Effect of Cannula Fenestration Area on Fat Graft Architecture and Histology: A Double-Blind, Split-Body Clinical Trial.

Authors

Yanko Castro-Govea, Dulce Maria Sanchez-Dauth, Cynthia M Gonzalez-Cantu, Luis Rodrigo Gomez-Alvarez, Pedro Emiliano Ramos-Morales, Luis Adrian Alvarez-Lozada, Everardo Valdés-Flores

Published in

Aesthetic plastic surgery. Jul 06, 2026. Epub Jul 06, 2026.

Abstract

Fat grafting is widely used in reconstructive and aesthetic surgery due to its autologous nature and biocompatibility; however, resorption rates of 40-50% remain a limitation. Adipocyte survival depends on harvesting, processing, and injection techniques. This study aimed to evaluate whether liposuction cannula diameter and fenestration area influence macroscopic and histologic characteristics of harvested adipose tissue.
A double-blind, non-randomized, split-body study was conducted. The abdomen was divided into four quadrants. Four cannula configurations were evaluated according to diameter (3 mm vs 5 mm) and fenestration area (1 mm² vs 2.5 mm²), resulting in four experimental groups: A) 3 mm/1 mm², B) 5 mm/1 mm², C) 3 mm/2.5 mm², and D) 5 mm/2.5 mm². Adipose tissue particle area, adipose and oily phase volumes, septal alterations, morphological changes, and cellular debris were evaluated.
Forty samples were analyzed. Cannula B produced the largest adipose tissue particle area (median 9.54 mm²), although differences among groups were not statistically significant (p = 0.49). Cannula D yielded the highest adipose phase volume (median 12.5 mL), whereas cannula C showed the greatest oily phase (median 2.44 mL), indicating increased lysis. Cannula A demonstrated more severe morphological and septal alterations. A significant association was identified between cannula type and presence of cellular debris (p = 0.03), with group B contributing most prominently.
Fenestration area influences adipocyte integrity. Smaller fenestrations (1 mm²) caused greater septal disruption and cellular debris, whereas the 5-mm cannula with a 2.5-mm² fenestration demonstrated the least histologic distortion. The oily fraction was consistently higher with 3-mm cannulas regardless of fenestration size. Larger-caliber cannulas with wider fenestrations appear to minimize adipocyte trauma and lysis.
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PMID:
42410195
Bibliographic data and abstract were imported from PubMed on 24 Aug 2026.

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