Histological Evaluation of the Skin After Fat Grafting: A Blinded, Randomized, Controlled Clinical Study

Abstract

Background Autologous fat graft is often employed to treat body contour defects. There is currently increased interest in the regenerative properties of fat grafting. Objectives The authors evaluated the histological changes of fat grafting in a blinded randomized controlled trial of staged fat grafting-abdominoplasty. Methods Ten women between 24 and 55 years of age with a body mass index <30 kg/m2 and previous cesarean scar were submitted to fat grafting followed by staged abdominoplasty. The C-section scar served as a landmark for standardization of fat grafting site and control. One side of the abdomen was fat grafted and the other was left intact (control). At the time of abdominoplasty, 4 months later, a full-thickness skin sample from each hemi abdomen (fat-grafted area and control) was collected and sent to histological analysis. Results All of the fat-grafted samples showed extracellular lipids and signs of fat graft viability, whereas no such changes occurred in the control group. There were no statistically significant differences in fat-grafted vs control samples regarding skin inflammatory infiltrate (P = 0.582), dermis thickness (P = 0.973), vascular density (P = 0.326), and amount of elastic fibers (P = 1). Conclusions The histological evaluation of women’s abdominoplasty surgical site skin after 4 months of fat grafting showed signs of fat graft in 100% of the grafted sides but no change in skin inflammatory infiltrate, dermis thickness, vascularity density, or elastic fiber quantity.

Effectiveness of fat grafting in scar reduction: A systematic review and meta‐analysis

“…Taking up 64% of SVF, ADSC can secrete a lot of growth factors, cytokines or immunomodulators, such as vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), 14 IL‐6, TGF‐β, etc., which can contribute to the formation of small blood vessels in scars, inhibit inflammation, and help wounds heal faster. The results of this study (OR = 5.63, 95% CI: 3.01–10.53, p < 0.01) suggest that fat grafting is effective in scar treatment, yet the forest plot shows that Juan's experimental results 8 ran contrary to other studies. The reason might be that the sample size was too small to show the difference, or that the assessment criteria were not rigorous.…”

“…After excluding duplicate articles and those not meeting the criteria by judging from the title and abstract, a total of 44 articles were singled out. The author further read through the full text of shortlisted articles, and finally included nine articles after excluding non‐conforming articles 3,4,5,6,7,8,9,10,11 . The flowchart is shown in Figure 1.…”

“…The author further read through the full text of shortlisted articles, and finally included nine articles after excluding non-conforming articles. 3,4,5,6,7,8,9,10,11 The flowchart is shown in Figure 1.…”

Autologous Lipofilling Improves Clinical Outcome in Patients With Symptomatic Dermal Scars Through Induction of a Pro-Regenerative Immune Response

“…In their recent elegant randomized trial on 10 gender-biased patients Maricevich et al investigated the treatment of the relatively small scars that remain after cesarean section, and found that lipografting caused an influx of immune cells and vasculature while the epidermis gained thickness at 4 months postoperatively. 28 Unfortunately, the small size of the trial and the semiquantitative nature of the scoring did not show statistically significant differences, although our quantitative data and statistics corroborate these findings. 28 Our study population, however, differs due to inclusion of males and females and considers scars that were substantially larger.…”

“… 28 Unfortunately, the small size of the trial and the semiquantitative nature of the scoring did not show statistically significant differences, although our quantitative data and statistics corroborate these findings. 28 Our study population, however, differs due to inclusion of males and females and considers scars that were substantially larger.…”