Fat graft – the natural choice for reconstructive, regenerative and aesthetic surgery

Abstract

Abstract The search for appropriate filler, which can be used for aesthetic and reconstructive operations is currently one of challenges for plastic surgery. The application of absorbable and permanent artificial fillers may cause adverse events. Thus, autologous fat grafting can be a safe alternative. Moreover, fat tissue is rich in adipose-derived stem cells (ASC), which can be successfully used for regenerative procedures. The paper reviews reports on fat grafting procedures, which indicate risks and their possible prophylactic. Adipose tissue is a much more prolific source of ASCs than bone marrow. Basically, ASC are characterized by a spectrum of markers: CD11b-CD45-CD13+CD73+CD90+, which can be widened by CD36+CD-106-CD10+CD26+CD49d+CD49e+CD3-D49f -PODXL- to improve phenotyping. It is suggested to use at least two negative markers and two positive markers during the same phenotyping analysis. Fat transfer requires appropriate approach, planning and technique to make it clinically successful. Fat grafting fulfills the expectations for ideal injectable agent, which can be used for aesthetic and reconstructive surgery. To improve the survival of fat graft, careful decisions on donor site, local anesthetic administration, liposuction method, processing and placement methods need to be made. Moreover, fat is the source of adipose-derived stem cells which can be used for regenerative procedures. A proper transformation and identification of those cells is required to improve clinical effects.