Abstract
A recent rise in the use of autologous fat transfer for soft tissue augmentation has paralleled the increasing popularity of liposuction body contouring. This creates a readily available and inexpensive product for lipografting, which is the application of lipoaspirated material. Consistent scientific proof about the long-term viability of the transferred fat is not available. Clinically, there is a reabsorption rate which has been reported to range from 20 to 90%. Results can be unpredictable with overcorrection and regular need for additional interventions. In this review, adipogenesis physiology and the adipogenic cascade from adipose-derived stem cells to adult adipocytes is extensively described to determine various procedures involved in the fat grafting technique. Variables in structure and physiology, adipose tissue harvesting- and processing techniques, and the preservation of fat grafts are taken into account to collect reproducible scientific data to establish standard in vitro and in vivo models for experimental fat grafting. Adequate histological staining for fat tissue, immunohistochemistry and viability assays should be universally used in experiments to be able to produce comparative results. By analysis of the applied methods and comparison to similar experiments, a conclusion concerning the ideal technique to improve clinical outcome is proposed.
Highlights
A recent rise in the use of autologous fat transfer for soft tissue augmentation has paralleled the increasing popularity of liposuction body contouring
Adipocytes derive from multipotent mesenchymal stem cells, conventionally called adipose-derived stem cells (ASCs)
No morphological difference can be made between the pre-adipocyte and its precursor, but the cell has lost its potential to differentiate into other cell types
Summary
According to the World Health Organization, the incidence of obesity has tripled since 1975. Late markers of differentiation, such as glycerol-3-phosphate dehydrogenase (G3PDH) and fatty acid synthetase (FAS) are detectable [5] During this adipogenic cascade, the signal transduction pathway is regulated by a large number of hormones, cytokines and growth factors. The basic organization of a white fat depot consists of mature adipocytes, stromal-vascular cells, blood vessels, lymph nodes and nerves. ASCs resemble the type of mesenchymal stem cells, that, since their original description in the 1960s [10,11], have been found in most adult tissues. The revascularization capacities of the fatty omentum on bowels or when used in sternal reconstruction are well described It is, amongst other reasons, the great synergistic potential between adipogenesis and angiogenesis in fat tissue that fuels the interest for using adipose tissue cells in tissue engineering
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