Additional Thoughts on the Future of Fat Grafting

We have perused with interest your article entitled “The Future of Fat Grafting” ¹ in which Dr Hanson discussed possible future applications and innovations in the field of fat grafting. We congratulate Dr Hanson for the paper and thank her for the citations. The described work highlights the rapidity through which autologous fat grafting (AFG) is expanding as a commonly employed regenerative procedure in plastic and reconstructive surgery, and, at the same time, it evidences the lack of validated indications concerning techniques for fat grafting.

In our experience, AFG is widely employed, and among the most common applications we find mammary reconstructive surgery, in particular intended as regenerative surgery to improve the trophism of tissues in breast reconstruction following mastectomy and radiotherapy.² In breast reconstruction, AFG, thanks to its great regenerative potential, is also employed to treat pain derived from post-mastectomy pain syndrome, as demonstrated by our prospective study.³

Focusing on the issue reported by Hanson on the current lack of well-defined evidence for a method for harvesting, processing, and delivering fat proven to be superior to others, we would like to highlight our experience. We proposed a study aimed to compare centrifuged lipoaspirates harvested and refined by the Coleman technique with noncentrifuged lipoaspirates in terms of cell number and viability, phenotypic profile, and clonogenic and proliferative potential of adipose-derived stem cell populations.⁴ We showed that centrifugation is safe and feasible and does not impair cell viability; furthermore, it can augment the content in adipose-derived stem cells and the frequency of colony forming units—fibroblasts, and it reduces the number of pro-inflammatory blood cells.

At the moment, the great challenge is in understanding how to reduce the local absorption rate of the grafted adipose tissue. We demonstrated in a recent study that Tamoxifen⁵ has no effect on this aspect, and our current focus is on exploring further the effects of different therapies commonly employed after surgical breast cancer treatment on the vitality of the grafted tissue.

Disclosures

The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.

Funding

The authors received no financial support for the research, authorship, and publication of this article.

References