Abstract

GIRARD, A.C. et al. From biology to fat grafting: how to improve lipofilling. Cir. plást. iberolatinoam. [online]. 2013, vol.39, suppl.1, pp.s33-s38. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922013000500010.

While fat grafting for soft tissue filling has gained popularity, there is no consensus on the best way how to handle adipose tissue. Protocols differ and results are often highly variable. Various factors influence the quality of injected fat, among which the toxic molecules coming from infiltration procedure prior to liposuction. In this work, we have confirmed the deleterious effect of anesthetics on adipose-derived stem cells, and determined the effect of washing and centrifugation on adipose tissue, in order to propose a simple and optimized protocol to improve graft survival. Lidocaine cytotoxicity on adipose-derived stem cells (ADSCs) was evaluated by LDH assay. Then, whole adipose tissue was subjected to various centrifugation types (from 1 sec to 10 min and from 0 g to 1800 g), and volume of liquid and oil released were measured immediately after centrifugation. After determination of the optimal conditions for tissue handling (400 g/1 min), adipose tissue from liposuction made without or with lidocaine was injected into immunodeficient mice. One month after injection, quality of the grafts was evaluated by histology, and compared with grafts obtained from one conventional protocol: a simple settling. Lidocaine exerts a cytotoxic effect on ADSCs, and this effect is dependent on the incubation time and concentrations. Concerning adipose tissue, strong centrifugation (900 g, 1800 g) is deleterious compared to the low centrifugation (100 g, 400 g). In addition, histological sections of the non-centrifuged adipose tissue grafts shows the presence of extensive oil vacuoles, whereas the grafts resulting from washing with soft centrifugation protocol (400 g/1 min) do not. To conclude that appropriate handling of adipose tissue, including washing and centrifugation, should be done in order to remove infiltration liquid and associated toxic molecules, which are deleterious for the grafts. However, strong centrifugation is not recommended since it leads very quickly to greater cell death. Thus, soft centrifugation (400 g/1 min), preceded by washings, seems to be the most appropriate protocol for the re-injection of adipose tissue.

Keywords : Autolougous fat grafting; Lidocaine; Centrifugation; Adipose-derived stem cells.

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