Objective: Soft tissue deficits associated with various craniofacial anomalies can be addressed by fat grafting, although outcomes remain unpredictable, and no consensus exists for timing of these procedures. While some... [ view full abstract ]
Objective: Soft tissue deficits associated with various craniofacial anomalies can be addressed by fat grafting, although outcomes remain unpredictable, and no consensus exists for timing of these procedures. While some advocate approaching soft tissue reconstruction after the underlying skeletal foundation has been corrected, other studies have suggested earlier grafting may exploit a younger recipient niche that is more conducive for fat graft survival. This study compares the effectiveness of fat grafting in younger versus older animals through a longitudinal, in vivo analysis utilizing a novel murine model.
Methods: Human lipoaspirate from two healthy female donors was grafted subcutaneously over the calvarium of immunocompromised mice. Volume retention over 8 weeks was evaluated using micro-computed tomography in three experimental ages - 3 weeks old, 6 months old, and 1 year old. Histology was performed on explanted grafts to evaluate graft health and vascularity.
Results: Superior retention of fat graft volume was noted in the youngest group compared to older groups (p < 0.05) at 6 and 8 weeks. Histological and immunohistochemical analyses suggested that improved retention in younger groups was, in part, attributable to more robust vascularization, sustained throughout 8 weeks.
Conclusion: Our study provides evidence that grafting fat into a younger recipient site correlates with superior volume retention over time, suggesting that beginning soft tissue reconstruction with fat grafting in patients at an earlier age may be preferable to late correction.
