title: Adipocytes Viability After Suction-Assisted Lipoplasty: Does the Technique Matter?
abstract: BACKGROUND
  Suction-assisted lipoplasty (SAL; liposuction) is an established aesthetic procedure in plastic surgery. The main parameters differentiating one method of lipoplasty from another are safety, consistency of results, and other more technical parameters. Due to the recent popularity of lipotransfer, the quality of extracted fat has become a relevant parameter. We compare the viability of extracted adipocytes after dry SAL, hyper-tumescent PAL (power-assisted lipoplasty), and water-assisted lipoplasty (WAL).
  
  
  METHODS
  We used fluorescent microscopy to differentiate viable from necrotic/apoptotic cells after liposuction using each of the mentioned methods.
  
  
  RESULTS
  The ratio of living cells between the three methods was significantly different with dry liposuction yielding inferior ratios (p = 0.011). When omitting extreme results, we found that the body-jet technique (WAL) yielded higher ratios of living cells than the hyper-tumescent technique (p < 0.001). The total number of cells was highest in the hyper-tumescent method (p = 0.013).
  
  
  CONCLUSIONS
  Our results indicate that the hyper-tumescent technique yields the highest number of cells, whereas the body-jet technique yields the highest living cells ratio. The dry technique is clearly inferior to both.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: The Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Ramat-Gan, Israel. harats@gmail.com.
authors.forename: Moti
authors.initials: M
authors.lastname: Harats
authors.affiliation: The Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Millet
authors.affiliation: The Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Marie
authors.initials: M
authors.lastname: Jaeger
authors.affiliation: The Advanced Technologies Center, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Orenstein
authors.affiliation: The Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Ramat-Gan, Israel.|The Talpiyot Medical Leadership Program, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Josef
authors.initials: J
authors.lastname: Haik
authors.affiliation: Chirurgie, Hôpital du Jura, Delémont, Switzerland.|Ella Institute of Melanoma, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Hajdu
authors.affiliation: The Talpiyot Medical Leadership Program, Sheba Medical Center, Ramat-Gan, Israel.|Ella Institute of Melanoma, Sheba Medical Center, Ramat-Gan, Israel.|Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gal
authors.initials: G
authors.lastname: Markel
authors.affiliation: The Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Winkler
authors.affiliation: The Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Ramat-Gan, Israel.|The Talpiyot Medical Leadership Program, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Tessone
mesh_terms: D017667:Adipocytes / Q000166:cytology*; D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D002470:Cell Survival / Q000502:physiology*; D004954:Esthetics; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008875:Middle Aged; D012494:Sampling Studies; D013518:Surgery, Plastic / Q000379:methods; D016896:Treatment Outcome
keywords: Adipocyte viability; Fat transfer; Liposuction