Effects of Recipient Area pH Change on Fat Graft Survival

INTRODUCTION: Predicting the integration and adaptation of adipose tissue grafts in the recipient area remains challenging. Since graft incorporation shares key mechanisms with wound healing, local environmental factors such as pH may influence graft viability. This study aimed to investigate the effects of different pH levels on preadipocyte viability and related cellular responses. METHODS: Adipose tissue obtained from the infraumbilical region of a healthy donor was processed and divided into 13 groups. Isolated preadipocytes were cultured at pH values ranging from 1 to 13. Metabolic activity-based viability was assessed using the MTS assay. Gene expression analyses (IL-6, COX-2, and caspase-3) were performed at selected pH levels (6, 8, 10, and 12) to evaluate inflammatory and apoptotic responses. RESULTS: Metabolic activity-based viability was significantly higher at mildly acidic to moderately alkaline pH levels (pH: 6-11), with the highest values observed at pH 8 (P<0.05). Extreme pH values (1-5 and 12-13) demonstrated cytotoxic effects. Gene expression analysis revealed the lowest levels of IL-6, COX-2, and caspase-3 at pH 8. CONCLUSION: pH levels significantly influence preadipocyte metabolic viability and stress-related cellular responses. Mildly alkaline conditions, particularly around pH 8, may provide a favorable microenvironment during the early phase of fat graft integration. Further in vivo studies are required to validate these findings.