Improving fat graft survival through preconditioning of the recipient site with microneedling

https://doi.org/10.1016/j.bjps.2014.01.019Get rights and content

Summary

Although fat grafts are considered the ideal soft-tissue fillers, the main concern dealing with this technique is not being able to predict long-term graft survival due to high absorption rates. The purpose of this study was to investigate the angiogenic effects of preconditioning the recipient area with micro-needling and to determine its overall impact on fat graft survival.

The study consisted of a sham, control and study group. The source of fat was the Wistar albino rat inguinal fat pad while the recipient area was a dorsal subcutaneous pouch. The dorsal area was preconditioned with standard technique micro-needling 1-week prior to fat graft transfer in the study group while the control group did not undergo micro-needling. At the end of 15 weeks, morphological, biochemical, histological and immunohistochemical evaluation was carried out.

Fat grafts in the study group had better integrity and a higher level of vascularity compared to the control group. Volume analysis demonstrated higher graft survival in the study group in comparison to the control group. Histomorphometric and immunohistochemical evaluation showed better graft integrity and uniform adipocytes, less fibrosis, less vacuolisation and inflammation and better vascularisation in the study group. Although higher triglyceride concentrations were measured for the study group, the difference between the two groups was statistically insignificant.

In conclusion, fat grafting performed in an area preconditioned with micro-needling results in higher graft volume, better integrity and vascularisation and an overall higher graft survival rate.

Section snippets

Animal model

Following approval of the study protocol by the Ethics Committee for Laboratory Animals of Gazi University Medical School, 18 Wistar albino rats, each weighing 380 (±30) g, were used for this study. The source of fat was determined as the inguinal fat pad, while the recipient site was a subcutaneous pouch in the dorsal area of the rat. The study consisted of three groups: the study (micro-needle) group consisted of six rats that underwent standard technique micro-needling followed by fat

Gross observations

The weight of all animals was measured and recorded prior to fat grafting and at the end of the study. Analysis showed that there was no statistical significance in the change of body weight in the animals (p > 0.05).

At the end of 15 weeks, the grafted fat tissue was harvested through longitudinal incisions made over the skin overlying the fat grafts. At gross observation, it was noted that the study group had maintained good structural integrity of the fat grafts, and there was notable

Discussion

Numerous studies have focussed on the effects of harvesting and preparation of fat grafts on graft take, yet the properties of the recipient bed are also among the main determinants of long-term graft survival. One of the main factors that can affect graft take is the vascularity of the recipient site. A review of the literature demonstrates satisfactory outcomes when very small volumes of fat are used in areas of higher vascularity.33, 34, 35, 36, 37, 38, 39, 40, 41 Guerrerosantos et al. and

Conflict of interest statement

All authors report no conflicts of interest. No competing financial interests exist.

Acknowledgements

This study was approved by the Gazi University Ethical Committee for Experimental Research on Animals (Project no: G.U.ET-11.109) and was financially supported by the Gazi University Research Fund (Project no: 01/2012-36).

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