Viable Adipocytes Research Articles

Heat-Shock Protein 70 Overexpression in Adipose-Derived Stem Cells Enhances Fat Graft Survival.

Autologous fat grafting is a prevalent technique used for soft-tissue augmentation; however, the poor survival rate of the grafted tissue remains a drawback of this method. Although adipose-derived stem cells (ASCs) are an attractive candidate for enhancing graft retention, the poor posttransplantation viability of these cells limits their application. Here we investigated whether overexpression of the antiapoptotic protein heat-shock protein 70 (Hsp70) could enhance ASCs' therapeutic potential for fat transplant survival. Recombinant adenoviral vectors were used to overexpress Hsp70 in ASCs isolated from a healthy woman. The Hsp70 expression was assessed by quantitative real-time polymerase chain reaction and Western blot analyses. The adipose tissue granules aspirated from another woman were mixed with ASCs expressing green fluorescent protein (GFP)-tagged Hsp70 (group A) or GFP alone (group B), untreated ASCs (group C), and phosphate-buffered saline (group D). Fat mixtures were then injected subcutaneously into the backs of nude mice, and graft survival was compared after 3 months. Adipose-derived stem cells transduced with recombinant adenoviral vectors exhibited significantly increased Hsp70 expression in vitro. Meanwhile, weight retention analyses demonstrated that fat grafts using the group A cell population exhibited significantly higher survival rates than the other treatment groups in vivo. Moreover, histological analyses revealed that fat grafts containing GFP-Hsp70-expressing ASCs yielded significantly lower levels of tissue fibrosis and fat cysts/vacuoles, higher capillary densities, and increased numbers of viable adipocytes than the control groups. Our data indicate that Hsp70 overexpression enhances the efficacy of ASC therapy by improving the survival and quality of the transplanted fat tissues.

Purple corn silk: A potential anti-obesity agent with inhibition on adipogenesis and induction on lipolysis and apoptosis in adipocytes

Ethnopharmacological relevanceCorn silk or the stigma of Zea mays L. has traditionally been used in weight loss stimulation and treatment of cystitis, urinary infections and obesity. Purple corn silk, rich of polyphenolic substances, was reported on anti-diabetic and anti-obesity effect in animal studies. However, scientific evidence on mechanisms and targets of action of purple corn silk related to adipocyte life cycle has been limited. Aim of studyTo determine phytochemical compositions and investigate anti-obesity potential of the purple corn silk focusing on interruption of adipocyte life cycle; effect on pre-adipocyte proliferation, adipogenesis, adipocyte lipolysis, and apoptosis. Materials and methodsThe ethanolic purple corn silk extract (PCS) was prepared and investigated for phytochemical compositions by LC/MS/MS technique and anti-obesity potential using murine 3T3-L1 cell line. Using methyl thiazole tetrazolium (MTT) assay, the effects on pre-adipocytes and adipocyte viability and on pre-adipocytes proliferation at 24-, 48-, and 72-h incubation period were evaluated. In addition, anti-adipogenesis via inhibition on adipocyte differentiation and reduction of total lipid accumulation was evaluated using Oil Red O staining and spectrophotometric methods, respectively. The lipolysis effect was determined by measurement of glycerol released content using glycerol test kit after 48-h treatment of PCS to adipocytes. Apoptosis inductive effect was done by using 2-(4-Amidinophenyl)-6-indolecarbamidine dihydrochloride (DAPI) staining method. ResultsThe polyphenols including anthocyanins, quercetin and phenolic acids and derivatives were found as the major chemical compositions of the PCS. With multiple-stages interruption on the adipocyte life cycle, anti-obesity effect of PCS was interestingly demonstrated. When compared to the control, the PCS at concentration range between 250–1000 μg/mL showed anti-adipogenesis effect as expressing of significant inhibition on pre-adipocyte proliferation at all incubation period (43.52±5.28 – 75.51±9.09%) and significant decreasing of total lipid accumulation at concentration of 500μg/mL (80.22±6.58%) and 1000μg/mL (69.62±5.42%). Moreover, the PCS exhibited lipolysis and apoptosis inductive effect with dose dependent manner and significance at concentration of 1000μg/mL by increase of released glycerol content (173.88±6.13% of the control) and of nuclei condensing and apoptotic bodies (with relative apoptosis induction as 131.74±1.64% of the control). ConclusionOur data has evidenced the anti-obesity potential of PCS related interruption at multiple stages of adipocyte life cycle. Its potency was attributed to inhibition on adipocyte proliferation and adipogenesis as well as induction on lipolysis and apoptosis at high concentration. However, further in vivo investigation should be considered to insist the possibility in applications of PCS in prevention and treatment of obesity.

Comments on "The Effects of Fat Harvesting and Preparation, Air Exposure, Obesity, and Stem Cell Enrichment on Adipocyte Viability Prior to Graft Transplantation".

The authors provide a thorough investigation into the variables affecting adipocyte viability ahead of graft transplantation.1 While several reports have examined individual components of techniques used for fat harvest, processing, and injection in relation to adipocyte survival and fat graft retention, there is a lack of systematic and objective evaluation integrating all of these factors in one study. This study is novel in its inclusion of many such variables and it is certainly unique in its integration of them into a single study involving almost fifty patients. The authors evaluated low vs high pressure lipoaspiration, decantation vs centrifugation, high vs low gravitational force centrifugation, serial syringe transfer among dissimilar calibers, ambient air exposure, and use of local anesthetic. Of particular interest is the inclusion of findings illuminating the relative frailty of the hypertrophic adipocytes of obese individuals. Moreover, their findings regarding ASC enrichment corroborate the body of knowledge extoling the benefits of cell assisted lipotransfer in graft retention.2 Similar …

Response to "Comments on 'The Effects of Fat Harvesting and Preparation, Air Exposure, Obesity, and Stem Cell Enrichment on Adipocyte Viability Prior to Graft Transplantation'".

Response to "Comments on 'The Effects of Fat Harvesting and Preparation, Air Exposure, Obesity, and Stem Cell Enrichment on Adipocyte Viability Prior to Graft Transplantation'".

Exposure to Tumescent Solution Significantly Increases Phosphorylation of Perilipin in Adipocytes.

Lidocaine and epinephrine could potentially decrease adipocyte viability, but these effects have not been substantiated. The phosphorylation status of perilipin in adipocytes may be predictive of cell viability. Perilipin coats lipid droplets and restricts access of lipases; phospho-perilipin lacks this protective function. The authors investigated the effects of tumescent solution containing lidocaine and epinephrine on the phosphorylation status of perilipin in adipocytes. In this in vitro study, lipoaspirates were collected before and after tumescence from 15 women who underwent abdominoplasty. Fat samples were fixed, sectioned, and stained for histologic and immunohistochemical analyses. Relative phosphorylation of perilipin was inferred from pixel intensities of immunostained adipocytes observed with confocal microscopy. For adipocytes collected before tumescent infiltration, 10.08% of total perilipin was phosphorylated. In contrast, 30.62% of total perilipin was phosphorylated for adipocytes collected from tumescent tissue (P < .01). The tumescent technique increases the relative phosphorylation of perilipin in adipocytes, making these cells more vulnerable to lipolysis. Tumescent solution applied for analgesia or hemostasis of the donor site should contain the lowest possible concentrations of lidocaine and epinephrine. LEVEL OF EVIDENCE 5.

Analysis of Lipoasiprated Following Centrifugation

The success of lipotransfer strongly depends on the harvesting, processing, and placement of the lipoaspirated samples. This study was designed to assess the histomorphometric characteristics and viability of fat harvested using different techniques (wet and dry) following centrifugation, as described by Coleman. The study enrolled 85 consecutive, nonrandomized, healthy patients from March 2010 to December 2014 (45 males and 40 females). The mean age was 40 years (range, 18-59 years), and the mean body mass index was 25.8 (range, 24-32). The authors performed a histological analysis (hematoxylin/eosin), morphometry (ImageJ 1.33 free-share image analysis software), and a viability assessment (Trypan Blue exclusion test; Sigma-Aldrich, Milan, Italy) of the lipoaspirated samples. The hematoxylin and eosin-stained sections exhibited similar features; in particular, clear-cut morphological signs of adipocyte disruption, apoptosis, or necrosis were not detected in the examined samples. Morphometry confirmed the visual findings, and the values of the mean surface area of the adipocyte vacuoles were not significantly different. Additionally, the adipocyte viability was not significantly different in the analyzed fat tissue samples. The results from this study showed, for the first time, that there is not a reduction in the viability of fat grafts harvested with the dry or wet technique following centrifugation according to Coleman technique. Both methods of fat harvesting collect viable cells, which are not influenced by standard centrifugation. The fat grafts harvested and processed by this technique could be used in clinical settings without increasing the reabsorption rate. V.

The Effects of Fat Harvesting and Preparation, Air Exposure, Obesity, and Stem Cell Enrichment on Adipocyte Viability Prior to Graft Transplantation

Adipocyte viability is affected by fat preparation and processing methods, but rigorous and objective studies of these relationships are lacking. The authors conducted a comprehensive evaluation of variables affecting adipocyte viability prior to injection of fat at the recipient site. Lipoaspirates from 48 patients were processed by high or low vacuum pressure, decantation, electric or manual centrifugation, concentration with cotton gauze, washing, repeated syringe transfer, exposure to lidocaine, and exposure to air. The effects of these variables on adipocyte viability in vitro were ascertained with the MTT assay. The influences of patient obesity (ie, a body mass index [BMI] >30 kg/m2) and enrichment with stem cells on adipocyte viability also were determined. High vacuum pressure decreased adipocyte viability. Decantation yielded the highest cell viability, followed by washing, concentration with cotton gauze, and centrifugation. Exposure to concentrated lidocaine ambient air exposure, and transfer between syringes significantly decreased viability. Patient obesity was predictive of lower adipocyte viability regardless of processing method, whereas stem cell enrichment significantly improved viability (P < .0001). To maximize adipocyte viability, fat should be obtained with dilute local anesthetics and low vacuum pressure, and the lipoaspirate should be maintained in a closed system. To clear cellular debris and blood, the lipoaspirate should be prepared by washing, and the fat should be enriched with adipose stem cells. Decreased adipocyte viability should be expected when fat is harvested from patients with high BMIs.

Commentary on: The Effects of Fat Harvesting and Preparation, Air Exposure, Obesity, and Stem Cell Enrichment on Adipocyte Viability Prior to Graft Transplantation.

The authors provide a thorough investigation into the variables affecting adipocyte viability ahead of graft transplantation.1 While several reports have examined individual components of techniques used for fat harvest, processing, and injection in relation to adipocyte survival and fat graft retention, there is a lack of systematic and objective evaluation integrating all of these factors in one study. This study is novel in its inclusion of many such variables and it is certainly unique in its integration of them into a single study involving almost fifty patients. The authors evaluated low vs high pressure lipoaspiration, decantation vs centrifugation, high vs low gravitational force centrifugation, serial syringe transfer among dissimilar calibers, ambient air exposure, and use of local anesthetic. Of particular interest is the inclusion of findings illuminating the relative frailty of the hypertrophic adipocytes of obese individuals. Moreover, their findings regarding ASC enrichment corroborate the body of knowledge extoling the benefits of cell assisted lipotransfer in graft retention.2 Similar …

Remote Ischemic Preconditioning Recipient Tissues Improves the Viability of Murine Fat Transfer

Local ischemia before the development of recipient circulation may contribute to the highly variable long-term results of fat grafting. Remote ischemic preconditioning before adipose procurement augments the retention of fat grafts and limits subsequent liposclerosis. However, there is no literature examining what role remote ischemic preconditioning has on the fat graft recipient site. Subcutaneous adipose tissue from transgenic mice expressing green fluorescent protein/luciferase was injected into skin folds of wild-type mice. Donors and recipients experienced intermittent temporary hindlimb tourniquet application before harvest and transfer, respectively. The viability of the transferred tissue was examined over 28 days by luciferin bioluminescence and subsequent histologic analysis. There was a difference in bioluminescence at days 0, 14, and 28. The remote ischemic preconditioning donor or recipient mouse-alone groups demonstrated an approximately 2- to 3-fold increase in bioluminescence. Donor and recipient remote ischemic preconditioning had a 9-fold increase in bioluminescence. Histologic analysis at 28 days confirmed the presence of donor adipocytes, and they were gradually replaced by recipient inflammation and scar tissue. However, the amount of interstitial fibrosis was substantially less in the remote ischemic preconditioning groups. These findings were more pronounced when remote ischemic preconditioning was used for both donor and recipient mice. Remote ischemic preconditioning has the ability to increase the viability of donor adipocytes and limit interstitial fibrosis. More specifically, remote ischemic preconditioning treatment of both donated adipose tissue and recipient wound beds demonstrates the greatest overall adipose cellular viability and native architecture.

Skin Rejuvenation and Volume Enhancement with the Micro Superficial Enhanced Fluid Fat Injection (M-SEFFI) for Skin Aging of the Periocular and Perioral Regions.

Adipose-derived stromal and stem cells (ADSC) in autologous fat promises regenerative advantages, and injected into the dermal and subdermal layers, enhances rejuvenation and volume. However, extremely superficial fat injection with current techniques is limited. Efficacy and viability evaluation of fat harvested with extremely small side port (0.3 mm) cannulae without further tissue manipulation for the correction of aging/thin skin in the periocular and perioral regions. Micro-superficial enhanced fluid fat injection (M-SEFFI) harvests adipose tissue with a multi-perforated cannula (0.3 mm), and autologous platelet rich plasma (PRP) is added. The tissue is injected into the dermal region of the periocular and perioral zones. Efficacy and viability were evaluated by histological and cell culture analysis. Clinical assessment included retrospective evaluation according to 1 = no effect, 2 = fair effect, 3 = good effect, 4 = excellent effect. Between June 2014 and July 2015, 65 patients (7 men; mean age 49.7 years) were treated with M-SEFFI. No intraoperative complications or visible lumpiness were recorded. Analysis demonstrated mature, viable adipocytes with a strong stromal component. Following PRP addition, there was a greater proliferation noted in the M-SEFFI compared to the SEFFI (0.5 mm). Mean follow-up was 4.1 months. Clinical assessment by surgeons and patients at 1 month was 3.52 and 3.74, and 6 months 3.06 and 2.6 respectively. M-SEFFI is effective and viable for lump free skin rejuvenation and volume enhancement, through the extraction of smoother ADSC rich, autologous fat tissue that does not require further tissue manipulation, to correct skin aging. 4 Therapeutic.

Improvement of Fat Graft Survival with Autologous Bone Marrow Aspirate and Bone Marrow Concentrate: A One-Step Method.

Stem cells have proven to be beneficial to fat graft survival, but a one-step method of cell-assisted lipotransfer is still missing. In the present work, the authors improved the fat graft survival using bone marrow aspirate and bone marrow concentrate, to ensure that both liposuction and cell-assisted lipotransfer were included in the same procedure. Bone marrow aspirate was collected from the iliac crest of the rabbits. Bone marrow concentrate was obtained using density gradient centrifugation and labeled with PKH26 fluorescent cell linker. Rabbits were divided into three groups: group A, bone marrow aspirate; group B, bone marrow concentrate; and group C, phosphate-buffered saline buffer as a blank control. The implanted mixture contained 1.5 ml of adipose granule and 1 ml of bone marrow aspirate or bone marrow concentrate. The rabbits were subjected to fluorescence imaging in vivo at four time points. Grafts were harvested and analyzed at 4 weeks and 12 weeks after fat grafting. Bone marrow cell fluorescence signals were observed in the rabbits' injection regions during a follow-up of 12 weeks. The fat grafts of group A and B showed a better weight and volume retention, living quality, adipocyte viability, and angiogenesis after transplantation. The results of living tissue imaging also showed that the implanted bone marrow cells could contribute to fat graft survival by multilineage differentiation and could also contribute to adipogenesis and angiogenesis. Both bone marrow aspirate and bone marrow concentrate improved the survival and angiogenesis of grafted fat tissue.

Injected Implant of Uncultured Stromal Vascular Fraction Loaded Onto a Collagen Gel: In Vivo Study of Adipogenesis and Long-term Outcomes.

Stromal vascular fraction (SVF) cells were used to increase the efficacy of a newly formed adipose tissue in a collagen gel in vitro. However, the outcome of the seeded cells in the collagen gel in vivo remains unknown. We traced the SVF cells in the host tissue and evaluated the efficacy of SVF for fat tissue engineering. The aggregates implanted in the experimental and control groups were prepared by mixing SVF with the collagen gel and Dulbecco's modified Eagle medium with the collagen gel, respectively. The aggregates were implanted using a subcutaneous injection into the backs of immunodeficient mice. The aggregates were harvested 1, 2, 4, and 6 months after implantation; and 9 mice were euthanized each time. Macroscopic changes in the volume and wet weight of the aggregates were assessed. The formation of adipose tissue was studied using hematoxylin and eosin and Nile red staining. The origin and survival of adipocytes in the aggregates were examined through the immunostaining of leptin antibodies, DNA assay, and tracing of SVF cells by 1,1'-dioctadecyl-3,3,3',3'- tetramethylindocarbocyanine perchlorate labeling. The formation of adipose tissue was observed in all of the aggregates. Implanted human SVF cells remained in the experimental aggregates harvested after 1, 2, and 4 months but not after 6 months. At 6 months, viable adipocytes in both groups were of murine origin. Furthermore, at 6 months, the mean volume of the aggregate (P < 0.001) and the mean percentage of adipocytes (P < 0.001) were significantly higher in the experimental group than in the control group. Implanted SVF cells could not be traced in the aggregates harvested at 6 months but promoted the recruitment of host adipocytes to generate more adipose tissue in the experimental group than in the control group.

DHA induces mitochondria-mediated 3T3-L1 adipocyte apoptosis by down-regulation of Akt and ERK

Docosahexaenoic acid (DHA) possesses various bioactivities. However, the effects of DHA on adipocyte homeostasis remain unclear. Here the effects of DHA (0, 50, 100, 150 µM) on the apoptosis of mature 3T3-L1 adipocytes was investigated in order to elucidate potential mechanisms. It was shown that DHA decreased adipocyte viability, induced apoptosis, and reduced the cellular lipid content. DHA treatment also caused mitochondrial membrane potential (MMP) loss and caspase-3 activation, as well as the up-regulation of pro-apoptotic protein Bad and an increase in the Bax/Bcl-2 ratio. Additionally, treatment with DHA down-regulated the levels of CREB, total Akt, p-Akt, total ERK, and p-ERK. Our data confirmed that DHA induced mitochondria-dependent apoptosis in 3T3-L1 adipocytes and that the CREB/Akt and ERK signalling pathways were involved in DHA-triggered apoptosis, which provides new information for the development of anti-obesity strategies.

Identification of the Centrifuged Lipoaspirate Fractions Suitable for Postgrafting Survival.

The Coleman centrifugation procedure generates fractions with different adipocyte and progenitor cell densities. This study aimed to identify all fractions that are feasible for implantation. Human lipoaspirates were processed by Coleman centrifugation. The centrifugates were divided arbitrarily into upper, middle, and lower layers. Adipocyte viability, morphology, numbers of stromal vascular fraction cells, and adipose-derived mesenchymal stem cells of each layer were determined. The 12-week volume retention of subcutaneously implanted 0.3-ml lipoasperate of each layer was investigated in an athymic mice model. Most damaged adipocytes were located in the upper layers, whereas the intact adipocytes were distributed in the middle and lower layers. A gradient of stromal vascular fraction cell density was formed in the centrifugates. The implant volume retentions of samples from the upper, middle, and lower layers were 33.44 ± 5.9, 55.11 ± 4.4, and 71.2 ± 5.8 percent, respectively. Furthermore, the middle and lower layers contained significantly more adipose-derived stem cells than did the upper layer. The lower layer contains more viable adipocytes and stromal vascular fraction cells leading to the highest implant volume retention, whereas the most impaired cells are distributed in the upper layer, leading to the least volume retention. Although with a lower stromal vascular fraction content, the middle layer has a substantial number of intact adipocytes that are capable of retaining partial adipose tissue volume after implantation, suggesting that the middle layer may be an alternative fat source when large volumes of fat grafts are needed for transplantation.

What is the current optimal fat grafting processing technique? A systematic review.

With the advents of new processing techniques and new graft survival theories in fat grafting, the question is: Which processing technique is of preference? This study systematically reviewed literature regarding current techniques for processing fat grafts. PubMed, Embase, Cinahl, and Cochrane databases were searched until August 2015. Studies comparing different fat grafting processing techniques were included. Outcomes were viability of adipocytes, number of adipose-derived stromal/stem cells (ASC) and growth factors in vitro, volume and quality of the graft in animal studies, and satisfaction and volume retention in human studies. Thirty-five studies were included. Adipocyte viability and ASC numbers were the best using the gauze/towel technique (permeability principle) compared to centrifugation. With regard to centrifugation, the pellet contained more ASCs compared to the middle layer. The animal studies' and patients' satisfaction results were not distinctive. The only study assessing volume retention in humans showed that a wash filter device performed significantly better than centrifugation. In this study, processing techniques using permeability principles proved superior to centrifugation (reinforced gravity principle) regarding viability and ASC number. Due to the variety in study characteristics and reported outcome variables, however, none of the processing techniques in this study demonstrated clinical evidence of superiority.

Platelet-Rich Plasma Increases Growth and Motility of Adipose Tissue-Derived Mesenchymal Stem Cells and Controls Adipocyte Secretory Function.

ABSTRACTAdipose tissue‐derived mesenchymal stem cells (Ad‐MSC) and platelet derivatives have been used alone or in combination to achieve regeneration of injured tissues. We have tested the effect of platelet‐rich plasma (PRP) on Ad‐MSC and adipocyte function. PRP increased Ad‐MSC viability, proliferation rate and G1‐S cell cycle progression, by at least 7‐, 2‐, and 2.2‐fold, respectively, and reduced caspase 3 cleavage. Higher PRP concentrations or PRPs derived from individuals with higher platelet counts were more effective in increasing Ad‐MSC growth. PRP also accelerated cell migration by at least 1.5‐fold. However, PRP did not significantly affect mature adipocyte viability, differentiation and expression levels of PPAR‐γ and AP‐2 mRNAs, while it increased leptin production by 3.5‐fold. Interestingly, PRP treatment of mature adipocytes also enhanced the release of Interleukin (IL)‐6, IL‐8, IL‐10, Interferon‐γ, and Vascular Endothelial Growth Factor. Thus, data are consistent with a stimulatory effect of platelet derivatives on Ad‐MSC growth and motility. Moreover, PRP did not reduce mature adipocyte survival and increased the release of pro‐angiogenic factors, which may facilitate tissue regeneration processes. © 2015 The Authors. Journal of Cellular Biochemistry Published by Wiley Periodicals, Inc. J. Cell. Biochem. 116: 2408–2418, 2015. © 2015 The Authors. Journal of Cellular Biochemistry Published by Wiley Periodicals, Inc.

In vitro Hypolipidemic and Antioxidant Effects of Leaf and Root Extracts of Taraxacum Officinale.

Adipose tissue dysfunction constitutes a primary defect in obesity and might link this disease to severe chronic health problems. We aimed to evaluate the antioxidant activity of three extracts from Taraxacum officinale (dandelion) as well as their effects on mature 3T3-L1 adipocytes concerning intracellular lipid accumulation and cytotoxicity, this would give indications regarding therapeutic interest of dandelion as potential anti-obesity candidate. Antioxidant activities of extracts from dandelion roots and leaves were evaluated in vitro using 1,1-diphenyl-2-picrylhyorazyl (DPPH) and Ferric Reducing Antioxidant Power (FRAP) methods at the concentration range used in cellular assays (300–600 µg/mL). The influence of the extracts on mature 3T3-L1 adipocyte viability was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Lipid content was determined by Oil-red-O staining. The extracts showed effective antioxidant activity correlating with total flavonoid and polyphenol contents. However, the functionality level was weakly associated with the antioxidant activity. Further, our data demonstrated that mature 3T3-L1 adipocytes reduced in size and number when incubated with the extracts, which suggests a significant increase in lipolysis activity. Particularly, leaf extract and crude powdered root of dandelion reduced triglyceride accumulation in mature 3T3-L1 adipocytes to a greater extent that the extract from the root. Our study shows anti-lipogenic effects of dandelion extracts on adipocytes as well as radical scavenging and reducing activity. Importantly, along with previous results indicating that cell populations cultivated in the presence of the dandelion extracts decrease in 3T3-L1 adipogenesis capacity, these results suggests that these extracts might represent a treatment option for obesity-related diseases by affecting different processes during the adipocyte life cycle.

Adipocyte and preadipocyte viability in autologous fat grafts: comparing the water jet-assisted liposuction (WAL) and Coleman techniques

Background Autologous fat transplantation is a promising technique for soft tissue augmentation. However, the long-term maintenance of fat grafts remains unpredictable. Based on Peer’s cell theory, techniques that cause less cellular damage will optimize graft integration. Water jet-assisted liposuction (WAL) was introduced as a gentle and efficient technique for harvesting a large volume of fat in a short period of time. In this study, we evaluated the viability and function of adipocytes and preadipocytes harvested using WAL and compared this with the Coleman technique.

Superficial Enhanced Fluid Fat Injection (SEFFI) to Correct Volume Defects and Skin Aging of the Face and Periocular Region.

Although recent research on micro fat has shown the potential advantages of superficial implantation and high stem cell content, clinical applications thus far have been limited. The authors report their experience with superficial enhanced fluid fat injection (SEFFI) for the correction of volume loss and skin aging of the face in general and in the periocular region. The finer SEFFI preparation (0.5 mL) was injected into the orbicularis in the periorbital and perioral areas, and the 0.8-mL preparation was injected subdermally elsewhere in the face. The records of 98 consecutive patients were reviewed. Average follow-up time was 6 months, and average volume of implanted fat was 20 mL and 51.4 mL for the 0.5-mL and 0.8-mL preparations, respectively. Good or excellent results were achieved for volume restoration and skin improvement in all patients. Complications were minor and included an oil cyst in 3 patients. The smaller SEFFI quantity (0.5 mL) was well suited to correct volume loss in the eyelids, especially the deep upper sulcus and tear trough, whereas the larger SEFFI content was effective for larger volume deficits in other areas of the face, including the brow, temporal fossa, zygomatic-malar region, nasolabial folds, marionette lines, chin, and lips. The fat administered by SEFFI is easily harvested via small side-port cannulae, yielding micro fat that is rich in viable adipocytes and stem cells. Both volumes of fat (0.5 mL and 0.8 mL) were effective for treating age-related lipoatrophy, reducing facial rhytids, and improving skin quality. 4 Therapeutic.

Strategic sequences in fat graft survival.

Although lipotransfer, or fat grafting, is a commonly used procedure in aesthetic and reconstructive surgery, there is still variability in graft survival and neoadipogenesis from one procedure to the next. A better understanding of the sequential molecular events occurring with grafting would allow us to strategize methods to improve the regenerative potency of the grafted tissue. These steps begin with an autophagic process, followed by the inclusion of stromal vascular fraction and matrix components. By tailoring and modifying each of these steps for a particular type of aesthetic or reconstructive procedure, strategic sequencing represents a dynamic approach to lipotransfer with the aim of maximizing adipocyte viability and growth. In the implementation of the strategic sequence, it remains important to consider the clinical viability of each step and its compliance with the US Food and Drug Administration regulations. This review highlights the basic science behind clinically translatable approaches to supplementing various fat grafting procedures.