Mobilization of subcutaneous fascia contributes to the vascularization and function of acellular adipose matrix via formation of vascular matrix complex.

Summary

Using multi-tracing approaches in mice, the authors show that subcutaneous fascia migrates to encase acellular adipose matrix implants, delivering fascia-embedded vessels and forming a vascular matrix complex critical for implant vascularization and survival. Limiting fascia mobility or removing fascia markedly impairs vascularization and leads to later implant collapse, highlighting fascia as an active driver of regenerative integration.

Key Findings

• Subcutaneous fascia migrates to encase acellular adipose matrix (AAM) implants and delivers fascia-embedded vessels.
• A vascular matrix complex (VMC) forms on the implant surface and dynamically remodels in parallel with vascularization.
• Restricting fascia mobility or removing fascia markedly reduces AAM vascularization and impairs regeneration, leading to later implant collapse.

Clinical Implications

Preserving and harnessing subcutaneous fascia at implantation sites may enhance vascularization and long-term volume retention of soft-tissue scaffolds (e.g., acellular adipose matrix) in aesthetic and reconstructive surgery. Scaffold designs that recruit or integrate with fascia could improve implant survival.

Limitations

• Murine model; translational relevance to human fascia dynamics and clinical outcomes remains to be validated.
• Comparative performance versus other scaffold types and long-term functional perfusion metrics were not fully detailed.

Future Directions

Define fascia–scaffold interface biology in large-animal/human studies; engineer scaffolds that actively recruit fascia; develop surgical protocols optimizing fascia preservation and mobilization.