BACKGROUND: The use of fat grafts in plastic, reconstructive, and aesthetic surgery has been increasing. Although fat grafting has many advantages, there is limited evidence regarding its survival rates. Current studies focus on improving fat graft survival rates. This study aimed to evaluate the effect of therapeutic ultrasound (TERUS) application on fat graft survival. METHODS: The study involved 42 adult male Wistar Albino rats, which were randomly divided into seven groups of six rats each: Group 1 served as the control group and received only fat grafting
Group 2 received preoperative daily TERUS for one week, followed by fat grafting
Group 3 underwent preoperative daily massage for one week, followed by fat grafting
Group 4 received preoperative daily TERUS for one week, followed by fat grafting and postoperative daily TERUS for one week
Group 5 underwent preoperative daily massage for one week, followed by fat grafting and postoperative daily massage for one week
Group 6 received postoperative daily TERUS for one week
and Group 7 received postoperative daily massage for one week. After volume and weight measurements, immunohistochemical evaluation was conducted using perilipin and PECAM-1. Apoptosis was assessed using the TUNEL method. RESULTS: No statistically significant differences were observed in the macroscopic measurements. While TERUS increased the vascularization of fat grafts, it did not improve survival rates. The mean fat graft survival rate in the preoperative-postoperative massage group (Group 5) was statistically significantly higher than in the other groups. CONCLUSIONS: The findings of this study suggest that the massage effect of TERUS, independent of ultrasonic energy, may be beneficial for fat graft survival. Although TERUS increases the vascularity of fat grafts, it does not improve fat graft survival rates. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .