Autologous plasma and its supporting role in fat graft survival: a relevant vector to counteract resorption in lipofilling

Publication date: Available online 29 March 2016
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Filip Stillaert, Bernard Depypere, Maarten Doornaert, David Creytens, Heidi De Clercq, Ria Cornelissen, Stan Monstrey, Phillip Blondeel
Fat grafting has become a widespread technique for different reconstructive and aesthetic purposes. However, the disadvantage of fat grafting is the unpredictable resorption rate that often necessitates repetitive procedures, which in turn may have an impact on the morbidity. During the immediate, post-graft, ischemic period, cells survive due to the process of plasmatic imbibition. This biological phenomenon precedes the ingrowth of neo-capillaries that eventually will nourish the graft and bring it in a homeostatic equilibrium at the long-term. Both partners, the graft and the recipient bed, will have to contribute to the revascularization process. Hypothetically, enrichment of the recipient site with autologous plasma could have a beneficial role to enhance fat graft survival. We investigated whether plasma supported the viability of lipoaspirate (LA) material. Plasma was isolated from a blood sample from 8 patients during elective lipofilling procedures. An in vitro study assessed the viability of LA cells using plasma as a culture medium compared to traditional culture media. In vitro analysis confirmed sustained viability of LA cells compared to standard media and control media during seven consecutive days. The behavior of the fat grafts in plasma showed similarities with those incubated in traditional culture media. In the nearby future, these findings could be translated to a clinical setting. Plasma is the only autologous substrate available in large quantities in the human body. The addition of supporting agents – such as plasma - could contribute to a better graft survival with more stable clinical outcomes at the long-term. The rationale behind the technique is based on the phenomenon of plasmatic imbibition and the reasoning that the extracellular matrix plays a pivotal role in cellular survival.



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