Higher Cell Viability and Enhanced Sample Quality Following Laser-Assisted Liposuction versus Mechanical Liposuction

Alexander Levenberg^1*, Mickey Scheinowitz², Orna Sharabani-Yosef²

¹Department of Plastic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
²Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.

DOI: 10.4236/jcdsa.2015.53029                

Abstract

Background: Despite the popularity of autologous fat transfer applications, high resorption rates, and consequential volume loss, have been reported. Viable adipocyte content has been defined as a key determinant of fat transfer longevity. Moreover, traces of blood, free oil fat and fibrotic tissue accelerate adipocyte degradation. Objective: To compare the effectiveness of a 1470 nm, radial emitting laser-assisted liposection device to a mechanical liposection device in maintaining adipocyte viability in fat tissue harvests. Methods: Bilateral subcutaneous adipose tissue samples were harvested from ten female patients. Fat was harvested from one side using the LipoLife laser-assisted liposuction device and from the other side with a Byron mechanical aspirator. Samples were visually analyzed and blood:fat ratios and cell viability were determined. Results: Laser-harvested samples separated into two distinct phases, with a negligible blood phase at the bottom (1.1%) and a significant adipose phase at the top (98.9%), containing small, uniform-sized cells, of which 95.7% ± 2.7% proved viable. Mechanically harvested samples separated into blood (18%), adipose (60%) and lipid (22%) phases. The adipose phase contained significant amounts of connective tissue, large adipose tissue fragments, large oil droplets and a mean 79.7% ± 18.3% viable adipocytes. Conclusions: Laser liposuctioning was superior to mechanical liposuctioning, providing both higher cell viability and enhanced sample quality. The 1470 nm diode laser bears the potential of improving long-term clinical outcomes of fat transfer procedures. Improved purity of the harvested sample and heightened preadipocyte content are projected to provide for extended graft longevity.

Keywords

Laser Liposuction, Cell Viability, Fat Transfer, Preadipocyte

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	http://www.plasticsurgerypractice.com/2015/01/baaps-data-plastic-surgery-falls-across-pond/
[2]	Atiyeh, B., Costagliola, M., Illouz, Y.G., et al. (2015) Functional and Therapeutic Indications of Liposuction: Personal Experience and Review of the Literature. Annals of Plastic Surgery.
[3]	Banyard, D.A., Salibian, A.A., Widgerow, A.D. and Evans, G.R. (2015) Implications for Human Adipose-Derived Stem Cells in Plastic Surgery. Journal of Cellular and Molecular Medicine, 19, 21-30. http://dx.doi.org/10.1111/jcmm.12425
[4]	Peer, L.A. (1950) Loss of Weight and Volume in Human Fat Grafts. Plastic and Reconstructive Surgery, 5, 217. http://dx.doi.org/10.1097/00006534-195003000-00002
[5]	Etzkorn, J.R., Divine, J.M., Lopez, J.J., et al. (2011) Autologous Fat Transfer: Techniques, Indications and Future Investigation. Cosmetic Dermatology, 24, 470-476.
[6]	Kaufman, M.R., Miller, T.A., Huang, C., et al. (2007) Autologous Fat Transfer for Facial Recontouring: Is There Science behind the Art? Plastic and Reconstructive Surgery, 119, 2287-2296. http://dx.doi.org/10.1097/01.prs.0000260712.44089.e7
[7]	Fournier, P.F. (2000) Fat Grafting: My Technique. Dermatologic Surgery, 26, 1117-1128. http://dx.doi.org/10.1046/j.1524-4725.2000.00272.x
[8]	Peer, L.A. (1956) The Neglected Free Fat Graft, Its Behavior and Clinical Use. American Journal of Surgery, 92, 40-44. http://dx.doi.org/10.1016/S0002-9610(56)80009-3
[9]	Fagrell, D., Enestrom, S., Berggren, A., et al. (1996) Fat Cylinder Transplantation: An Experimental Comparative Study of Three Different Kinds of Fat Transplants. Plastic and Reconstructive Surgery, 98, 90-96, 97-98. http://dx.doi.org/10.1097/00006534-199607000-00014
[10]	Coleman, S.R. (1995) Long-Term Survival of Fat Transplants: Controlled Demonstrations. Aesthetic Plastic Surgery, 19, 421-425. http://dx.doi.org/10.1007/BF00453875
[11]	Sommer, B. and Sattler, G. (2000) Current Concepts of Fat Graft Survival: Histology of Aspirated Adipose Tissue and Review of the Literature. Dermatologic Surgery, 26, 1159-1166. http://dx.doi.org/10.1046/j.1524-4725.2000.00278.x
[12]	Har-Shai, Y., Lindenbaum, E., Ben-Itzhak, O., et al. (1996) Large Liponecrotic Pseudocyst Formation Following Cheek Augmentation by Fat Injection. Aesthetic Plastic Surgery, 20, 417-419. http://dx.doi.org/10.1007/BF02390317
[13]	Carpaneda, C.A. (1996) Study of Aspirated Adipose Tissue. Aesthetic Plastic Surgery, 20, 399-402. http://dx.doi.org/10.1007/BF02390314
[14]	Heymans, O., Castus, P., Grandjean, F.X., et al. (2006) Liposuction: Review of the Techniques, Innovations and Applications. Acta Chirurgica Belgica, 106, 647-653.
[15]	Prado, A., Andrades, P., Danilla, S., et al. (2006) A Prospective, Randomized, Double-Blind, Controlled Clinical Trial Comparing Laser-Assisted Lipoplasty with Suction-Assisted Lipoplasty. Plastic and Reconstructive Surgery, 118, 1032-1045. http://dx.doi.org/10.1097/01.prs.0000232428.37926.48
[16]	Abdelaal, M.M. and Aboelatta, Y.A. (2014) Comparison of Blood Loss in Laser Lipolysis vs Traditional Liposuction. Aesthetic Surgery Journal, 34, 907-912. http://dx.doi.org/10.1177/1090820X14536904
[17]	Badin, A.Z., Moraes, L.M., Gondek, L., et al. (2002) Laser Lipolysis: Flaccidity under Control. Aesthetic Plastic Surgery, 26, 335-339. http://dx.doi.org/10.1007/s00266-002-1510-3
[18]	Goldman, A. (2006) Submental Nd:Yag Laser-Assisted Liposuction. Lasers in Surgery and Medicine, 38, 181-184. http://dx.doi.org/10.1002/lsm.20270
[19]	Yoshimura, K., Shigeura, T., Matsumoto, D., et al. (2006) Characterization of Freshly Isolated and Cultured Cells Derived from the Fatty and Fluid Portions of Liposuction Aspirates. Journal of Cellular Physiology, 208, 64-76. http://dx.doi.org/10.1002/jcp.20636