Enhancing the viability of fat grafts using new transfer medium containing insulin and β-fibroblast growth factor in autologous fat transplantation

With the increasing application of liposuction in reconstructive surgery of the head and neck region and aesthetic plastic surgery of the facial region, autologous fat transplantation is widely used. However, due to the high absorption rate of fat grafts, a number of studies have examined the use of different agents to increase the viability of such grafts. Here, we evaluated the effects of a new transfer medium containing insulin and β-fibroblast growth factor, which can increase the viability of fat grafts before performing autologous fat transplantation. Twenty-four New Zealand white rabbits were used in this study. For each rabbit, we harvested 4mg of fat from both inguinal regions. The samples from each rabbit were pooled, divided into four equal aliquots and then soaked in a transfer medium. Group I was the control group with normal saline as the transfer medium, group II used modified Dulbecco's modified Eagle's medium (modified DMEM), group III used modified DMEM with insulin and group IV used modified DMEM with insulin and β-fibroblast growth factor. After dividing the dorsum of each rabbit into four even parts, one fat sample from each group was transplanted into one of the pockets created in the loose areolar tissue immediately beneath the dermis. Six rabbits were euthanised using pentobarbital sodium each time, 1, 3, 6 and 12 months after fat transplantation, and we measured the weights of the fat grafts and examined the histological changes using light microscopy. Groups III and IV showed significantly greater viability of fat grafts than the controls in the group I. On histological examination, large numbers of mature adipocytes were observed in groups III and IV, and reduced cyst formation and fibrosis were also observed. Autologous fat transplantation using the new transfer medium containing insulin and β-fibroblast growth factor is a simple, promising strategy for clinical application designed to augment the viability of fat transplantation.