要抽脂補脂的客人通常會問我要從那兒抽？我說隨便，看你喜歡從肚子或大腿都可以。有些人聽到這答案後會正色的對我說：醫師，可是我上次去xx診所詢問，那個醫師說從大腿抽出來的脂肪比較好；不然就是說：網路上很多人說肚子的脂肪太軟很容易吸收掉。
Wo-oh, 網路上鄉民的見解就算了，我比較在意的是那個醫師說從大腿抽出來的脂肪比較好？
讓我們來看看專家實驗結果吧！
篇名: In Search of Improved Fat Transfer Viability
作者: Rod J Rohrich , Evan S Sorokin, Spencer A Brown
雜誌: PRS 2004;113:391
簡述:
Fat grafting is an unpredictable procedure that continues
to challenge the field of plastic surgery due to irregular
resorption. Applications for this procedure are broad in both
reconstructive and cosmetic plastic surgery. Fat grafts are
carefully obtained and manipulated to obtain better graft
takes and results, yet there is no universal agreement on what
constitutes an ideal methodology. The present study examines
adipocyte viability from four commonly used donor sites
in five subjects.No statistical differences in adipocyte viability
were demonstrated among abdominal fat, thigh fat, flank fat,
or knee fat donor sites that were immediately removed and
untreated (p 0.225). In addition, no differences were
observed in representative tissue samples that were removed
and centrifuged (thigh, p 0.508; knee, p 0.302; flank, p
0.088; abdomen, p 0.533). On the basis of these quantitative
data, neither harvest location nor centrifugation
demonstrated any advantage in terms of lipocyte viability. Fat
tissue transfers from these common sites may be considered
equal, and centrifugation does not appear to enhance immediate
fat tissue viability before implantation.
結果如這二表所示
簡單地說明結論：從四個不同部位（肚子、腰、大腿、膝蓋）取出的脂肪，不論有沒有離心，它們的存活率沒有差別。下一次再有人跟你說什麼大腿的脂肪因為有在運動所以比較結實比較好時（山雞比肉雞有咬勁的反射式推理？）你就可以告訴他這種說法是沒有根據的。
上述實驗仍然有些瑕疵，因為只觀察脂肪細胞活性並沒有真的移植，臨床上結果可能會有差異。接下來這篇實驗補足這個缺點，研究者把不同部位取出的脂肪注入老鼠體內，12周後取出脂肪比較大小，這就接近臨床條件了。此外本文也比較不同部位抽出的SVF (stromal Vascular Fraction)是否不同。
篇名: Selection of Donor Site for Fat Grafting and Cell Isolation
作者: Kecheng Li, Jianhua Gao, Zhidan Zhang, Jie Li, Pengfei Cha, Yunjun Liao, Guan Wang and Feng Lu
雜誌: Aesthetic plastic surgery 37.1 (2013): 153-158
簡述:
Background
Autologous fat grafting has rapidly become an important treatment for soft tissue defects in cosmetic and reconstructive surgery. However, consensus is lacking on the ideal donor site for harvesting and isolating stromal vascular fraction (SVF) cells to improve survival of fat grafts. We aimed to determine the best donor site for tissue harvesting and isolation of SVF cells for fat graft survival.Methods
Adipose tissue samples were harvested from six women who underwent an aesthetic procedure. The samples were harvested by needle aspiration of five commonly used donor sites: flank, upper and lower abdomen, and lateral and inner thigh. The adipose tissue was injected subcutaneously into nude mice and grafts were harvested at 12 weeks. We evaluated graft volume, weight, and histologic parameters of the grafts: integrity, cysts/vacuoles, inflammation, fibrosis, and neovascularization. SVF cells isolated from donor sites were counted and assayed by flow cytometry.Results
At 12 weeks post-transplantation, weight, volume, and histologic parameters did not differ among the grafts from the five tissue donor sites. Also, SVF and levels of cell surface markers did not differ by donor site.Conclusions
This study revealed no ideal tissue donor site for fat grafting and SVF isolation. Choosing a site should be based on ease and safety of access and the preference and request of the patient.
結論很簡單：不同部位抽出的脂肪細胞和SVFs，移植後3個月的存活率沒有差別。從2004年 RJ Rohrich 到2013年Kecheng Li的實驗得到一樣結論，Li的實驗進一步告訴我們不同部位抽出的脂肪幹細胞含量也相同，所以不必拘泥要選那個部位了。不過我個人的心得是抽肚子比較方便也少糾紛。
