Background
Our goal was to determine whether N-acetylcysteine (NAC) administered to the tumescent solution can reduce oxidative stress and increase autologous fat graft (AFG) viability.
Methods
The study included 15 women with a mean age of 31.8 years (range 23–39 years) who underwent breast asymmetry correction with AFG harvested from both thighs. One thigh was infiltrated with a standard tumescent fluid (control graft) and other with a NAC-enriched tumescent fluid (NAC-treated graft). Each participant had breast MRI imaging before and 6 months after the procedure. Also, adipose tissue samples from each graft were subjected to biochemical analysis, flow cytometric assay and qRT-PCR to determine the markers of oxidative stress, angiogenesis and adipogenesis.
Results
Concentration and activity of superoxide dismutase in the NAC-treated grafts turned out to be significantly higher than in the control grafts, in both fresh (
p
 = 0.041 and
p
 = 0.023, respectively) and frozen samples (
p
 = 0.004 and
p
 = 0.003, respectively). The level of nitric oxide in frozen samples from the control grafts was significantly higher than in the NAC-treated grafts (
p
 = 0.009). iNOS was the only qRT-PCR target showing significant intergroup differences, with higher transcription levels observed in the control grafts (
p
 = 0.027). Breast volumetric analysis demonstrated that the NAC-treated group had a 12.19% lower resorption rate than the control group, although it was found to be statistically insignificant (
p
 = 0.149). No postoperative complications were observed during a 6-month follow-up.
Conclusions
Some results of this study are promising. Further studies on larger groups are needed to determine NAC impact on AFG.
Level of Evidence IV
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www.springer.com/00266
.
Trial registry name
The Impact of N-Acetylcysteine on Volumetric Retention of Autologous Fat Graft for Breast Asymmetry Correction.
Registration identification number
NCT03197103.
URL for the registry
https://clinicaltria...

10.1007/s00266-020-01633-1