared. Immediately after the implantation, the patient's proteinuria decreased temporarily to mild levels and gradually increased to the baseline. At 48 weeks after implantation, the patient's proteinuria deteriorated with the development of mild hypertension. By the treatment with antihypertensives, the patient's blood pressure normalized. With the normalization of blood pressure, the proteinuria rapidly decreased to mild proteinuria levels. Conclusions LCAT-GMAC implantation in a patient with FLD is shown to be safe and appears to be effective, in part, for treating anemia and proteinuria in FLD.
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Affiliation(s)
| | | | - Masayuki Kuroda
- Center for Advanced Medicine, Chiba University Hospital, 2608677 Chiba, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 7008530 Okayama, Japan
| | - Yoshitaka Kubota
- Department of Plastic and Reconstructive Surgery, Chiba University, Faculty of Medicine, 2608670 Chiba, Japan
| | - Ko Ishikawa
- Department of Endocrinology, Hematology, and Gerontology, Chiba University, Graduates School of Medicine and Department of Diabetes, Metabolism, and Endocrinology, Chiba University Hospital, 2608670 Chiba, Japan
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology, and Gerontology, Chiba University, Graduates School of Medicine and Department of Diabetes, Metabolism, and Endocrinology, Chiba University Hospital, 2608670 Chiba, Japan
| | - Naoya Teramoto
- Department of Endocrinology, Hematology, and Gerontology, Chiba University, Graduates School of Medicine and Department of Diabetes, Metabolism, and Endocrinology, Chiba University Hospital, 2608670 Chiba, Japan
| | - Ayako Tawada
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, 2608670 Chiba, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | - Takayuki Ikeuchi
- Chiba University Hospital Clinical Research Center, 2608677 Chiba, Japan
| | - Hidetoshi Igari
- Division of Infection Control, Chiba University Hospital, 2608677 Chiba, Japan
| | - Nobuyuki Mitsukawa
- Department of Plastic and Reconstructive Surgery, Chiba University, Faculty of Medicine, 2608670 Chiba, Japan
| | - Hideki Hanaoka
- Chiba University Hospital Clinical Research Center, 2608677 Chiba, Japan
| | - Koutaro Yokote
- Department of Endocrinology, Hematology, and Gerontology, Chiba University, Graduates School of Medicine and Department of Diabetes, Metabolism, and Endocrinology, Chiba University Hospital, 2608670 Chiba, Japan
- Corresponding author.
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20
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Zhang X, Jin X, Li Y, Xu M, Yao Y, Liu K, Ma C, Zhang Y, Ru J, He Y, Gao J. Macrophage-mediated extracellular matrix remodeling after fat grafting in nude mice. FASEB J 2022; 36:e22550. [PMID: 36098482 DOI: 10.1096/fj.202200037r] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 08/12/2022] [Accepted: 09/02/2022] [Indexed: 11/11/2022]
Abstract
Clinical unpredictability and variability following fat grafting remain non-negligible problems due to the unknown mechanism of grafted fat retention. The role of the extracellular matrix (ECM), which renders cells with structural and biochemical support, has been ignored. This study aimed to clarify the ECM remodeling process, related cellular events, and the spatiotemporal relationship between ECM remodeling and adipocyte survival and adipogenesis after fat grafting. Labeled Coleman fat by the matrix-tracing technique was grafted in nude mice. The ECM remodeling process and cellular events were assessed in vivo. The related cytokines were evaluated by qRT-PCR. An in vitro cell migration assay was performed to verify the chemotactic effect of M2-like macrophages on fibroblasts. The results demonstrated that in the periphery, most of the adipocytes of the graft survived or regenerated, and the graft-derived ECM was gradually replaced by the newly-formed ECM. In the central parts, most adipocytes in the grafts died shortly after, and a small part of the graft-derived and newly-formed ECM was expressed with irregular morphology. Adipose ECM remodeling is associated with increased infiltration of macrophages and fibroblasts, as well as up-regulated expression of cytokines in the adipose tissue. To sum up, our results describe the various preservation mode of fat grafts after transplantation and underscore the importance of macrophage-mediated ECM remodeling in graft preservation after fat grafting. The appreciation and manipulation of underlying mechanisms that are operant in this setting stand to explore new therapeutic approaches and improve clinical outcomes of fat grafting.
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Affiliation(s)
- Xiangdong Zhang
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoxuan Jin
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yibao Li
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mimi Xu
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yao Yao
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Kaiyang Liu
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chijuan Ma
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuchen Zhang
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiangjiang Ru
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yunfan He
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianhua Gao
- Department of Plastic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Bianconi E, Tassinari R, Alessandrini A, Ragazzini G, Cavallini C, Abruzzo PM, Petrocelli G, Pampanella L, Casadei R, Maioli M, Canaider S, Facchin F, Ventura C. Cytochalasin B Modulates Nanomechanical Patterning and Fate in Human Adipose-Derived Stem Cells. Cells 2022; 11:cells11101629. [PMID: 35626666 PMCID: PMC9139657 DOI: 10.3390/cells11101629] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Cytoskeletal proteins provide architectural and signaling cues within cells. They are able to reorganize themselves in response to mechanical forces, converting the stimuli received into specific cellular responses. Thus, the cytoskeleton influences cell shape, proliferation, and even differentiation. In particular, the cytoskeleton affects the fate of mesenchymal stem cells (MSCs), which are highly attractive candidates for cell therapy approaches due to their capacity for self-renewal and multi-lineage differentiation. Cytochalasin B (CB), a cyto-permeable mycotoxin, is able to inhibit the formation of actin microfilaments, resulting in direct effects on cell biological properties. Here, we investigated for the first time the effects of different concentrations of CB (0.1–10 μM) on human adipose-derived stem cells (hASCs) both after 24 h (h) of CB treatment and 24 h after CB wash-out. CB influenced the metabolism, proliferation, and morphology of hASCs in a dose-dependent manner, in association with progressive disorganization of actin microfilaments. Furthermore, the removal of CB highlighted the ability of cells to restore their cytoskeletal organization. Finally, atomic force microscopy (AFM) revealed that cytoskeletal changes induced by CB modulated the viscoelastic properties of hASCs, influencing their stiffness and viscosity, thereby affecting adipogenic fate.
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Affiliation(s)
- Eva Bianconi
- Laboratory of Cardiovascular Biology, IRCCS Ospedale Policlinico San Martino, Viale Rosanna Benzi 10, 16132 Genova, Italy;
- National Laboratory of Molecular Biology and Stem Cell Bioengineering of the National Institute of Biostructures and Biosystems (NIBB)—Eldor Lab, Innovation Accelerator, CNR, Via Piero Gobetti 101, 40129 Bologna, Italy; (R.T.); (C.C.); (C.V.)
| | - Riccardo Tassinari
- National Laboratory of Molecular Biology and Stem Cell Bioengineering of the National Institute of Biostructures and Biosystems (NIBB)—Eldor Lab, Innovation Accelerator, CNR, Via Piero Gobetti 101, 40129 Bologna, Italy; (R.T.); (C.C.); (C.V.)
| | - Andrea Alessandrini
- Department of Physics, Informatics and Mathematics, University of Modena and Reggio Emilia, Via Campi 213/A, 41125 Modena, Italy; (A.A.); (G.R.)
- CNR-Nanoscience Institute-S3, Via Campi 213/A, 41125 Modena, Italy
| | - Gregorio Ragazzini
- Department of Physics, Informatics and Mathematics, University of Modena and Reggio Emilia, Via Campi 213/A, 41125 Modena, Italy; (A.A.); (G.R.)
- CNR-Nanoscience Institute-S3, Via Campi 213/A, 41125 Modena, Italy
| | - Claudia Cavallini
- National Laboratory of Molecular Biology and Stem Cell Bioengineering of the National Institute of Biostructures and Biosystems (NIBB)—Eldor Lab, Innovation Accelerator, CNR, Via Piero Gobetti 101, 40129 Bologna, Italy; (R.T.); (C.C.); (C.V.)
| | - Provvidenza Maria Abruzzo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (P.M.A.); (G.P.); (L.P.)
| | - Giovannamaria Petrocelli
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (P.M.A.); (G.P.); (L.P.)
| | - Luca Pampanella
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (P.M.A.); (G.P.); (L.P.)
| | - Raffaella Casadei
- Department for Life Quality Studies (QuVi), University of Bologna, Corso D’Augusto 237, 47921 Rimini, Italy;
| | - Margherita Maioli
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy;
| | - Silvia Canaider
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (P.M.A.); (G.P.); (L.P.)
- Correspondence: (S.C.); (F.F.); Tel.: +39-051-2094114 (S.C.); +39-051-2094104 (F.F.)
| | - Federica Facchin
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (P.M.A.); (G.P.); (L.P.)
- Correspondence: (S.C.); (F.F.); Tel.: +39-051-2094114 (S.C.); +39-051-2094104 (F.F.)
| | - Carlo Ventura
- National Laboratory of Molecular Biology and Stem Cell Bioengineering of the National Institute of Biostructures and Biosystems (NIBB)—Eldor Lab, Innovation Accelerator, CNR, Via Piero Gobetti 101, 40129 Bologna, Italy; (R.T.); (C.C.); (C.V.)
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (P.M.A.); (G.P.); (L.P.)
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Winkler NS, Tran A, Kwok AC, Freer PE, Fajardo LL. Autologous Fat Grafting to the Breast: An Educational Review. JOURNAL OF BREAST IMAGING 2022; 4:209-221. [PMID: 38422423 DOI: 10.1093/jbi/wbab055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Indexed: 03/02/2024]
Abstract
Autologous fat grafting (AFG) is a technique that is increasingly utilized in breast cosmetic and reconstructive surgery. In this procedure, fat is aspirated by liposuction from one area of the body and injected into the breast. The procedure and process of AFG has evolved over the last few decades, leading to more widespread use, though there is no standard method. Autologous fat grafting is generally considered a safe procedure but may result in higher utilization of diagnostic imaging due to development of palpable lumps related to fat necrosis. Imaging findings depend on surgical technique but typically include bilateral, symmetric, retromammary oil cysts and scattered dystrophic and/or coarse calcifications when AFG is used for primary breast augmentation. More focal findings occur when AFG is used to improve specific areas of cosmetic deformity, scarring, or pain following breast cancer surgery. As with any cause of fat necrosis, imaging features tend to appear more benign over time, with development of rim calcifications associated with oil cysts and a shift in echogenicity of oil cyst contents on ultrasound towards anechoic in some cases. This article reviews the AFG procedure, uses, complications, and imaging findings.
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Affiliation(s)
- Nicole S Winkler
- University of Utah and Huntsman Cancer Institute, Department of Radiology and Imaging Sciences, Salt Lake City, UT, USA
| | - Alexander Tran
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Alvin C Kwok
- University of Utah and Huntsman Cancer Institute, Department of Plastic Surgery, Salt Lake City, UT, USA
| | - Phoebe E Freer
- University of Utah and Huntsman Cancer Institute, Department of Radiology and Imaging Sciences, Salt Lake City, UT, USA
| | - Laurie L Fajardo
- University of Utah and Huntsman Cancer Institute, Department of Radiology and Imaging Sciences, Salt Lake City, UT, USA
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Çakan D, Çiloglu S, Keskin ER. The Effect of Locally Delivered Apocynin on Fat Graft Survival in an Experimental Rat Animal Model. Facial Plast Surg 2022; 38:419-427. [PMID: 35021235 DOI: 10.1055/a-1738-1194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES We aimed to investigate the efficacy of locally delivered apocynin on fat graft survival in an experimental autologous fat grafting (AFG) model created in rats. METHODS Twenty-one Wistar albino male rats were included in this study. The 0.647 g mean weight grafts were harvested from the inguinal region and transferred to the nape of every rat. The subjects were randomly separated into three groups. Saline, dimethyl sulfoxide (DMSO) and apocynin, a dose of 20 mg/kg, solutions were applied once a day for 2 weeks. After 3 months, the rats were sacrificed. The evaluation of physical measurements (weight and volume) and survival rates of the grafts for volume (SRV) and weight (SRW), the viable cell count (VC) with the MTT assay, and histopathological parameters were done. RESULTS All biophysical parameters were found to be significantly higher in the apocynin group compared to other groups (p < .05). In the MTT test, the saline group was normalized to 100%. According to this, DMSO and apocynin groups' means were 106% and 163%, respectively. The VC was significantly higher in the apocynin group than the other groups (p < .05). The VC was significantly higher in the DMSO group than in the saline group (p < .05). No significant difference was found in other comparisons performed according to biophysical and histopathological parameters (p > .05). CONCLUSION The locally delivered apocynin decreases fat graft volume loss in an experimental AFG model. Consequently, apocynin can be used as an effective substance to increase graft survival.
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Affiliation(s)
- Doğan Çakan
- ENT Department, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sinem Çiloglu
- plastic and aesthetic surgery, Istsanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Jeyaraman M, Muthu S, Sharma S, Ganta C, Ranjan R, Jha SK. Nanofat: A therapeutic paradigm in regenerative medicine. World J Stem Cells 2021; 13:1733-1746. [PMID: 34909120 PMCID: PMC8641019 DOI: 10.4252/wjsc.v13.i11.1733] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/15/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Adipose tissue is a compact and well-organized tissue containing a heterogeneous cellular population of progenitor cells, including mesenchymal stromal cells. Due to its availability and accessibility, adipose tissue is considered a “stem cell depot.” Adipose tissue products possess anti-inflammatory, anti-fibrotic, anti-apoptotic, and immunomodulatory effects. Nanofat, being a compact bundle of stem cells with regenerative and tissue remodeling potential, has potential in translational and regenerative medicine. Considering the wide range of applicability of its reconstructive and regenerative potential, the applications of nanofat can be used in various disciplines. Nanofat behaves on the line of adipose tissue-derived mesenchymal stromal cells. At the site of injury, these stromal cells initiate a site-specific reparative response comprised of remodeling of the extracellular matrix, enhanced and sustained angiogenesis, and immune system modulation. These properties of stromal cells provide a platform for the usage of regenerative medicine principles in curbing various diseases. Details about nanofat, including various preparation methods, characterization, delivery methods, evidence on practical applications, and ethical concerns are included in this review. However, appropriate guidelines and preparation protocols for its optimal use in a wide range of clinical applications have yet to be standardized.
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Affiliation(s)
- Madhan Jeyaraman
- Department of Biotechnology, School of Engineering and Technology, Sharda University , Greater Noida 201306, Uttar Pradesh, India
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida 201306, Uttar Pradesh, India
- Indian Stem Cell Study Group, Lucknow 226010, Uttar Pradesh, India
| | - Sathish Muthu
- Department of Biotechnology, School of Engineering and Technology, Sharda University , Greater Noida 201306, Uttar Pradesh, India
- Indian Stem Cell Study Group, Lucknow 226010, Uttar Pradesh, India
- Department of Orthopaedics, Government Medical College and Hospital, Dindigul 624001, Tamil Nadu, India
| | - Shilpa Sharma
- Indian Stem Cell Study Group, Lucknow 226010, Uttar Pradesh, India
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, New Delhi, India
| | - Charan Ganta
- Indian Stem Cell Study Group, Lucknow 226010, Uttar Pradesh, India
- Department of Stem Cells and Regenerative Medicine, Kansas State University, Manhattan, United States 10002, United States
| | - Rajni Ranjan
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida 201306, Uttar Pradesh, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University , Greater Noida 201306, Uttar Pradesh, India
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Molitor M, Trávníčková M, Měšťák O, Christodoulou P, Sedlář A, Bačáková L, Lucchina S. The Influence of High and Low Negative Pressure Liposuction and Various Harvesting Techniques on the Viability and Function of Harvested Cells-a Systematic Review of Animal and Human Studies. Aesthetic Plast Surg 2021; 45:2379-2394. [PMID: 33876289 DOI: 10.1007/s00266-021-02249-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND An understanding of fat grafting methodology, techniques and patient-related factors is crucial when considering fat grafting. Multiple factors can influence the success of a fat graft and consequently the outcome of the procedure. The aim of this systematic review is to elucidate the influence of negative pressure and various techniques of fat harvesting on the viability and function of cells, particularly adipocytes and adipose-derived stem cells. METHODS We conducted a literature search from 1975 to 2020 using the PubMed bibliography, ScienceDirect, SCOPUS and the Google Scholar databases which produced 168,628 articles on the first pass. After applying all the exclusion criteria by two independent reviewers, we were left with 21 articles (level IV of Oxford Centre for Evidence-Based Studies and Grade C of Grade Practice Recommendation from the American Society of Plastic Surgeons) on which this review is based. RESULTS From 11 studies focused on different negative pressures, no one found using high negative pressure advantageous. Summarising 13 studies focused on various harvesting techniques (excision, syringe, and pump-machine), most often equal results were reported, followed by excision being better than either syringe or liposuction. CONCLUSION From our systematic review, we can conclude that the low negative pressure seems to yield better results and that the excision seems to be the most sparing method for fat graft harvesting. However, we have to point out that this conclusion is based on a very limited number of statistically challengeable articles and we recommend well-conducted further research. LEVEL OF EVIDENCE III 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 .
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Affiliation(s)
- Martin Molitor
- Department of Plastic Surgery, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Budinova 67/2, 180 81, Prague 8-Liben, Czech Republic.
| | - Martina Trávníčková
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4-Krc, Czech Republic
| | - Ondřej Měšťák
- Department of Plastic Surgery, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Budinova 67/2, 180 81, Prague 8-Liben, Czech Republic
| | - Petros Christodoulou
- Department of Plastic Surgery, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Budinova 67/2, 180 81, Prague 8-Liben, Czech Republic
| | - Antonín Sedlář
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4-Krc, Czech Republic
| | - Lucie Bačáková
- Department of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague 4-Krc, Czech Republic
| | - Stefano Lucchina
- Hand Unit, General Surgery Department, Locarno's Regional Hospital, Via Ospedale 1, 6600, Locarno, Switzerland
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Chen Q, Liu S, Cao L, Yu M, Wang H. Effects of macrophage regulation on fat grafting survival: Improvement, mechanisms, and potential application-A review. J Cosmet Dermatol 2021; 21:54-61. [PMID: 34129721 DOI: 10.1111/jocd.14295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/08/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Autologous fat grafting has become a popular tool in plastic surgery to solve soft tissue defects and achieve skin rejuvenation, but the volume loss after transplantation remains a disturbing problem. In recent years, some new strategies have improved the outcome to some extent, but the fat graft retention is still far from ideal, so there remains a wide development prospect in this field. Macrophages are closely related to the local microenvironment and tissue regeneration, and their role in fat grafting has been increasingly highlighted. AIMS This article was aimed to review the efficacy, possible mechanisms, and potential application of macrophage regulation on fat grafting, as well as concerns and future perspectives of this filed. METHODS A retrospective review of the published data was conducted. RESULTS Most studies indicated that up-regulating M2 macrophages during fat grafting would improve fat retention via promoting neovascularization. M2 macrophages could secrete several pro-angiogenic factors, accelerate extracellular matrix (ECM) remodeling, and directly function on endothelial cells to encourage vascular expansion. In addition, macrophages could influence the proliferation, apoptosis, and adipogenic differentiation of preadipocytes. CONCLUSIONS During autologous fat grafting, appropriately regulating macrophages may become a promising method to increase fat retention. Nevertheless, the M2 macrophage polarizing agents, treatment opportunity, and contraindications require further discussion. We hope our work could promote more in-depth studies in this field, and we are looking forward to a standard procedure for the macrophage therapy in clinical practice.
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Affiliation(s)
- Qiuyu Chen
- State Key Laboratory of Oral Diseases, Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuo Liu
- State Key Laboratory of Oral Diseases, Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lideng Cao
- State Key Laboratory of Oral Diseases, Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mei Yu
- State Key Laboratory of Oral Diseases, Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hang Wang
- State Key Laboratory of Oral Diseases, Department of Cosmetic and Plastic Surgery, Oral and Maxillofacial Surgery, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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