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Page 10 of 16 Shaaban et al. Plast Aesthet Res 2023;10:12 https://dx.doi.org/10.20517/2347-9264.2022.91

[136]
22-year-old female who presented with multiple abscesses in her face requiring a year to control .

To avoid secondary procedures altogether, a variety of biologics have been admixed with lipoaspirate to
improve overall take. To date, the most compelling outcomes have been obtained using culture-expanded
adipose stem cells, whereby Kolle et al. obtained mean retention of 80.9% in 10 patients measured by
MRI [137,138] . Other Level I/II studies have reported utilizing platelet-rich plasma or stromal vascular
[139]
fraction [140,141] with lipoaspirate but have been unable to achieve reliably increased retention outcomes in the
breast and both increased the incidence of complications and did not decrease the frequency of multiple
operations after lipo-transfer . Current clinical data suggests that the addition of adipose stromal cells
[142]
(e.g., not culture expanded) to a fat graft may be most effective for treating hypertrophic or retractile scars
and thus most critical when transplanting into a “hostile” recipient bed such as irradiated or scarred
tissue .
[143]
Interestingly, studies have been conducted using lipoaspirate washed with Poloxamer 188, or P188 and
determined that the copolymer may reduce apoptosis, increase the mass of the fat transplant, improve cell
viability and DNA content, and enhance the histological composition of the fat grafts. The investigators
hypothesized that P188 copolymer stabilized adipocyte cell membranes to, preventing reabsorption and cell
death .
[144]

CONCLUSION
The surgical approach for breast reconstruction involves many patient-specific factors including anticipated
outcomes and patient preference. Fat grafting is, by now, an established part of the surgical armamentarium
for improving the final appearance and feel of the breast and can be used successfully as an adjunct to
traditional prosthetic/implant or flap-based approaches. With the continuous evolution of the technique,
autologous fat grafting is likely to emerge as an acceptable option to provide higher patient satisfaction and
improved quality of life.

DECLARATIONS
Authors’ contributions
Contributed to review design: De La Cruz C, Kokai L, Shaaban B
Contributed to writing: Shaaban B, Kokai L, Guerrero D, De La Cruz C
Approved the final draft: De La Cruz C, Kokai L

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.