The effect of hyaluronan hydrogel on fat graft survival

Mohammed Alghoul*, Amanda Mendiola, Rahul Seth, Brian P. Rubin, James E. Zins, Anthony Calabro, Maria Siemionow, Shashidhar Kusuma

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Autologous fat transplantation is a common technique for soft tissue augmentation in aesthetic and reconstructive surgery; however, the degree of fat graft take can be unpredictable. Hyaluronan has been shown to be a promising cell carrier in adipose tissue engineering. Objectives: The authors investigate the effect of a hyaluronan hydrogel on fat graft survival, angiogenesis, and volume maintenance in a rat model. Methods: Fat was harvested from the groins of 27 rats, processed, and injected beneath the animals' dorsums to form 2 grafts: 1 containing fat alone and 1 containing fat and hyaluronan hydrogel in a 1:1 mix (fat-HA). The grafts were scanned in vivo under high-resolution computed tomography at baseline and prior to euthanasia at 4, 12, and 20 weeks to measure total fat-HA graft volume as well as the volume of the fat component alone. Histological studies were performed after sacrifice to evaluate fat necrosis and blood vessel density. Results: All grafts were clinically viable. Overall, fat necrosis was significantly reduced in the fat-HA grafts compared with the grafts containing fat alone (P < .001). This difference was most profound at 4 weeks (P = .008) but did not reach statistical significance at 12 and 20 weeks. At 12 weeks, blood vessel density in the fat-HA grafts was significantly greater than in the grafts containing fat alone (P = .016), but this did not reach statistical significance at 4 or 20 weeks. At 20 weeks, the fat component of the fat-HA graft had significantly less volume loss than the fat-alone graft (P = .008). Conclusions: When mixed with fat, hyaluronan hydrogel can improve early fat graft survival and may enhance vascularity and prolong volume maintenance.

Original languageEnglish (US)
Pages (from-to)622-633
Number of pages12
JournalAesthetic surgery journal
Issue number5
StatePublished - Jul 2012


  • autologous fat transplant
  • fat graft
  • hyaluronan
  • hydrogel
  • research
  • soft tissue augmentation

ASJC Scopus subject areas

  • Surgery


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