Doornaert Maarten, Colle Julien, De Maere Elisabeth, Declercq Heidi, Blondeel Phillip
University Hospital Gent, Belgium.
Ann Med Surg (Lond). 2018 Oct 16;37:47-53. doi: 10.1016/j.amsu.2018.10.016. eCollection 2019 Jan.
A recent rise in the use of autologous fat transfer for soft tissue augmentation has paralleled the increasing popularity of liposuction body contouring. This creates a readily available and inexpensive product for lipografting, which is the application of lipoaspirated material. Consistent scientific proof about the long-term viability of the transferred fat is not available. Clinically, there is a reabsorption rate which has been reported to range from 20 to 90%. Results can be unpredictable with overcorrection and regular need for additional interventions. In this review, adipogenesis physiology and the adipogenic cascade from adipose-derived stem cells to adult adipocytes is extensively described to determine various procedures involved in the fat grafting technique. Variables in structure and physiology, adipose tissue harvesting- and processing techniques, and the preservation of fat grafts are taken into account to collect reproducible scientific data to establish standard in vitro and in vivo models for experimental fat grafting. Adequate histological staining for fat tissue, immunohistochemistry and viability assays should be universally used in experiments to be able to produce comparative results. By analysis of the applied methods and comparison to similar experiments, a conclusion concerning the ideal technique to improve clinical outcome is proposed.
最近,自体脂肪移植用于软组织填充的应用增加,这与抽脂身体塑形日益普及同步。这为脂肪移植创造了一种现成且廉价的产品,脂肪移植即应用抽脂获得的材料。目前尚无关于移植脂肪长期存活的一致科学证据。临床上,据报道再吸收率在20%至90%之间。结果可能不可预测,存在过度矫正的情况,且通常需要额外干预。在本综述中,广泛描述了脂肪生成生理学以及从脂肪来源干细胞到成熟脂肪细胞的脂肪生成级联反应,以确定脂肪移植技术中涉及的各种程序。考虑到结构和生理学变量、脂肪组织采集和处理技术以及脂肪移植的保存,收集可重复的科学数据,以建立用于实验性脂肪移植的标准体外和体内模型。在实验中应普遍使用对脂肪组织进行充分的组织学染色、免疫组织化学和活力测定,以便能够产生可比较的结果。通过对应用方法的分析并与类似实验进行比较,提出了关于改善临床结果的理想技术的结论。