Biomechanics of Negative-Pressure-Assisted Liposuction and Their Influence on Fat Regeneration

Abstract

Autologous fat grafting has been widely adopted in cosmetic and reconstructive procedures recently. With the emerging of negative-pressure-assisted liposuction system, the harvesting process of fat grafting is more standardized, controllable, and efficient. Each component in the system could influence the biomechanical environment of lipoaspirate. Several reviews have studied the impact of negative pressure on fat regeneration. As the initial part of the harvesting system, cannulas possess their unique mechanical parameters and their influence on lipoaspirate biomechanical characters, biological behaviors, and regeneration patterns remains unclear. Basic in vivo and in vitro studies have been performed to determine the possible mechanisms. Instant in vivo studies focus on adipocytes, stromal vascular fraction cells, fat particles, and growth factors, while in vivo grafting experiments analyze the graft retention rate and histology. Understanding the different regeneration patterns of lipoaspirate and the mechanisms behind may facilitate the choice of harvesting cannulas in clinical practice.

Impact Statement

The retention rate and regeneration pattern of autologous fat grafting vary widely. As a mechanically sensitive tissue, fat experiences various kinds of forces and shows different biomechanical characters, which could also affect the graft result. However, a comprehensive overview of biomechanics in fat grafting is absent. In this review, we focus on negative-pressure-assisted harvesting step (especially cannulas) and summarize the available in vivo and in vitro studies. This review innovatively employs biomechanical knowledge to link clinical instruments, laboratory experiments, and animal studies together, providing alternative strategies for plastic surgeons to choose harvesting cannulas during fat grafting.