TY - JOUR
T1 - Improved Adipocyte Viability in Autologous Fat Grafting with Ascorbic Acid-Supplemented Tumescent Solution
AU - Lunger, Alexander
AU - Ismail, Tarek
AU - Todorov, Atanas
AU - Buergin, Joel
AU - Lunger, Fabian
AU - Oberhauser, Ida
AU - Haug, Martin
AU - Kalbermatten, Daniel Felix
AU - Largo, Rene Denis
AU - Martin, Ivan
AU - Scherberich, Arnaud
AU - Schaefer, Dirk Johannes
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Introduction In reconstructive surgery, fat volume augmentation is often necessary for esthetic or functional reasons. As an alternative to synthetic and xenogeneic materials, autologous fat grafting (AFG) based on liposuction is gaining popularity, yet successful transplantation and long-term volume maintenance are difficult. Standard tumescent solution formulations neglect adipocyte and stromal vascular fraction (SVF) cell survival during extraction, as well as SVF differentiation into adipocytes thereafter, all of which are crucial for the success of AFG. Here we hypothesized that addition of ascorbic acid (AA) to the tumescent solution could prevent liposuction-induced cell damage. Materials and Methods The effect of 0.1 mmol/L AA in tumescent solution was investigated in a previously described ex vivo model of AFG. Briefly, excision fat was infiltrated with tumescent solution, with or without AA, and incubated for 20 minutes at 37°C. Hand-assisted liposuction was then performed with a blunt cannula. Total cell viability, clonogenicity, and differentiation capacity of the SVF cells were assessed. Results With AA, 10.3% more cells and in particular 14.9% more adipocytes survived liposuction. Clonogenicity, adipocyte and osteoblast differentiation by SVF cells remained unchanged. Conclusions Addition of AA successfully improved survival of adipocytes during liposuction without affecting SVF growth and differentiation. This study therefore identified a useful supplement to the tumescent solution which may lead to improving AFG success.
AB - Introduction In reconstructive surgery, fat volume augmentation is often necessary for esthetic or functional reasons. As an alternative to synthetic and xenogeneic materials, autologous fat grafting (AFG) based on liposuction is gaining popularity, yet successful transplantation and long-term volume maintenance are difficult. Standard tumescent solution formulations neglect adipocyte and stromal vascular fraction (SVF) cell survival during extraction, as well as SVF differentiation into adipocytes thereafter, all of which are crucial for the success of AFG. Here we hypothesized that addition of ascorbic acid (AA) to the tumescent solution could prevent liposuction-induced cell damage. Materials and Methods The effect of 0.1 mmol/L AA in tumescent solution was investigated in a previously described ex vivo model of AFG. Briefly, excision fat was infiltrated with tumescent solution, with or without AA, and incubated for 20 minutes at 37°C. Hand-assisted liposuction was then performed with a blunt cannula. Total cell viability, clonogenicity, and differentiation capacity of the SVF cells were assessed. Results With AA, 10.3% more cells and in particular 14.9% more adipocytes survived liposuction. Clonogenicity, adipocyte and osteoblast differentiation by SVF cells remained unchanged. Conclusions Addition of AA successfully improved survival of adipocytes during liposuction without affecting SVF growth and differentiation. This study therefore identified a useful supplement to the tumescent solution which may lead to improving AFG success.
KW - ascorbic acid
KW - autologous fat grafting
KW - lipografting
KW - stromal vascular fraction
KW - tumescent solution
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U2 - 10.1097/SAP.0000000000001857
DO - 10.1097/SAP.0000000000001857
M3 - Article
C2 - 31524744
AN - SCOPUS:85072197127
SN - 0148-7043
VL - 83
SP - 464
EP - 467
JO - Annals of plastic surgery
JF - Annals of plastic surgery
IS - 4
ER -