Coleman Sydney R
New York University School of Medicine, New York 10013, USA.
Plast Reconstr Surg. 2006 Sep;118(3 Suppl):108S-120S. doi: 10.1097/01.prs.0000234610.81672.e7.
Grafted fat has many attributes of an ideal filler, but the results, like those of any procedure, are technique dependent. Fat grafting remains shrouded in the stigma of variable results experienced by most plastic surgeons when they first graft fat. However, many who originally reported failure eventually report success after altering their methods of harvesting, refinement, and placement. Many surgeons have refined their techniques to obtain long-term survival and volume replacement with grafted fat. They have observed that transplanted fat not only adjusts facial and body proportion but also improves surrounding tissues into which the fat is placed. They have noted not only the improvement in the quality of aging skin and scars but also a remarkable improvement in conditions such as radiation damage, chronic ulceration, breast capsular contracture, and damaged vocal cords. The mechanism of fat graft survival is not clear, and the role of adipose-derived stem cells and preadipocytes in fat survival remains to be determined. Early research has indicated the possible involvement of more undifferentiated cells in some of the observed effects of fat grafting on surrounding tissues. Of particular interest is the research that has pointed to the use of stem cells to repair and even to become bone, cartilage, muscle, blood vessels, nerves, and skin. Further studies are essential to understand grafted fat tissue.
移植脂肪具有理想填充物的许多特性，但与任何手术一样，其效果取决于技术。脂肪移植仍然笼罩在大多数整形外科医生首次进行脂肪移植时所经历的效果不一的阴影之下。然而，许多最初报告失败的人在改变了采集、提纯和植入方法后最终报告成功。许多外科医生已经改进了他们的技术，以实现移植脂肪的长期存活和体积替代。他们观察到，移植的脂肪不仅能调整面部和身体比例，还能改善脂肪所植入的周围组织。他们不仅注意到老化皮肤和疤痕质量的改善，还注意到诸如放射性损伤、慢性溃疡、乳房包膜挛缩和声带损伤等情况有显著改善。脂肪移植存活的机制尚不清楚，脂肪来源干细胞和前脂肪细胞在脂肪存活中的作用仍有待确定。早期研究表明，在脂肪移植对周围组织的一些观察到的影响中，可能有更多未分化细胞参与其中。特别值得关注的是那些指出使用干细胞进行修复甚至使其变成骨骼、软骨、肌肉、血管、神经和皮肤的研究。进一步的研究对于理解移植脂肪组织至关重要。
