The November 2018 issue of Plastic and Reconstructive Surgery Journal was full of fat grafting studies. I love it! Our never ending quest is to figure out how to get the fat to survive, and how we can help it. This article was – get ready for it- “The Disturbed Function of Neutrophils at the Early Stage of Fat Grafting Impairs Long Term Fat Graft Retention.”
wowsa. That is a mouthful, eh?
To distill it down, we know neutrophils are the first responders in inflammation and a key to help tissues regenerate.
- Neutrophils help clear dead cells. If this doesn’t happen then macrophages come in (which come in at 1 week),
- Neutrophils help form new blood vessels by secreting a protein matrix MMP-9, and
- Neutrophils help regulate the inflammation levels. Too many neutrophils caused an increase in inflammation IL-6, which damaged the healthy tissue.
The study found neutrophils got to the new tissue as early as 24 hours out. If they weren’t there, new blood vessels didn’t form; and if they were over stimulated, there was severe tissue damage. So the key is to leave the neutrophils alone- the “just right,” undisturbed function.
What does this mean to me?
Understanding what influences fat will help us improve fat survival. With all of these studies, we are inching closer to understanding how to optimize new blood vessel formation and lower levels of inflammation. This is truly science at work here, though any findings here are far away from being usable for me in the OR to improve my fat survival after grafting. It was interesting that too many neutrophils or too few were both bad.