要抽脂补脂的客人通常会问我要从那儿抽？我说随便，看你喜欢从肚子或大腿都可以。有些人听到这答案后会正色的对我说：医师，可是我上次去xx诊所询问，那个医师说从大腿抽出来的脂肪比较好；不然就是说：网路上很多人说肚子的脂肪太软很容易吸收掉。
Wo-oh, 网路上乡民的见解就算了，我比较在意的是那个医师说从大腿抽出来的脂肪比较好？
让我们来看看专家实验结果吧！
篇名: In Search of Improved Fat Transfer Viability
作者: Rod J Rohrich , Evan S Sorokin, Spencer A Brown
杂志: PRS 2004;113:391
简述:
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.
结果如这二表所示
简单地说明结论：从四个不同部位（肚子、腰、大腿、膝盖）取出的脂肪，不论有没有离心，它们的存活率没有差别。下一次再有人跟你说什么大腿的脂肪因为有在运动所以比较结实比较好时（山鸡比肉鸡有咬劲的反射式推理？）你就可以告诉他这种说法是没有根据的。
上述实验仍然有些瑕疵，因为只观察脂肪细胞活性并没有真的移植，临床上结果可能会有差异。接下来这篇实验补足这个缺点，研究者把不同部位取出的脂肪注入老鼠体内，12周后取出脂肪比较大小，这就接近临床条件了。此外本文也比较不同部位抽出的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
杂志: Aesthetic plastic surgery 37.1 (2013): 153-158
简述:
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.
结论很简单：不同部位抽出的脂肪细胞和SVFs，移植后3个月的存活率没有差别。从2004年 RJ Rohrich 到2013年Kecheng Li的实验得到一样结论，Li的实验进一步告诉我们不同部位抽出的脂肪干细胞含量也相同，所以不必拘泥要选那个部位了。不过我个人的心得是抽肚子比较方便也少纠纷。
