ArticleAesthetic plastic surgery2026
Functional Stratification of Adipose-Derived Stem Cells via Gradient Density Centrifugation: D-ASCs Drive Vascularization for Enhanced Fat Graft Survival.
Article in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate the functional heterogeneity of adipose-derived stem cells (ASCs) in fat grafting and develop a density-based separation method to isolate distinct ASC subpopulations for improving graft survival.
methodsASCs were isolated from human lipoaspirates and subjected to adipogenic differentiation. A novel Percoll density gradient centrifugation protocol (10-100%, 300 × g, 35 min) was developed to separate ASCs into upper-layer (U-ASCs) and lower-layer (D-ASCs) subpopulations. Their adipogenic and angiogenic potentials were assessed through Oil Red O staining and Matrigel tube formation assays. In vivo functionality was evaluated in nude mice (n = 84) receiving fat grafts supplemented with GFP-labeled U-ASCs, D-ASCs, or unsorted ASCs (n = 28/group), with graft retention, histology, and cellular fate analyzed over 12 weeks.
resultsDensity separation yielded two functionally distinct populations: U-ASCs exhibited 3.2-fold greater lipid accumulation (p < 0.001), while D-ASCs showed 2.7-fold enhanced tube formation (p < 0.01). In vivo, D-ASCs grafts demonstrated 58.3 ± 6.7% retention at 12 weeks versus 32.1 ± 5.2% for U-ASCs (p < 0.001), with significantly reduced oil cysts (p < 0.05) and 2.4-fold higher vascular density (p < 0.001). Immunofluorescence revealed U-ASCs primarily differentiated into adipocytes (GFP+/Perilipin+), whereas D-ASCs integrated into vasculature (GFP+/CD31+).
conclusionASC subpopulations differentially regulate fat graft outcomes-U-ASCs drive adipogenesis while D-ASCs enhance vascularization. The developed density separation method enables isolation of therapeutic ASC subsets, with D-ASCs showing superior potential for improving graft survival through neovascularization. These findings support precision strategies in cell-assisted lipotransfer. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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