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What Lies Beneath the Surface: The Architecture of Fat Grafting
Isaac James, Debra Bourne, Sheri Wang, Kacey Marra, Peter Rubin
University of Pittsburgh, Department of Plastic Surgery
2015-03-15
Presenter: Isaac James
Affidavit:
This represents original work by the authors and has not been previously presented at any national meetings or previously published.
Director Name: Joseph Losee
Author Category: Medical Student
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Background:
Fat grafting is an important and versatile procedure, but is limited by unpredictable volume retention. Grafted tissue must be deposited within 2mm of a blood supply to survive. This study aims to better understand the architecture of grafted fat within the recipient bed.
Methods:
Fat was harvested by liposuction and stained with methylene blue. Stained fat was grafted into 4x4x2cm sections of pannus at six graft to recipient volume ratios (1:1, 1:2, 1:4, 1:6, 1:8 and 1:10). Fat deposit mean diameter was analyzed by ANOVA. The number of fat deposits with radius greater than 2mm was calculated and compared using Fisher Exact comparisons. p≤0.05 was considered significant.
Results:
As the volume ratio of grafted fat decreased, the mean fat deposit diameter decreased significantly (p<0.001) from 1:1 (0.574±0.046cm), to 1:2 (0.404±0.034cm), to 1:4 (0.305±0.024cm), to 1:6 (0.184±0.018cm). As the volumes continued to decrease, the mean diameter continued to decrease, but significance was not reached between 1:8 (0.180±0.018cm) and 1:10 (0.148±0.014cm). Similarly, the percentage of deposits with radius greater than 2mm decreased significantly (p<0.001) as volume ratio decreased from 1:1 (70.1%), to 1:2 (47.2%), to 1:4 (22.6%), to 1:6 (2.3%).
Conclusions:
Volume loss after fat grafting is related to central necrosis of bulky fat deposits. This study demonstrates that as the total volume of fat transferred exceeds a ratio of 1:4, the average diameter of individual fat deposits increases significantly, and the percentage with radius greater than 2mm (which would be expected to undergo central fat necrosis) increases significantly.
