Does water-jet force make a difference in fat grafting? In vitro and in vivo evidence of improved lipoaspirate viability and fat graft survival.

BACKGROUND Recent literature has revealed that water-jet-assisted liposuction offers a new method of conventional liposuction techniques by using the gentle spray of fluid. However, there has not yet been a systematic, randomized, controlled study to demonstrate its effect on the vitality and postoperative fat survival of fresh lipoaspirates. In this study, the authors compared liposuction with or without water-jet assistance in a blinded fashion. METHODS Human lipoaspirates were obtained from healthy Chinese female volunteers for body shaping. Lipoaspirates were harvested by a single surgeon using the same material and machine; water-jet assistance was the only variance in this study. At the beginning of surgery, the authors randomly performed conventional manual liposuction without water-jet assistance for one side to obtain 50 ml of lipoaspirate (group B). At the corresponding area of the other side, the authors used water-jet-assisted liposuction to obtain another 50 ml of lipoaspirate (group A). All of the harvested lipoaspirates were used in the in vitro and in vivo experiments to evaluate the effect of water-jet force on the vitality and postoperative fat survival of fresh lipoaspirates. RESULTS Fresh lipoaspirates from group A had greater viability and a higher percentage of CD34/CD45 cells than group B. Grafted lipoaspirates in group A had better weight retention, less apoptosis, and greater angiogenesis. CONCLUSIONS The fate of grafted lipoaspirates was affected by water-jet force. With the assistance of water-jet force during the harvesting procedure, the authors could obtain more viable lipoaspirates and achieve better fat survival.