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Facial Cosmetic Surgery. J Oral Maxillofac Surg 2023; 81:E300-E324. [PMID: 37833027 DOI: 10.1016/j.joms.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Lemaitre M, Chevalier B, Jannin A, Bourry J, Espiard S, Vantyghem MC. Multiple symmetric and multiple familial lipomatosis. Presse Med 2021; 50:104077. [PMID: 34687914 DOI: 10.1016/j.lpm.2021.104077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/20/2021] [Accepted: 10/12/2021] [Indexed: 01/18/2023] Open
Abstract
Lipomas are the most common soft tissue tumors and are malignant in only 1% of cases. Lipomatosis is defined as the presence of multiple benign lipomas on the body, without lipoatrophy. Their impact on quality of life is significant. Different entities have been described such as symmetrical multiple lipomatosis (MSL), also called Madelung's disease and familial multiple lipomatosis (FML). MSL occurs preferentially in men (but also women) who are alcohol abuser. There are different subtypes of the disease, the most classic of which affects the upper body and the nuchal region with a buffalo hump appearance. A metabolic component with obesity is frequent. In contrast to Dercum's disease, there is no pain. SAOS, complications of the metabolic syndrome and of alcohol abuse including cancers, may be associated and should be screened. FML has been little described in the literature since Brodie's first report in 1846. FML occurs preferentially in the third decade but equally in women and men. Its autosomal dominant component is classically accepted with variable penetrance within the same family. Association with naevi, angiomas, polyneuropathies and with gastrointestinal comorbidities has been reported. Interestingly, and in contrast with most lipodystrophy disorders, the patients show an insulin sensitivity profile. A better understanding of the underlying pathophysiological mechanisms would open up avenues on therapeutic research, since treatments are only symptomatic to date.
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Affiliation(s)
- Madleen Lemaitre
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000 Lille, France; Univ. Lille, F-59000 Lille, France.
| | - Benjamin Chevalier
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000 Lille, France; Univ. Lille, F-59000 Lille, France
| | - Arnaud Jannin
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000 Lille, France; Univ. Lille, F-59000 Lille, France
| | - Julien Bourry
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000 Lille, France; Univ. Lille, F-59000 Lille, France
| | - Stéphanie Espiard
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000 Lille, France; Inserm U1190, F-59000 Lille, France; Univ. Lille, F-59000 Lille, France
| | - Marie-Christine Vantyghem
- CHU Lille, Endocrinology, Diabetology and Metabolism, F-59000 Lille, France; Inserm U1190, F-59000 Lille, France; Univ. Lille, F-59000 Lille, France.
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Cuomo R, Grimaldi L, Brandi C, Sisti A, Nisi G. Vaginoplasty: What's New From 1946 to Date Commentary on: Vaginoplasty with Acellular Dermal Matrix after Radical Resection for Carcinoma of the Uterine Cervix. J INVEST SURG 2018; 32:186-188. [PMID: 29333882 DOI: 10.1080/08941939.2017.1411544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Roberto Cuomo
- a Unit of Plastic Surgery, University of Siena, Santa Maria Alle Scotte Hospital, Viale Mario Bracci, Siena ( SI ), Italy
| | - Luca Grimaldi
- a Unit of Plastic Surgery, University of Siena, Santa Maria Alle Scotte Hospital, Viale Mario Bracci, Siena ( SI ), Italy
| | - Cesare Brandi
- a Unit of Plastic Surgery, University of Siena, Santa Maria Alle Scotte Hospital, Viale Mario Bracci, Siena ( SI ), Italy
| | - Andrea Sisti
- a Unit of Plastic Surgery, University of Siena, Santa Maria Alle Scotte Hospital, Viale Mario Bracci, Siena ( SI ), Italy
| | - Giuseppe Nisi
- a Unit of Plastic Surgery, University of Siena, Santa Maria Alle Scotte Hospital, Viale Mario Bracci, Siena ( SI ), Italy
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Cuomo R, Nisi G, Grimaldi L, Brandi C, D'Aniello C. Use of ultraportable vacuum therapy systems in the treatment of venous leg ulcer. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:297-301. [PMID: 29083334 PMCID: PMC6142840 DOI: 10.23750/abm.v88i3.5737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 09/28/2017] [Accepted: 09/26/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND The high incidence of venous leg ulcers and the difficult to give a complete healing involves in an increase of costs for National Health System. Main therapies to obtain a fast healing are compressive bandages, treatment of abnormal venous flow and in-situ-strategies of wound care. Negative pressure therapy does not conventionally used, because these systems not allow the use of compression bandages. Recently the development of ultraportable devices has improved the compliance and the results. METHODS Ten patients with venous chronic ulcer on the lower extremities were recruited for this study: all patients had venous leg ulcers from at least one year. We treated the patients with autologous partial thickness skin graft and subsequently we applied NANOVA device included in compressive bandage. We used NANOVA for fourteen days and after we made traditional medications. We submitted a questionnaire to evaluate the impact of dressing and NANOVA device in the quality of life of patients. RESULTS The device contributed to the formation of granulation tissue and increased the success rate of autologous skin graft without limiting mobility of patient. In addition to this, we have been able to perform compression bandages thanks to small size of this device. Eight ulcers healed within 90 days of medication. CONCLUSIONS We believe that ultraportable negative pressure systems are useful devices for treatment of venous leg ulcers because them allows to realize a compressive bandage without mobility limitations.
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Tremp M, Menzi N, Tchang L, di Summa PG, Schaefer DJ, Kalbermatten DF. Adipose-Derived Stromal Cells from Lipomas: Isolation, Characterisation and Review of the Literature. Pathobiology 2016; 83:258-66. [PMID: 27225269 DOI: 10.1159/000444501] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/04/2016] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The aim of this study was to characterize adipose-derived stromal cells (ADSCs) from patients diagnosed with multiple symmetric lipomatosis (MSL) in order to obtain potentially new insights into the pathophysiology, pathogenesis and treatment of this disease. METHODS Cells from the stromal vascular fraction were analysed by the colony-forming efficiency assay and flow cytometry using standard markers. Moreover, the power of adipogenic plasticity was evaluated. Finally, a literature review was performed from 1982 to 2015 using the US National Institutes of Health's PubMed database. RESULTS Three European-descent patients diagnosed with either MSL type I or II could be identified for analysis. The resulting mean colony-forming efficiency assay was 14.3 ± 5%. Flow-cytometric analysis of the ADSCs revealed high levels of CD34 (70 ± 9%), CD45 (37 ± 13%) and CD73 (55.8 ± 14%), whereas low levels of CD31 (16.8 ± 14%) and CD105 (5.8 ± 0.7%) were detected. Furthermore, ADSCs showed a strong adipogenic potential, which is in line with the literature review. The stem cell pool in lipoma shows several alterations in biological activities, such as proliferation, apoptosis and stemness. CONCLUSIONS ADSCs from lipoma may be interesting in the application of regenerative medicine. We discuss possible molecular treatment options to regulate their activities at the source of the MSL.
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Affiliation(s)
- Mathias Tremp
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
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Enzi G, Busetto L, Sergi G, Coin A, Inelmen EM, Vindigni V, Bassetto F, Cinti S. Multiple symmetric lipomatosis: a rare disease and its possible links to brown adipose tissue. Nutr Metab Cardiovasc Dis 2015; 25:347-353. [PMID: 25770761 DOI: 10.1016/j.numecd.2015.01.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/28/2015] [Accepted: 01/28/2015] [Indexed: 02/06/2023]
Abstract
AIM Aim of this study is an updated review of our case series (72 patients) as well as available literature on the Multiple Symmetric Lipomatosis (MSL), a rare disease primarily involving adipose tissue, characterized by the presence of not encapsulated fat masses, symmetrically disposed at characteristic body sites (neck, trunk, proximal parts of upper and lower limbs). DATA SYNTHESIS The disease is more frequent in males, associated to an elevated chronic alcohol consumption, mainly in form of red wine. Familiarity has been reported and MSL is considered an autosomic dominant inherited disease. MSL is associated to severe clinical complications, represented by occupation of the mediastinum by lipomatous tissue with a mediastinal syndrome and by the presence of a somatic and autonomic neuropathies. Hyper-alphalipoproteinemia with an increased adipose tissue lipoprotein-lipase activity, a defect of adrenergic stimulated lipolysis and a reduction of mitochondrial enzymes have been described. The localization of lipomatous masses suggests that MSL lipomas could originate from brown adipose tissue (BAT). Moreover, studies on cultured pre-adipocytes demonstrate that these cells synthetize the mitochondrial inner membrane protein UCP-1, the selective marker of BAT. Surgical removal of lipomatous tissue is to date the only validated therapeutic approach. CONCLUSIONS MSL is supposed to be the result of a disorder of the proliferation and differentiation of human BAT cells.
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Affiliation(s)
- G Enzi
- Department of Medicine, University of Padua, Italy
| | - L Busetto
- Department of Medicine, University of Padua, Italy.
| | - G Sergi
- Department of Medicine, University of Padua, Italy
| | - A Coin
- Department of Medicine, University of Padua, Italy
| | - E M Inelmen
- Department of Medicine, University of Padua, Italy
| | - V Vindigni
- Institute of Plastic Surgery, University of Padua, Italy
| | - F Bassetto
- Institute of Plastic Surgery, University of Padua, Italy
| | - S Cinti
- Department of Experimental and Clinical Medicine & Diagnostic Electron Microscopy, United Hospitals, University of Ancona (Politecnico delle Marche), Italy
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Power-assisted liposuction (PAL) of multiple symmetric lipomatosis (MSL)--a longitudinal study. Surg Obes Relat Dis 2014; 11:155-60. [PMID: 25393046 DOI: 10.1016/j.soard.2014.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/30/2014] [Accepted: 05/05/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Multiple symmetric lipomatosis (MSL) is a rare condition leading to grotesque disfigurement. Complete removal is almost impossible and recurrences inevitable. The objective of this study was to evaluate powered-assisted liposuction (PAL) for the treatment of MSL. METHODS Magnetic resonance imaging (MRI) was performed before and after surgery for quality assessment. To exclude malignancy incisional biopsies were taken before surgery. Outcome measures included aspiration volumes, duration of surgery, early morbidity, recurrence rates, and overall patient satisfaction. RESULTS Seven male patients aged between 43 and 70 years were identified. The mean liposuction volume equaled 2948±1566 mL, the mean surgery time 74±28 minutes. One hematoma was observed, whereas 1 recurrence rate was noticed after a mean follow-up of 14 months. Malignancy was excluded by histology in 5 patients. Preoperative MRI confirmed the diagnosis with no signs for malignancy and showed an efficient removal of the lesions. After a mean follow-up of 18 months, a high patient satisfaction was achieved. CONCLUSION PAL can serve as an efficient method for the treatment of MSL. It has a significant effect on tightening of the skin, leading to a high patient satisfaction.
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Hundeshagen G, Hundeshagen G, Assadov KF, Podmelle F. Facelift- and circum-occipital incision placement for fat extirpation of the neck in Madelung's disease - a two-case report. J Craniomaxillofac Surg 2013; 42:175-9. [PMID: 23757287 DOI: 10.1016/j.jcms.2013.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 04/14/2013] [Accepted: 04/15/2013] [Indexed: 12/19/2022] Open
Abstract
Benign symmetric lipomatosis (Madelung's disease) is a rare disorder of fat metabolism that is characterized by progressive symmetrical formation of unencapsulated and painless excess fat masses around the neck and trunk that result in cosmetic disfiguration and functional impairment. Since the disorder is incompletely understood and causal therapy is unavailable, surgical removal of fatty masses is the mainstay of treatment. In this paper the authors describe their use of the classical facelift incision placement as well as a horizontal circum-occipital incision to approach and excise excess fat of the anterior and posterior neck in two patients. This method yielded satisfying results with a combination of good access to fat masses, smooth trimming and redraping of redundant skin, in addition to fairly inconspicuous scarring post-operatively. After removal of 1.5 kg of fat from each patient and a period of uncomplicated wound healing, both patients showed no signs of relapsing fatty growth. Although more challenging than most conventional approaches, the authors' technique has shown good outcomes in those treated with this condition.
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Affiliation(s)
- Gregor Hundeshagen
- Department for Oral and Maxillofacial Surgery/Plastic Surgery, Greifswald University, Greifswald, Germany
| | | | | | - Fred Podmelle
- Department for Oral and Maxillofacial Surgery/Plastic Surgery, Greifswald University, Greifswald, Germany
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