PhD defense Dr Stillaert (December 2022)

Adipose tissue is a “first-class” tissue substitute in plastic surgery. Adipose tissue engineering solutions might offer clinical applications for autologous tissue replacement.

Adipose tissue engineering research explores different approaches to “fabricate” fat tissue. These approaches use natural or synthetic scaffolds that are seeded with lineage-specific precursor cells. However, fat tissue is a dynamic mesenchymal tissue that is highly vascularized. These characteristics require particular attention in fat tissue engineering approaches. The initial enthusiasm to create “off the shelf” adipose tissue constructs is tempered by limited successes in adipose tissue engineering and the problem of upscaling. We have demonstrated three dimensional, vascularized adipose tissue growth in the mouse tissue engineering chamber model revealing some crucial processes in adipogenic formation. On the contrary, a scaffold-based approach in a human clinical trial was less successful confirming the need to include vascularity in a tissue engineering approach. Fat grafting is a minimal invasive technique that bypasses the disadvantages of microsurgical tissue transfer but is related with an unpredictable resorption rate. The efforts in adipose tissue engineering research might not result yet in the wanted outcome but they do contribute to a better understanding of how to improve our clinical applications of fat grafting and include more autologous-based techniques in our practice.