Abstract
BACKGROUND: Acoustic Wave Therapy (AWT) is a particular shock wave treatment that combines focused and radial shock waves, resulting in particular efficiency in the body's superficial layers. Its application before fat grafting has the potential to enhance it, favoring a better result of the graft. AIMS: The aim of this study was to analyze the effects of AWT on fat tissue. METHODS: Histological analysis of fat harvested from the abdomen of 40 subjects was evaluated. Twenty subjects had been pre-treated with AWT, while 20 had not. Extraction and characterization of adipose-derived stem cells (ADSCs) were performed for all. The multilineage differentiation capacity of extracted ADSCs and exosome extracellular vesicles' production from the fat samples were analyzed in both groups of specimens. RESULTS: All 40 specimens presented both preservation of the structure of the tissue and of the cells, particularly of adipocytes. The cell growth resulted higher for pre-treated samples. All ADSCs from all the samples were able to differentiate along adipogenic, chondrogenic, and osteogenic lineages. In particular, for pre-treated samples, in the adipogenic lineage, a more advanced maturation phase was observed, and in the chondrogenic lineage, a chondroid matrix was evident around chondrocyte aggregates. All the samples reacted with exosome extracellular vesicles' production to stress. CONCLUSIONS: The results highlighted that AWT aligns with the in-force minimal manipulation regulations, as the tissue and cells' structure and functionality were preserved. The types of differentiation observed permitted us to speculate about possible new applications in aesthetic and regenerative medicine.