title: The Combination of Tissue Dissection and External Volume Expansion Generates Large Volumes of Adipose Tissue.
abstract: BACKGROUND
  Noninvasive external volume expansion device has been applied to stimulate nonsurgical breast enlargement in clinical settings. Although previous results demonstrate the capacity of external volume expansion to increase the number of adipocytes, this strategy alone is insufficient to reconstruct soft-tissue defects or increase breast mass. The authors combined a minimally invasive tissue dissection method with external volume expansion to generate large volumes of adipose tissue.
  
  
  METHODS
  In vitro, various densities of adipose-derived stem cells were prepared to evaluate relations between cell contacts and cell proliferation. In vivo, dorsal adipose tissue of rabbits was thoroughly dissected and the external volume expansion device was applied to maintain the released state. External volume expansion without tissue dissection served as the control.
  
  
  RESULTS
  In the dissection group, the generated adipose tissue volume was much larger than that in the control group at all time points. A larger number of proliferating cells appeared in the dissection samples than in the control samples at the early stage after tissue dissection. At low cell density, adipose-derived stem cells displayed an increasing proliferation rate compared to high cell density. Protein expression analysis revealed that cell proliferation was mediated by a similar mechanism both in vivo and in vitro, involving the release of cell contact inhibition and Hippo/Yes-associated protein pathway activation.
  
  
  CONCLUSIONS
  Adipose tissue dissection releases cell-to-cell contacts and induces adipose-derived stem cell proliferation. Preexpanded adipose-derived stem cells undergo adipogenesis under the adipogenic environment created by external volume expansion, leading to better adipose regeneration compared with the control.
authors.affiliation: Guangzhou, Guangdong, People's Republic of China.|From the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University.
authors.forename: Yunfan
authors.initials: Y
authors.lastname: He
authors.affiliation: Guangzhou, Guangdong, People's Republic of China.|From the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University.
authors.forename: Ziqing
authors.initials: Z
authors.lastname: Dong
authors.affiliation: Guangzhou, Guangdong, People's Republic of China.|From the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University.
authors.forename: Gan
authors.initials: G
authors.lastname: Xie
authors.affiliation: Guangzhou, Guangdong, People's Republic of China.|From the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.affiliation: Guangzhou, Guangdong, People's Republic of China.|From the Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University.
authors.forename: Feng
authors.initials: F
authors.lastname: Lu
mesh_terms: D017667:Adipocytes; D050156:Adipogenesis; D000273:Adipose Tissue / Q000166:cytology / Q000601:surgery*; D000818:Animals; D049109:Cell Proliferation; D002478:Cells, Cultured; D004210:Dissection; D005260:Female; D017346:Protein Serine-Threonine Kinases / Q000502:physiology; D051575:Proto-Oncogene Proteins c-yes / Q000502:physiology; D011817:Rabbits; D015398:Signal Transduction; D015626:Tissue Expansion
chemical_list: D051575:Proto-Oncogene Proteins c-yes; D017346:Protein Serine-Threonine Kinases