Clinical Controlled Study Of SVF-gel And Coleman Adipose Tissue Transplantation

BackgroundAutologous fat transplantation is a common technique for plastic surgeons to repair soft tissue defects,improve facial contour and achieve facial rejuvenation.However,there are still some problems in fat transplantation,such as high absorption rate,low survival rate,oil sac formation and fibrosis calcification.Our previous research innovatively extracted SVF-gel from adipose tissue by mechanical method.Previous research showed that the retention rate of SVF-gel was significantly higher than that of normal fat after transplantation,and the grafts had higher angiogenesis/adipogenesis and lower inflammation reaction.Can SVF-gel replace the traditional Coleman fat for facial filling?We used SVF-gel instead of Coleman fat for facial filling to improve facial contour and achieve facial rejuvenation.Postoperative observation showed that compared with the experience of facial Coleman fat transplantation,the swelling degree of SVF-gel injection area was significantly lower than that of Coleman fat transplantation,and the volume retention of SVF-gel graft was more stable than that of Coleman fat transplantation.However,there is still a lack of objective evaluation indicators for the effect of SVF-gel transplantation.Therefore,we designed a prospective clinical controlled study of SVF-gel and Coleman fat transplantation.Previous researchers used the methods of pre-and post-operative photographs or patient satisfaction questionnaires,but these methods were subjective.Some researchers also use other methods,such as anthropometry,animal experiments or drainage,but these methods are inaccurate and inconvenient.Magnetic resonance and ultrasonography are also used in clinic,but their application is limited by long time and high cost.In recent years,the three-dimensional technology has been introduced into the evaluation of the efficiency of fat aspiration and fat transplantation because of its convenience and accuracy.In this study,CASZM MVS-600 was used for three-dimensional imaging.Methods and resultsFrom September 2017 to February 2018,10 patients with bilateral temporal depression were filled with temporal soft tissue to improve their facial contour.The patients were randomly divided into two groups.Coleman fat（n=10）and SVF-gel（n=10）were injected into the subfascial layer of superficial temporal fascia through multiple tunnels and multiple points of 25g unilateral orifice fat injection needle.Three-dimensional scanning was performed pre-operation,1 month and 3 months post-operation,and the graft retention rate was quantified.No serious complications such as infection,lipocyst,granuloma or other side effects were found in this clinical trial.In this study,CASZM MVS-600 was used for three-dimensional scanning.The average amount of injections of Coleman adipose tissue into each temporal region was 8.50（±1.08 ml）and that of SVF-gel was 7.90（±1.10 ml）.The average volume retention rates at 1 month and 3 months follow-up were 42±9%vs 60±10%（P<0.05）,38±10%vs 54±9%（P<0.05）,respectively.These data indicate that SVF-gel has higher volume retention than Coleman fat.Gender,age and body mass index were not related to volume maintenance rate.Postoperative facial swelling in SVF-gel group was slighter than that in Coleman group,and the swelling time was significantly shortened.ConclusionThe retention rate of SVF-gel was evidently higher than that of Coleman fat after transplantation,and the swelling after transplantation was slighter and the recovery period was shorter.However,due to the small sample size and short observation period,the results of this study have some limitations.It still needs a large sample of multi-center clinical research,and needs to extend the observation period in order to obtain more reliable clinical evidence.