Fat grafting based on 3D printed polyhydroxyalkanoate scaffolds.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Autologous fat grafting holds significant promise for soft tissue repair and reconstruction. However, its clinical application faces challenges, including insufficient graft strength for optimal shaping and poor long-term retention rates, particularly in large-volume transplantation. Three-dimensional (3D)-printed biodegradable scaffolds offer a potential solution by mitigating graft ischemia and hypoxia, thereby improving retention, while offering temporary mechanical support before degradation. Polyhydroxyalkanoates (PHA) containing 3-hydroxybutyrate and 4-hydroxybutyrate monomers, a promising class of biomaterials in tissue engineering, were employed in this study to fabricate 3D-printed scaffolds for fat grafting. Their effects on graft retention were explored for underlying mechanisms. In vivo studies demonstrated that 3D-printed PHA scaffolds significantly enhanced fat graft retention by stimulating angiogenesis, promoting adipocyte viability, inducing macrophage polarization toward the M2 phenotype, attenuating oxidative stress, and optimizing mitochondrial functions. Additionally, the scaffolds further improved retention by facilitating beige adipogenesis or white adipose tissue browning. In vitro experiments confirmed the excellent biocompatibility of PHA, with its degradation product -3-hydroxybutyrate (3HB) exhibiting no cytotoxicity. Furthermore, 3HB enhanced the en

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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