title: The role of estrogen in the modulation of autologous fat graft outcomes.
abstract: BACKGROUND
  Autologous fat grafting is a widely used procedure, yet the mechanisms that regulate graft outcomes are poorly understood. Estrogen signaling is a potent regulator of lipid handling, inflammation, fibrosis, and adipocyte progenitor recruitment in adipose tissues. To date, no studies have investigated the effect of circulating estrogens on fat graft outcomes.
  
  
  METHODS
  Immunosuppressed (Nu/Nu) mice underwent ovariectomy or sham surgery. Forty-five days later, half the mice (donors) were killed, and adipose tissue was taken and transplanted into the remaining cohort (recipients). Forty-five days after transplantation, grafts were dissected, weighed, and assessed for expression of vascular endothelial growth factor, estrogen receptor-α, and vascular density.
  
  
  RESULTS
  Grafts harvested from and transplanted into sham environments are smaller but more highly vascularized compared with ovariectomy environments. The estrogenic effects on grafts are more critical at the site of the donor tissue than the recipient. Finally, expression of estrogen receptor-α in the grafted tissue correlates with the observed graft characteristics, which is altered by both the donor and recipient environments.
  
  
  CONCLUSIONS
  Circulating estrogens have significant effects on fat graft outcomes, primarily at the site of the donor tissue. As there are well-established depot-specific estrogenic responses, the choice of adipose depot used as a donor for fat grafting may affect outcomes. In addition, outcomes may be confounded by the patient's hormonal status. Understanding the mechanisms by which estrogen signaling regulates graft outcomes is important in refining this commonly used clinical procedure.
authors.affiliation: Dallas and Richardson, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and the Department of Chemistry, University of Texas at Dallas.
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Bills
authors.forename: Christopher
authors.initials: C
authors.lastname: Derderian
authors.forename: Jenny
authors.initials: J
authors.lastname: Barker
authors.forename: Alysia
authors.initials: A
authors.lastname: Lowe
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Lavery
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Davis
mesh_terms: D000273:Adipose Tissue / Q000502:physiology* / Q000637:transplantation*; D000818:Animals; D064592:Autografts / Q000502:physiology*; D004967:Estrogens / Q000502:physiology*; D005260:Female; D051379:Mice; D008819:Mice, Nude
chemical_list: D004967:Estrogens