Autologous Fat Grafting Aid In The Sustained Release Of Il-13 And Tgf-beta By Septal Cartilages To Promote Aesthetic Outcomes In Rhinoplasty
Kaiti Duan, BS, Alvaro Reategui, BA, Sarah Phillips, BS, Arvind Gowda, MD, Biraja Dash, PhD, Henry Hsia, MD, Derek Steinbacher, MD, DMD, FACS.
Yale School of Medicine, New Haven, CT, USA.
PURPOSE:Adding fat grafts to crushed septal cartilage in rhinoplasty has been shown to have solid association with strong graft retention, rapid swelling resolution, and patient satisfaction, However, there is a paucity of translational research of what the septal chondrocytes are secreting in the presence of fat grafts.
METHODS:Crushed and intact cartilage, with autologous fat, were obtained from 15 patients undergoing rhinoplasty at Yale New Haven Hospital, CT. Each patient's tissue samples were divided into 6 groups: intact, crushed, and crushed-at-lab cartilages +/- fat graft. The samples were incubated and mediums were collected at 12h, 24h, and 48h. ELISAs were performed to analyze chondrocyte IL-4, IL-10, IL-13, and TGF-Beta levels.
RESULTS:Il-4 and IL-10 failed to demonstrate any significant difference. In the absence of adipose grafts, chondrocytes that were crushed exhibited significant less IL-13 secretion throughout the 48 hours (p value= 0.043). While the same group of chondrocytes that were incubated with adipose grafts did not exhibit significant drop in IL-13 secretion. Furthermore, uncrushed chondrocytes without the protection of adipose grafts decreased TGF-beta secretion (p value= 0.0008) while cartilages with adipose grafts maintained and increased TGF-Beta secretion.
CONCLUSION:Fat graft aided the sustained release of Il-13 and TGF-Beta. Il-13 has a variety functions such being an immunoregulatory cytokine and prevents cartilage matrix degradation. Those Il-13 properties may potentially be underlying cause of strong graft retention and inhibition of cartilage resorption. TGF-Beta is involved in wound healing and anti-inflammation, which explain quicken swelling resolution.
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