Grasys Justinas, Kim Bong-Sung, Pallua Norbert
From the Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Aesthet Surg J. 2016 Jul;36(7):831-41. doi: 10.1093/asj/sjw022. Epub 2016 Feb 23.
Although fat grafting has emerged as a major force in plastic, reconstructive, and aesthetic surgery, some questions regarding its reliability and regenerative potential remain unanswered.
The authors examined the influence of three anatomic areas on various lipoaspirate properties to identify the most appropriate harvest site for fat-grafting procedures.
Lipoaspirates from 25 healthy patients were harvested from the abdomen, inner thigh, and knee. The authors measured the content of soluble factors in the lipoaspirate followed by the assessment of the yield, adipogenic differentiation, proliferation of stromal vascular fraction (SVF) cells, and the percentage of adipose-derived stem cells (ASC) in the SVF. The results also were correlated with the age and body mass index of the donors.
Lipoaspirates from the abdomen showed significantly higher concentrations of matrix metalloproteinase (MMP)-9 compared with the knee. The content of basic fibroblast growth factor (b-FGF), platelet-derived growth factor (PDGF)-BB, and insulin-like growth factor (IGF)-1 tended to be highest in the abdomen but did not reach statistical significance. Vascular endothelial growth factor (VEGF)-A and bFGF-2 contents both correlated negatively with age in lipoaspirates from at least two different anatomic areas.
The authors' results indicate that the abdomen may be a slight favorite over the inner thigh and knee because of its richer content of soluble factors. However, because only the difference of MMP-9 content actually reached statistical significance and because no differences in SVF characteristics were observed, a decision primarily based on other criteria appears to be justifiable.
尽管脂肪移植已成为整形、重建和美容外科的一股主要力量，但关于其可靠性和再生潜力的一些问题仍未得到解答。
作者研究了三个解剖区域对各种抽脂物特性的影响，以确定脂肪移植手术最合适的取材部位。
从25名健康患者的腹部、大腿内侧和膝盖处获取抽脂物。作者测量了抽脂物中可溶性因子的含量，随后评估了产量、成脂分化、基质血管成分（SVF）细胞的增殖以及SVF中脂肪来源干细胞（ASC）的百分比。结果还与供体的年龄和体重指数相关。
与膝盖处相比，腹部抽脂物中基质金属蛋白酶（MMP）-9的浓度显著更高。碱性成纤维细胞生长因子（b-FGF）、血小板衍生生长因子（PDGF）-BB和胰岛素样生长因子（IGF）-1的含量在腹部往往最高，但未达到统计学意义。血管内皮生长因子（VEGF）-A和bFGF-2的含量在至少两个不同解剖区域的抽脂物中均与年龄呈负相关。
作者的结果表明，由于腹部可溶性因子含量更丰富，可能略优于大腿内侧和膝盖。然而，由于实际上只有MMP-9含量的差异达到统计学意义，且未观察到SVF特征的差异，主要基于其他标准做出决定似乎是合理的。
