Are Preadipocytes More Advantageous Than Adipocytes in Soft Tissue Augmentation?

Abstract

Background: Autologous fat grafting in pediatric patients is limited due to restricted fat tissue reserves. Preadipocytes, derived from adipose tissue, offer a promising alternative for soft tissue augmentation in children. Objectives: This study aims to compare the effectiveness of preadipocyte fat grafting with conventional adipose grafting, particularly in cases where adipose tissue availability is limited. Methods: In this experimental study, 28 male Wistar albino rats were used. Fat was harvested from periepididymal fat pads to prepare preadipocyte and adipocyte suspensions. These suspensions were injected subcutaneously into the right and left scapular areas, respectively. The rats were divided into four groups based on post-injection excision timing. Volumes of excised tissue were calculated using a hemi-ellipse formula. Histopathological examinations were conducted, comparing necrosis, fibrosis, vascularity changes, cyst formation, and inflammatory cell density. Results: Statistical analysis was performed using GraphPad Instat 3.0 and SPSS 17.0 software. Histopathologically, preadipocyte grafts showed better scores for necrosis, fibrosis, cyst formation, vascularity, and inflammation across all groups. Although no significant volumetric differences were observed in the other groups, in the fourth group (22 weeks), volumetric loss of adipocyte grafts was significantly greater than that of the preadipocyte grafts (0.09 ± 0.01 vs. 0.05 ± 0.02, P < 0.05). Conclusions: The findings suggest that preadipocyte grafting holds promising potential for soft tissue augmentation, particularly in pediatric cases where limited fat tissue availability presents challenges. Preadipocytes' inherent characteristics, including resistance to hypoxia and enhanced promotion of angiogenesis, may contribute to their sustained volume retention and improved histopathological outcomes. The significant reduction in adipocyte graft volumes may be attributed to their susceptibility to hypoxia and graft resorption. The ability of preadipocytes to withstand ischemic conditions and promote angiogenesis could contribute to their enhanced viability. Further research and clinical investigations are warranted to establish preadipocyte grafting as a viable solution for soft tissue augmentation, especially in pediatric patients with limited adipose tissue availability. A comprehensive assessment of volumetric changes and histopathological outcomes provides deeper insight into the potential benefits of preadipocyte grafting in pediatric healthcare.