Fat Grafting as Regenerative Surgery: A Current Review.

Autologous fat grafting has long been regarded as an ideal filler, lauded for its ability to restore soft-tissue contour. In recent times, fat grafting has exhibited regenerative capacity, largely secondary to the action of adipose-derived stem cells and preadipocytes in the stromal vascular fraction of adipose tissue. This has birthed a new field of regenerative surgery with benefits germane to scarring, fibrosis, atrophy, burns, neuropathic pain, and autoimmune disease.

Smoking and Physical Activity Significantly Influence Stromal Vascular Fraction Cell Yield and Viability.

Background: Subcutaneous tissue is an abundant source of adipose-derived regenerative cells. It is readily available and easy to extract by means of liposuction, making it one of the most popular sources for tissue engineering and regenerative medical applications.

Methods: The stromal vascular fraction (SVF) cell yield and viability of the lipoaspirate obtained from 43 patients undergoing elective liposuction were examined in correlation with their age, gender, body mass index, smoking status, and physical activity.

A 3-step Mechanical Digestion Method to Harvest Adipose-derived Stromal Vascular Fraction.

Background: Adipose stromal vascular fraction (SVF) isolation with enzymatic digestion is the gold standard, but is expensive, having practical and legal concerns. The alternative mechanical SVF isolation methods provide lower cell yields as they employ either centrifugation, emulsification, or digestion steps alone. We combined mechanical processing with buffer incubation and centrifugation steps into an isolation method called "mechanical digestion" and compared the cell yields with that of enzymatic digestion.

An Enzyme-free Method for Isolation and Expansion of Human Adipose-derived Mesenchymal Stem Cells.

Mesenchymal stem cells (MSCs) are a population of multipotent cells that can be isolated from various adult and fetal tissues, including adipose tissue. As a clinically relevant cell type, optimal methods are needed to isolate and expand these cells in vitro. Most methods to isolate adipose-derived MSCs (ADSCs) rely on harsh enzymes, such as collagenase, to digest the adipose tissue.

"Brazilian Butt Lift" Performed by Board-Certified Brazilian Plastic Surgeons: Reports of an Expert Opinion Survey.

Background: Gluteal fat augmentation has increased worldwide, and so have major complications. Brazilian plastic surgeons have been performing this procedure for more than 30 years, and more often every year. Therefore, the authors performed a study among board-certified plastic surgeons, members of the Brazilian Society of Plastic Surgery, to evaluate their techniques; identify their preferences, complications, and outcomes with this procedure; and make some recommendations.

Assessment of Female Genital Surgery Education in Plastic Surgery Training: Report of an Expert Opinion Survey.

Background: Patient demand for aesthetic genital surgery has markedly increased. The International Society of Aesthetic Plastic Surgery reported 95,010 labiaplasties and 50,086 vaginal rejuvenation procedures in 2015.

Methods: We performed an online anonymous survey to evaluate the teaching of female genital procedures in plastic surgery training programs worldwide.

Subcutaneous-Only Gluteal Fat Grafting: A Prospective Study of the Long-Term Results with Ultrasound Analysis.

In recent years, gluteal fat augmentation has exhibited some of the most significant growth among all plastic surgery procedures. However, as the popularity of and media attention to gluteal fat augmentation continue to rise, reports of fatalities, largely attributed to fat embolism, have raised valid concerns. Many plastic surgeons inject fat in the intramuscular plane and claim better graft take in the muscles and the possibility of injecting more volume in the gluteal region.

Enzyme-Free Isolation of Adipose-Derived Mesenchymal Stem Cells.

Mesenchymal stem cells (MSCs) are a population of multipotent cells that can be isolated from various adult and fetal tissues, including adipose tissue. These cells contain enormous clinical and basic research appeal due to their plasticity to differentiate into cells of all germ layers in vitro, cross allogeneic barriers in vivo, and suppress inflammation. Methods to isolate adipose-derived MSCs (ADSCs) primarily rely on enzymatic digestion of the adipose tissue using harsh enzymes such as collagenase.

Real-Time Ultrasound-Assisted Gluteal Fat Grafting.

Background: The number of gluteal fat augmentation procedures has increased recently and so has the number of complications. Because of the increased risk of morbidity and mortality when fat is injected intramuscularly, not knowing where fat is injected is concerning. We sought to identify the planes in which fat is injected during the procedure.

Use of Tranexamic Acid to Reduce Blood Loss in Liposuction.

Background: The use of tranexamic acid for blood loss prevention has gained popularity in many specialties, including plastic surgery. However, its use in liposuction has not been studied. The authors present a prospective, double-blind, nonrandomized study evaluating the efficacy of tranexamic acid in reducing perioperative blood loss during liposuction.

Shift toward Mechanical Isolation of Adipose-derived Stromal Vascular Fraction: Review of Upcoming Techniques.

Unlabelled: Standard isolation of adipose stromal vascular fraction (SVF) requires the use of collagenase and is considered more than "minimally manipulated" by current good manufacturing practice requirements. Alternatively, nonenzymatic isolation methods have surfaced using physical forces to separate cells from the adipose matrix. The purpose of this study was to review the literature on the use of mechanical isolation protocols and compare the results.

Fat Grafting for Gluteal Augmentation: A Systematic Review of the Literature and Meta-Analysis.

Background: With the increasing demand for gluteal fat augmentation, reports of fatal complications have surfaced. Therefore, the authors proposed to analyze the published techniques and compare different protocols, to identify those of potential concern.

Methods: A systematic review of the literature was performed with a search of 21 terms on the PubMed, MEDLINE, Cochrane, and Scientific Electronic Library Online databases.

Fat Grafting and Adipose-Derived Regenerative Cells in Burn Wound Healing and Scarring: A Systematic Review of the Literature.

Background: There is an abundance of literature supporting the efficacy of fat grafting in aesthetic and reconstructive cases. There has been a recent emphasis on the regenerative capacity of adipose-derived stem cells and their utility in the improvement of wound healing and scarring provided by their cytokine and growth factor profiles. Despite the wealth of evidence supporting their efficacy, little attention has been paid to their utility in burn treatment.

A discussion on adult mesenchymal stem cells for drug delivery: pros and cons.

Mesenchymal stem cells (MSCs) are emerging as candidates for drug delivery to treat numerous diseases. Their ease of isolation, expansion and reduced ethical concern, coupled with their 'plastic' immune functions and homing abilities make MSCs an appealing choice as cellular vehicle for drug delivery, including the delivery of RNA. However, while MSCs are currently listed for thousands of clinical trials, there are many confounding factors that have yet to be elucidated.

The Role of International Volunteers in the Growth of Surgical Capacity in Post-earthquake Haiti.

Background: The 2010 Haiti earthquake severely strained local healthcare infrastructure. In the wake of this healthcare crisis, international organizations provided volunteer support. Studies demonstrate that this support improved short-term recovery; however, it is unclear how long-term surgical capacity has changed and what role volunteer surgical relief efforts have played.