The effect of preoperative microporation of the recipient site on fat graft survival

Although autologous fat grafting is considered to be the ideal soft tissue filler by many authors, the main problem encountered with this technique is not being able to predict long-term graft survival due to high absorption rates. Many techniques have been described in the literature to enhance the vascularity of the graft recipient area and thereby increase survival. The purpose of this study was to investigate the angiogenic effects of preconditioning of the recipient area with microporation and determine its overall impact on fat graft survival.A total of 30 wistar rats for 5 study groups were used in the study. The source of fat was the inguinal fat pad while the recipient area was a subcutaneous pouch on the dorsum of the rat. To allow for the neovascularization process to take place, fat graft transfer was done one week after preconditioning with microporation.Morphological evaluation demonstrated higher vascularity in the subcutaneous area of the recipient bed in rats that had undergone microporation in comparison to the control group. Fat grafts in the microporation group had better integrity and a higher level of vascularity compared to the control group. Volume analysis with the water-overflow method showed that at the end of week 15, the microporation group had higher graft survival in comparison to the control group. Histomorphometric and immunohistological evaluation showed higher integrity and uniform adipocytes with intact nuclei, better lobulation, less fibrosis, vacuolization and inflammation and better vascularization in the microporation group.Although higher triglyceride concentrations were measured for the group that had undergone microporation, the difference between the two groups were statistically insignificant.In conclusion, fat grafting performed on an area that has been preconditioned with microporation results with higher graft volume, better integrity and vascularization and an overall higher survival rate.