Engels Patricia E, Kappos Elisabeth A, Sieber Patricia K, Benz Robyn M, Thommen Sarah, Schaefer Dirk J, Kalbermatten Daniel F
University Hospital Basel, Basel, Switzerland.
Aesthet Surg J. 2018 Jul 13;38(8):900-910. doi: 10.1093/asj/sjy073.
Autologous fat grafting (AFG) to the breast is a frequent procedure in aesthetic and reconstructive surgery. Despite pure volume gain, questions remain regarding the engraftment rate, quality, and longevity. Little is known about the role of recipient tissue or innervation of the grafted area.
The goal of this study was to determine the optimal recipient layer and muscular pretreatment of AFG.
Fat was grafted to the breast, pectoralis muscle, or adjacent subcutaneous tissue of 42 rats. Nerve treatment included excision of a nerve segment, botulinum toxin (BTX) injection, or no treatment. Magnetic resonance imaging (MRI) and histological workup were carried out after 2 and 6 weeks.
Six weeks after AFG, the proportion of viable fat cells within the grafted fat stayed high (median, [IQR]: 81% [72% to 85%]). The signs of inflammation decreased over time. Intramuscular grafting with intact nerves had a decreasing effect on the viability of the grafted cells compared with subcutaneous treatment (-10.21%; 95% confidence interval [-21.1 to 0.68]).
If utilized on an intact nerve, intramuscular injection may lead to inferior results. If the nerve was cut or treated with BTX; however, intramuscular injection tends to be superior. These findings may prove interesting for future studies and eventual clinical application.
自体脂肪移植到乳房是美容和重建手术中常见的操作。尽管单纯增加了体积，但关于移植率、质量和持久性仍存在疑问。关于受体组织或移植区域神经支配的作用知之甚少。
本研究的目的是确定自体脂肪移植的最佳受体层和肌肉预处理方法。
将脂肪移植到42只大鼠的乳房、胸大肌或相邻的皮下组织。神经处理包括切除一段神经、注射肉毒杆菌毒素（BTX）或不进行处理。在2周和6周后进行磁共振成像（MRI）和组织学检查。
自体脂肪移植6周后，移植脂肪内活脂肪细胞的比例保持较高（中位数，[四分位间距]：81%[72%至85%]）。炎症迹象随时间减少。与皮下处理相比，完整神经的肌肉内移植对移植细胞的活力有降低作用（-10.21%；95%置信区间[-21.1至0.68]）。
如果在完整神经上使用，肌肉内注射可能导致较差的结果。然而，如果神经被切断或用BTX处理，肌肉内注射往往更具优势。这些发现可能对未来的研究和最终的临床应用具有重要意义。
