# Investigation of the Effect of Preconditioning with Ultrasound on Fat Graft Survival

## TL;DR

This study investigates how therapeutic ultrasound affects the survival of fat grafts in rats, finding that massage-like effects may improve survival more than ultrasound energy alone.

## Contribution

The study introduces the idea that the mechanical massage effect of therapeutic ultrasound, rather than the ultrasound energy itself, may enhance fat graft survival.

## Key findings

- Therapeutic ultrasound increased fat graft vascularization but did not improve survival rates.
- The preoperative–postoperative massage group showed statistically significantly higher fat graft survival rates.
- Macroscopic measurements showed no statistically significant differences between groups.

## Abstract

The use of fat grafts in plastic, reconstructive, and aesthetic surgery has been increasing. Although fat grafting has many advantages, there is limited evidence regarding its survival rates. Current studies focus on improving fat graft survival rates. This study aimed to evaluate the effect of therapeutic ultrasound (TERUS) application on fat graft survival.

The study involved 42 adult male Wistar Albino rats, which were randomly divided into seven groups of six rats each: Group 1 served as the control group and received only fat grafting; Group 2 received preoperative daily TERUS for one week, followed by fat grafting; Group 3 underwent preoperative daily massage for one week, followed by fat grafting; Group 4 received preoperative daily TERUS for one week, followed by fat grafting and postoperative daily TERUS for one week; Group 5 underwent preoperative daily massage for one week, followed by fat grafting and postoperative daily massage for one week; Group 6 received postoperative daily TERUS for one week; and Group 7 received postoperative daily massage for one week. After volume and weight measurements, immunohistochemical evaluation was conducted using perilipin and PECAM-1. Apoptosis was assessed using the TUNEL method.

No statistically significant differences were observed in the macroscopic measurements. While TERUS increased the vascularization of fat grafts, it did not improve survival rates. The mean fat graft survival rate in the preoperative–postoperative massage group (Group 5) was statistically significantly higher than in the other groups.

The findings of this study suggest that the massage effect of TERUS, independent of ultrasonic energy, may be beneficial for fat graft survival. Although TERUS increases the vascularity of fat grafts, it does not improve fat graft survival rates.

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