Fat Graft Retention: Adipose Tissue, Adipose-Derived Stem Cells, and Aging

Over the past 30 years, there has been a dramatic increase in the use of autologous fat grafting for soft-tissue augmentation and to improve facial skin quality. Several studies have highlighted the impact of aging on adipose tissue, leading to a decrease of adipose tissue volume and preadipocyte proliferation and increase of fibrosis. Recently, there has been a rising interest in adipose tissue components, including adipose-derived stem/stromal cells (ASCs) because of their regenerative potential, including inflammation, fibrosis, and vascularization modulation. Because of their differentiation potential and paracrine function, ASCs have been largely used for fat grafting procedures, as they are described to be a key component in fat graft survival. However, many parameters as surgical procedures or adipose tissue biology could change clinical outcomes. Variation on fat grafting methods have led to numerous inconsistent clinical outcomes. Donor-to-donor variation could also be imputed to ASCs, tissue inflammatory state, or tissue origin. In this review, the authors aim to analyze (1) the parameters involved in graft survival, and (2) the effect of aging on adipose tissue components, especially ASCs, that could lead to a decrease of skin regeneration and fat graft retention.

Automated summary

In the past 30 years, autologous fat grafting has been widely used for soft-tissue augmentation and improving facial skin quality. Aging has a negative impact on adipose tissue, leading to a decrease in volume and proliferation of adipose tissue, as well as an increase in fibrosis. Adipose-derived stem/stromal cells (ASCs) have attracted attention due to their regenerative potential, and they have been utilized in fat grafting procedures to enhance graft survival. However, variations in surgical techniques and adipose tissue biology can affect clinical outcomes.