Autologous microlobular fat combined with platelet-rich fibrin is associated with good fat graft viability

Fat grafting is popular in facial plastic reconstructive surgery. However, a fat graft shows unpredictable resorption. The addition of autologous platelet-rich fibrin (PRF) may enhance its viability. PRF has several growth factors, including vascular endothelial growth factor (VEGF), and these factors can improve fat graft viability by enhancing angiogenesis. We aimed to determine whether the use of PRF and the graft processing method influence fat graft viability (angiogenesis and VEGF expression). The study included New Zealand white rabbits. The rabbits were divided into the following groups: microlobular fat (A), microlobular fat with PRF (B), centrifuged fat (C), and centrifuged fat with PRF (D). After 30 days, biopsy was performed for all grafts. Hematoxylin and eosin staining and immunohistochemical staining for VEGF were performed. The angiogenesis areas in groups A to D were 112.67, 90.51, 84.48, and 110.52, respectively. The VEGF expressions in groups A to D were 241.33, 287.22, 212.89, and 231.44, respectively. Increased angiogenesis and VEGF expression can improve graft viability. PRF was found to be associated with increased VEGF expression, whereas microlobular fat was found to be associated with good angiogenesis. Thus, microlobular fat combined with PRF is recommended as an autologous graft.