American Association of Plastic Surgeons

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Making Gains: Evaluating The Effect Of Lipoaspirate Processing Techniques On Longitudinal Volume Retention In Fat Grafting Surgery
Yunchan Chen, BS, Sophia Arbuiso, BS, Nicholas A. Vernice, MD, Kristy A. Brown, PhD, David M. Otterburn, MD.
Weill Cornell Medicine, New York, NY, USA.

PURPOSE: Autologous fat grafting is a method of improving aesthetic outcomes following both breast reconstruction and aesthetic surgery through volume enhancement and tissue contouring. Harvesting, processing, and injection techniques may all affect the longevity of deformity filling. Our objective is to evaluate the effect of lipoaspirate processing modality on longitudinal volume retention after surgery.
METHODS: A prospective, single institution randomized control trial placed consented post-mastectomy fat grafting patients into one of three treatment arms (active filtration, low-pressure decantation, and standard decantation) in a 1:1:1 ratio. A pre-operative three-dimensional scan of the upper torso is taken as baseline. This is repeated at the 3-month post-operative visit. Audodesk Meshmixer is used to evaluate the volume change.
RESULTS: The volume of fat injected during the initial procedure did not differ significantly between the treatment arms (p>0.05). Both active filtration and low-pressure decantation resulted in higher percent volume retention than traditional decantation (p<0.05). Active filtration and low-pressure decantation exhibited comparable degrees of fat maintenance at three-months (p>0.05).
CONCLUSION: Compared to using traditional decantation as the lipoaspirate purification technique, active filtration and low-pressure decantation may have led to higher levels of cell viability by way of reduced cellular debris and other inflammatory components that may contribute to tissue resorption and necrosis. Further immunohistochemistry studies are needed to examine whether active filtration and low-pressure decantation lead to lipoaspirates with more concentrated viable adipocytes, progenitor cells and factors for angiogenesis.
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