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Optimizing Fat Graft Processing: A Prospective, Controlled Clinical Trial Comparing Telfa Rolling Versus Centrifugation for Fat Grafting Craniofacial Deformities
James IB, Bourne DA, Minteer D, Schusterman MA, Wang S, Donnenberg AD, Donnenberg V, Branstetter B, Haas GL, Marra KG, Coleman S, Rubin JP
University of Pittsburgh
2020-02-09
Presenter: Isaac James
Affidavit:
The work on this project represents the original work of the resident. Isaac played a major role throughout this project and will be the first author for the manuscript.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
INTRODUCTION: Fat grafting is a versatile and powerful tool for soft tissue reconstruction. However, its utility remains tempered by variable retention. The aim of this prospective, controlled clinical trial is to compare two commonly used small-volume fat graft processing techniques: Telfa rolling and centrifugation.
METHODS: Twenty-nine patients underwent fat grafting procedures to treat craniofacial deformities. Lipoaspirate was processed by either centrifugation (n=19) or Telfa rolling (n=10). Patients were followed for nine months. Volume retention was assessed by 3D CT and by subjective assessment. The cellular composition of stromal vascular fraction (SVF) was measured by flow cytometry. Patient reported outcome measures were also collected.
RESULTS: Average age was 40. Average BMI was 27.5 and was stable throughout the study. Sixty-three percent of participants were male. Average volume injected was 26.1cc and 22.2cc in centrifugation and Telfa groups, respectively. Average volume retention was similar between groups at nine months (63.2% vs 64.2% in centrifugation and Telfa groups, respectively; p=0.89). However, the centrifugation group had a higher proportion of CD34+ adipose stem cells (ASCs) in SVF isolates (81.7% vs 56.5%; p=0.036). Subjective volume assessments and patient-reported outcomes were similar between the groups at nine months.
CONCLUSIONS: Fat grafts processed by either method resulted in significant improvement in facial appearance with no major complications and with high patient satisfaction. Processing method did not impact nine-month volume retention. Centrifugation may create grafts with a higher proportion of CD34+ ASCs. Whether this difference has implications for regenerative rather than volume-focused applications remains to be determined.
