Impaired Survival of Autologous Fat Grafts by Diabetes Mellitus in an Animal Model: A Pilot Study

Background: Many surgeons are reluctant to perform fat grafting in patients with diabetes because soft-tissue healing is impaired, but no previous study has reported data-driven outcomes of fat grafting in subjects with diabetes. Objective: The authors investigate whether diabetes affected survival and complication rates of autologous fat grafting (AFG) in Sprague-Dawley (SD) and Otsuka Long-Evans Tokushima Fatty (OLETF) rats. Methods: In total, 16 male SD and 16 male OLETF rats were prepared for AFG. Fat tissue was harvested from the inguinal fat pad and cut into 1-g (800-1250 mg) sections. Each rat received fat in a subcutaneous pocket in the paraspinal area. The grafted fat tissue was measured by ultrasonography at 30, 60, and 90 days after implantation and evaluated by histological analyses. Results: Ultrasonographic analysis indicated that compared with the SD group, the AFG survival rate was lower in OLETF rats (40.52% vs 53.38%), and the failure rate was higher in OLETF rats (31.25% vs 6.25%). The histological analysis indicated that compared with the OLETF group, adipocytes were more dense (3.18 vs 2.33; P = .025), cyst formation occurred less frequently (3.00 vs 3.61; P = .030), and more capillaries were formed (2.31/field vs 1.61/field; P = .001) in the SD rat group. Conclusions: Diabetes causes marked deterioration in the survival and quality of AFG in the diabetic rat model.