Facial Cell Assisted Lipograft Comparing Mechanical and Enzymatic Preparation of the Stromal Vascular Fraction: A Comparative Study

Abul Hassan, Aly Hussein Saber; Kadry, Hamed Mohammad; Ghanem, Lobna Yousef; Maamoun, Maamoun Ismail; Nour El Din, Ahmed Adel; AbulHassan, Hussein Saber

doi:10.21608/ejprs.2018.215088

Facial Cell Assisted Lipograft Comparing Mechanical and Enzymatic Preparation of the Stromal Vascular Fraction: A Comparative Study

Document Type : Original Article

Authors

¹ The Department of Plastic & Reconstructive Surgery, Faculties of Medicine, Alexandria & University

² The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Cairo University and

³ The Department of Clinical Pathology, Theodor Bilharz Institute

⁴ The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Cairo University

⁵ The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Alexandria University

10.21608/ejprs.2018.215088

Abstract

Background: For more than a century, clinicians have
attempted to use fat for the treatment of tissue deficiencies
and contour abnormalities with variable outcome and fate of
the transferred fat. Autologous fat transfer for facial contouring
has become popular in plastic surgery only in the past 20
years. In fact, surgeons have understood that ageing of the
face is not attributable to gravity-induced ptosis alone, but is
also a consequence of volume loss caused by tissue atrophy.
Thus, volume replacement using fat transfer is the aim of the
hereby presented treatment.
Aim of the Study: To evaluate the effect of two types of
isolation of lipograft in the face and their persistence and the
changes they will produce.
Material and Methods: This study was conducted on 50
patients complaining of facial ageing and facial scars whether
post traumatic or post burn from the period between January
2013 and December 2014. The sample population was divided
into two groups:
• Group A: Underwent fat processing using the mechanical
mesh/gauze to separate the SVF (39 patients) in order to
obtain micro and nanofat grafts.
• Group B: Underwent fat processing using the enzymatic
/collagenase technique to separate the SVF (11 patients).

Keywords

Main Subjects

Aesthetics

References

1- Fraser J.K., Zhu M., Wulur I. and Alfonso Z.: Adiposederived
stem cells. Methods. Mol. Biol., 449: 59-67, 2008.
2- Yoshimura K., Sato K., Aoi N., Kurita M., Hirohi T. and
Harii K.: Cell-assisted lipotransfer for cosmetic breast
augmentation: Supportive use of adipose-derived
stem/stromal cells. Aesthetic Plast Surg , 32 (1): 48-57,
2008.
3- Gimble J.M., Katz A.J. and Bunnell B.A.: Adipose-derived
stem cells for regenerative medicine. Circ. Res., 100 (9):
1249-60, 2007.
4- Jing W.1., Lin Y., Wu L., Li X., Nie X., Liu L., et al.:
Ectopic adipogenesis of preconditioned adipose-derived
stromal cells in an alginate system. Cell and Tissue. Cell.
Tissue. Res, 330 (3): 567-72, 2007.
5- Bunnell B.A., Flaat M., Gagliardi C., Patel B. and Ripoll
C.: Adipose-derived stem cells: Isolation, expansion and
differentiation. Methods., 45 (2): 115-20, 2008.
6- Baptista L.S., do Amaral R.J., Carias R.B., Aniceto M.
and Claudio-da-Silva C.: BorojevicR. An alternative
method for the isolation of mesenchymal stromal cells
derived from lipoaspirate samples. Cytotherapy, 11 (6):
706-15, 2009.
7- Ishige I., Nagamura-Inoue T., Honda M.J., Harnprasopwat
R., Kido M., Sugimoto M., et al.: Comparison of mesenchymal
stem cells derived from arterial, venous, and
Wharton's jelly explants of human umbilical cord. Int. J.
Hematol., 90 (2): 261-9, 2009.
8- Planat-Benard V., Silvestre J.S., Cousin B., Andre M.,
Nibbelink M., Tamarat R., et al.: Plasticity of human
adipose lineage cells toward endothelial cells: Physiological
and therapeutic perspectives. Circulation, 109 (5):
656-63, 2004.
9- Ceccarelli M. and García J.V.: The Medical Face Lift:
Face Tissue Regeneration, The Medical Letter Physiological,
I (1), 2010.
10- Bunnell B.A., Flaat M., Gagliardi C., Patel B. and Ripoll
C.: Adipose-derived stem cells: Isolation, expansion and
differentiation. Methods, 45 (2): 115-20, 2008.
11- Avram M.M., Avram A.S. and James W.D.: Subcutaneous
fat in normal and diseased states 3. Adipogenesis: From
stem cell to fat cell. J. Am. Acad. Dermatol., 56 (3): 472-
92, 2008.
12- Tonnard P., Verpaele A., Peeters G., Hamdi M., Cornelissen
M. and Declercq H.: Nanofat grafting: Basic research and
clinical applications. Plast. Reconstr. Surg., 132: 1017-
26, 2013
13- Kishi K., Imanishi N., Ohara H., Ninomiya R., Okabe K.,
Hattori N., et al.: Distribution of adipose-derived stem
cells in adipose tissues from human cadavers. J. Plast.
Reconstr. Aesthet. Surg., 63 (10): 1717-22, 2010.
14- Pérez-Cano R., Vranckx J.J, Lasso J.M., Calabrese C.,
Merck B., Milstein A.M., et al.: Prospective trial of
adipose-derived regenerative cell (ADRC)-enriched fat
grafting for partial mastectomy defects: The RESTORE-
2 trial. Eur. J. Surg. Oncol., 38 (5): 382-9, 2012.
15- Ishige I., Nagamura-Inoue T., Honda M.J., Harnprasopwat
R., Kido M., Sugimoto M., et al.: Comparison of mesenchymal
stem cells derived from arterial, venous, and
Wharton's jelly explants of human umbilical cord. Int. J.
Hematol., 90 (2): 261-9, 2009.
16- Miranville A., Heeschen C., Sengenès C., Curat C.A.,
Busse R. and Bouloumié A.: Improvement of postnatal
neovascularization by human adipose tissue-derived stem
cells. Circulation, 110 (3): 349-55, 2004.
17- Sommer B. and Sattler G.: Current concepts of fat graft
survival: Histology of aspirated adipose tissue and review
of the literature. Dermatol. Surg., 26 (12): 1159-1166,
2000