Fat Graft Processing Using TheREVOLVE ENVI™ System Versus Decantation: In Vitro Properties And Tissue Quality
Allen Gabriel, MD1, Nimesh Kabaria, MS2, Carrie Fang, PhD2, Jared Lombardi, BS2, Eric Stec, BS2, Li-Ting Huang, PhD2, Hui Li, PhD2, Maryellen Sandor, PhD2.
1PeaceHealth Medical Group, Vancouver, WA, USA, 2Allergan Aesthetics, an AbbVie Company, Branchburg, NJ, USA.
Purpose: Evaluate the in vitro properties and tissue quality of fat grafts using the REVOLVE ENVI™ 600 system (Allergan Aesthetics, an AbbVie Company) compared with decantation and evaluate the properties of ENVI waste. Methods: Lipoaspirate (N=6 patients) was aliquoted and processed using ENVI or decantation. The volume composition of each layer (fat content, free oil, aqueous, cellular debris), hematocrit content, particle size, fat cell viability (calcein AM assay), and activity (lipolysis assay) were analyzed. Stromal vascular fraction (SVF) was analyzed for CD45−/CD31−/CD34+ cells and colony-forming units (CFU). Results: ENVI grafts had a higher mean (±SD) fat content than decanted grafts (85.6%±6.1% vs 72.1%±4.0%, respectively; p<0.001); ENVI waste contained primarily aqueous fluid with negligible viable fat. ENVI grafts had significantly lower contaminants (free oil and cellular debris; p<0.001), as well as lower hematocrit content than decanted grafts (0.22±0.41 vs 5.18±6.88 optical density [OD]) or ENVI waste (2.81±2.74 OD). ENVI grafts contained a significantly greater population of large-particle fat globules than decanted grafts or ENVI waste (p<0.001), with the percentage of tissue particles >1000 µm being highest for ENVI (ENVI: 61.6%±9.2%; decantation: 52.5%±13.4%; ENVI waste: 0.49%±1.50%), and the percentage of particles <200 µm being lowest for ENVI (ENVI: 15.7%±2.6%; decantation: 32.2%±8.9%; ENVI waste: 97.9%±4.5%). Relative to decantation, ENVI produced 145.2%±36.0% (p=0.01) more viable adipocytes with 145.7%±46.2% (p=0.04) greater activity, 195.5%±104.2% (p=0.24) more CD45−/CD31−/CD34+ cells, and 363.5%±161.2% (p=0.04) more SVF CFU/cc of graft. Conclusions: Fat grafts processed using the ENVI system demonstrated greater viability and better fat quality than those processed by decantation.
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