Investigation of the effects of vitamin D3 (cholecalciferol) and Myrtus communis on fat graft survival in experimental autologous fat graft applications

Objective: This experimental study aimed to investigate the effects of Vitamin D3 (cholecalciferol) and Myrtus communis (myrtle) on fat graft survival, with the goal of improving the success of autologous fat graft applications commonly used in aesthetic and reconstructive surgery. The synergistic effects of the immunomodulatory and anti-inflammatory properties of Vitamin D3 and the antioxidant characteristics of Myrtus communis on fat graft outcomes were evaluated. Materials and Methods: The study was conducted using 42 male Wistar Albino rats aged 2–3 months. The animals were randomly divided into seven equal groups: 1.Group: Control group without surgical intervention, 2.Group: Fat graft + local Vitamin D3 application, 3.Group: Fat graft + local Vitamin D3 + oral Myrtus communis, 4.Group: Fat graft + systemic Vitamin D3, 5.Group: Fat graft + systemic Vitamin D3 + oral Myrtus communis, 6.Group: Fat graft-only control group, 7.Group: Fat graft + oral Myrtus communis application. At the end of the eight-week follow-up period, biochemical, histopathological, and immunohistochemical analyses were performed to assess graft outcomes. Results: Biochemical analysis revealed a significant reduction in inflammatory markers TNF-α and IL-1 levels in 3.Group and 5.Group compared to the control (1.Group) and fat graft-only (6.Group) groups. In the same group, there was an increase in the antioxidant enzyme SOD activity (646.20 ± 44.89 U/mg) and a decrease in MDA levels (0.73 ± 0.10 nmol/mg). Histopathological evaluations showed more organized adipocyte distribution, reduced fibrosis, and improved tissue architecture in the groups receiving combination therapy. Immunohistochemical findings indicated that Caspase-3 expression was significantly reduced in the combination therapy groups (p<0.0001), VEGF-A expression was increased in 3.Group (local Vitamin D3 application) (p<0.0001), and eNOS levels were decreased in the combination treatment groups. Systemic safety assessments demonstrated lower liver enzyme levels (ALT, ALP) in the combination therapy groups, while no significant differences were observed in renal function parameters across the groups. Conclusion: The combination of Vitamin D3 and Myrtus communis enhances autologous fat graft survival by reducing early inflammation and oxidative stress. This combined therapy offers both local and systemic protective and therapeutic effects and presents a promising strategy to improve fat graft retention. However, further studies are needed to assess long-term effects and to determine optimal dosing protocols.