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Mamizadeh M, Tahmasebi Ghorabi S, Mansourinia Z, Shadfar F, Karimi Rouzbahani A. Comparison the Effect of Conventional and Nanofat Injection Methods on Nasolabial Fold Lipofilling: A Case- Control Study. World J Plast Surg 2024; 13:24-31. [PMID: 38742030 PMCID: PMC11088738 DOI: 10.61186/wjps.13.1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/30/2024] [Indexed: 05/16/2024] Open
Abstract
Background Nasolabial folds are a common sign of aging, accompanied by various manifestations such as skin and tissue loosening, wrinkles, lip corner drooping, mandibular angle loss, platysmal bands, and skin pigmentation changes. Limited research has explored Nanofat injection methods. this study was done with the aim of comparing the effect of fat injection by two methods, conventional and Nanofat, in nasolabial folds. Method The study conducted in 2020-2021 at the skin clinic in Ilam, western Iran was a case-control study. Participants were divided into two groups, and lipofilling procedures were performed using conventional and nanofat methods with autologous fat. Data collection utilized a researcher-made questionnaire and radiographic results. Follow-up visits occurred on the 30th, 90th, and 180th days to assess complications and recovery rates. After 6 months, participant's photographs were taken and compared with pre-intervention photographs using the GIAS criteria. Data analysis was conducted using SPSS22 version software. Results The average age of the participants was 37.80±8.30 yr. The treatment response in the conventional fat injection group was significantly better than the nanofat group (P<0.05). Both groups were satisfied with the treatment methods, but high satisfaction was reported in the conventional group, but there was no statistically significant difference between the groups. Conclusion Both methods of improving wrinkles were effective, but the improvement and response to treatment in the conventional method was better than the Nanofat method, and its effect was felt by the participants for an average period of 3 months.
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Affiliation(s)
- Mina Mamizadeh
- Department of Dermatology, School of Medicine, Emam Khomeini Hospital, Ilam University of Medical sciences, Ilam, Iran
| | | | | | - Fariba Shadfar
- Department of Dermatology, School of Medicine, Emam Khomeini Hospital, Ilam University of Medical sciences, Ilam, Iran
| | - Arian Karimi Rouzbahani
- USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
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2
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Herold C, Rennekampff HO. Invited Discussion on "Meta-Analysis of the Oncological Safety of Autologous Fat Grafting after Breast Cancer on Basic Science and Clinical Studies". Aesthetic Plast Surg 2023:10.1007/s00266-023-03273-7. [PMID: 36849661 DOI: 10.1007/s00266-023-03273-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 01/28/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Christian Herold
- Medizin im Mühlenviertel, Bremen, Germany. .,Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Rhein-Maas Klinikum, Würselen, Germany.
| | - Hans Oliver Rennekampff
- Medizin im Mühlenviertel, Bremen, Germany.,Klinik für Plastische Chirurgie, Hand- und Verbrennungschirurgie, Rhein-Maas Klinikum, Würselen, Germany
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3
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Lin YN, Wu YC, Huang SH, Chou CK, Takahashi H, Lin TM. Periorbital Rejuvenation for Asians. Clin Plast Surg 2023; 50:91-100. [DOI: 10.1016/j.cps.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4
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Wang YH, Huang YL. Is Aspiration Prior to Filler Injection Beneficial in Preventing Inadvertent Vascular Adverse Events? Aesthet Surg J 2022; 42:NP434-NP436. [PMID: 34979542 DOI: 10.1093/asj/sjab404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yu-Hsin Wang
- Dermatology Department, Chang Gung Memorial Hospital, Linkou and Taipei,Taiwan
| | - Yau-Li Huang
- Department of Aesthetic Medicine, Chang Gung Memorial Hospital, Taipei,Taiwan
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5
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Autologous Conditioned Serum Increases Fat Graft Viability More than Platelet-Rich Plasma in a Controlled Rat Model. Plast Reconstr Surg 2022; 149:1123-1136. [PMID: 35271553 DOI: 10.1097/prs.0000000000009029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Platelet-rich plasma has been used to support fat graft retention, but it may include inflammatory mediators such as interleukin-1β. Autologous conditioned serum also contains high levels of various anti-inflammatory cytokines. The authors hypothesized that combining autologous conditioned serum with fat graft would increase fat graft survival more than platelet-rich plasma. METHODS Twenty-seven adult, male, Sprague-Dawley rats were divided into three groups of nine. Ten nonstudy rats were used to prepare platelet-rich plasma, autologous conditioned serum, and fat grafts. Next, 0.7-ml fat graft with a combination of 0.2 ml of autologous conditioned serum, platelet-rich plasma, or phosphate-buffered saline was applied to their dorsa. Fat graft volume was assessed on postoperative day 2 and on the day of euthanization at 1, 3, and 5 months postoperatively. Histopathologic analysis was performed to measure integrity, inflammation, fibrosis, and vascularization. RESULTS The median volume percentages and interquartile ranges at 1 month postoperatively were 97.3 percent (77.3 to 119.6 percent), 40.4 percent (30.9 to 46.9 percent), and 72.1 percent (53.6 to 84.9 percent) in autologous conditioned serum plus fat graft, phosphate-buffered saline plus fat graft, and platelet-rich plasma plus fat graft, respectively (p < 0.05); at 3 months postoperatively, values were 82.3 percent (70.3 to 88.3 percent), 36.6 percent (29.4 to 43.1 percent), and 48.3 percent (31.4 to 57.9 percent) (p < 0.001); and at 5 months postoperatively, values had increased to 83.9 percent (58.3 to 102.4 percent), 40.3 percent (20.1 to 50.6 percent), and 56.3 percent (37.7 to 74.9 percent), respectively (p < 0.05). CONCLUSIONS Autologous conditioned serum and platelet-rich plasma improved fat graft outcomes compared to saline, whereas autologous conditioned serum was associated with less inflammation, greater fat viability, and more integrity. CLINICAL RELEVANCE STATEMENT Combining fat graft with autologous conditioned serum may be a better option to minimize resorption rate and improve graft survival.
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Tripathy S, VinayKumar D, Mohsina S, Sharma R, Bhatia A. Histological analysis of the effect of nanofat grafting in scar rejuvenation. J Cutan Aesthet Surg 2022; 15:147-153. [PMID: 35965912 PMCID: PMC9364463 DOI: 10.4103/jcas.jcas_106_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: Aims: Materials and Methods: Results: Conclusion:
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7
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Huang H, Tang X, Li S, Huang D, Lu D, Wu F, Liu D, Li H. Advanced platelet-rich fibrin promotes the paracrine function and proliferation of adipose-derived stem cells and contributes to micro-autologous fat transplantation by modulating HIF-1α and VEGF. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:60. [PMID: 35282074 PMCID: PMC8848409 DOI: 10.21037/atm-21-6812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/05/2022] [Indexed: 01/01/2023]
Abstract
Background The micro-autologous fat transplantation (MAFT) technique has demonstrated its feasibility in multiple medical fields, such as facial rejuvenation. Advanced platelet-rich fibrin (APRF), an autologous platelet concentrated on a fibrin membrane without added external factors, has shown significant potential for tissue restoration. However, the role of APRF in the modulation of MAFT remains unclear. Here, we aimed to explore the effect of APRF on MAFT. Methods Adipose-derived stem cells (ASCs) were isolated from human gastric subcutaneous fat and treated with APRF. ELISA assays measured cytokines. The proliferation of ASCs was analyzed by CCK-8 assays. The levels of hypoxia-inducible factor-1α (HIF-1α), heat shock protein 70 (HSP70), insulin like growth factor 2 (IGF-2), interleukin-6 (IL-6), interleukin-8 (IL-8), and vascular endothelial growth factor (VEGF) were measured by ELISA assays, quantitative reverse transcription-PCR (qRT-PCR), and Western blot analysis. The effect of APRF/HIF-1α/VEGF on MAFT in vivo was analyzed in Balb/c nude mice. The BALB/c mice were subcutaneously co-transplanted with fat, APRF, and control shRNA, HIF-1α shRNA, or VEGF shRNA into the dorsal area. The serum and protein levels of the above cytokines were analyzed by ELISA assays and Western blot analysis. Lipid accumulation was measured by Oil Red O staining. The expression of CD34 was assessed by immunohistochemical staining. Results APRF continuously secreted multiple cytokines, including epidermal growth factor (EGF), FGF-2, insulin like growth factor 1 (IGF-1), interleukin-1beta (IL-1β), interleukin-4 (IL-4), platelet-derived growth factor alpha polypeptide b (PDGF-AB), platelet-derived growth factor beta polypeptide b (PDGF-BB), transforming growth factor-beta (TGF-β), and VEGF. APRF was able to promote the proliferation of ASCs. APRF dose-dependently activated the expression of HIF-1α, HSP70, IGF-2, IL-6, IL-8, and VEGF in ASCs. APRF regulated the paracrine function of ASCs by modulating HIF-1α and VEGF.APRF increased the survival of MAFT by modulating HIF-1α and VEGF in vivo. Conclusions APRF promotes the paracrine function and proliferation of ASCs and contributes to MAFT by modulating HIF-1α and VEGF. Our findings provide new insights into the mechanism by which APRF regulates MAFT.
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Affiliation(s)
- Hao Huang
- Department of Plastic and Aesthetic Surgery, Zhujiang Hospital, Southern Medical University/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xike Tang
- Dermatology Department, The Affiliated Nanning Infectious Disease Hospital of Guangxi Medical University and the Fourth People's Hospital of Nanning, Nanning, China
| | - Shounan Li
- Department of Thoracic Surgery, the People's Hospital of Binyang County, Nanning, China
| | - Donglin Huang
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China
| | | | - Fuzhi Wu
- Nanning Wilking Biological Technology Co., Ltd., Nanning, China
| | - Dalie Liu
- Department of Plastic and Aesthetic Surgery, Zhujiang Hospital, Southern Medical University/The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Hongmian Li
- Research Center of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, China
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Demirel O. Forehead Contouring as an Adjunct to Rhinoplasty: Evaluation of the Effect on Facial Appearance, Personal Traits and Patient Satisfaction. Aesthetic Plast Surg 2021; 45:2257-2266. [PMID: 33811290 DOI: 10.1007/s00266-021-02236-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/07/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The nose has a great impact on facial beauty and appearance. Therefore rhinoplasty is one of the most performed procedures worldwide. However, considering the varying degrees of cosmetic operations holistic approach to face is essential to achieve more successful results. In order to this, the forehead is noteworthy with its gender-related features and important relation to the nose. The purpose of this study is to assess the effect of forehead contouring with fat grafting adjunct to rhinoplasty on personal traits, facial appearance and patient satisfaction. METHODS A total of 15 patients who underwent rhinoplasty and forehead contouring with fat grafting were enrolled in this retrospective study. Facial appearance and personal traits were evaluated via subject Global Aesthetic Improvement Scale (S-GAIS), and patient satisfaction was assessed with custom design Forehead Rhinoplasty Outcome Evaluation Questionnaire (F/ROE-Q). Forehead inclination was calculated as an objective indicator of fat graft survival and contour improvement. Pre- and postoperative photographs were taken and used for evaluation. RESULTS According to the F/ROE-Q score, mean total preoperative score was 9,13 and the mean total postoperative score was 24,86 (p < 0,01). High postoperative satisfaction scores were observed in all patients. Statistically significant improvement was observed in attractiveness, femininity, youthfulness, facial harmony, forehead contour, facial profile view parameters based on S-GAIS assessment. The mean forehead inclination angle was 19,04o preoperatively and 16,74° postoperatively. CONCLUSION With the important benefits such as higher patient satisfaction and improvement on facial appearance and personal traits, forehead contouring with fat grafting was an efficient and applicable procedure adjunct to rhinoplasty. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. 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 .
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Affiliation(s)
- Oguzhan Demirel
- Denizli State Hospital Department of Plastic, Reconstructive, and Aesthetic Surgery, Sırakapılar, Selcuk Caddesi, Merkezefendi, 20100, Denizli, Turkey.
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Restoring Facial Contour and Harmony Using Biphasic Calcium Phosphate Bioceramics. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3516. [PMID: 33854862 PMCID: PMC8032359 DOI: 10.1097/gox.0000000000003516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 01/07/2021] [Indexed: 11/27/2022]
Abstract
Background: The restoration of facial contour is one of the pillars for the treatment of facial disharmonies and deformities. Fat transplantation and fillers have been widely used to improve the positioning of soft tissues, which are, however, directly related to the conditions and positioning of the underlying bone tissue. Recontouring of the latter has been performed using osteotomies and several types of bone grafts or biomaterials, as inlay or onlay grafts/implants. Here, biphasic calcium phosphate bioceramics were applied in a series of cases, their long-term results are shown, and their advantages, discussed. Methods: A retrospective analysis of 20 patients, who were subjected to facial recontour with onlay implants of biphasic calcium phosphate bioceramics, is reported. Patients were seeking to improve facial harmony due to congenital deformities, trauma, tumor resection or signs of aging, and were followed for up to 16 years. Clinical data, radiographic images, and information regarding pain and other findings were retrieved from medical records. Results: Six patients were men and 14 were women. Their ages ranged from 19 to 64 years. Bioceramics were implanted under the periosteum through external or intraoral incisions. Some patients underwent combined procedures, such as rhinoplasties or facial lifting. None of the patients presented exacerbated inflammation or pain. One of them had infection in the intraoral incision, which was resolved with medication. Conclusion: All patients had improved facial contours following the use of bio-ceramics to augment bone tissue and presented stable results at long-term evaluation.
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10
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Möllhoff N, Koban KC, Engelhardt TO, Tonn JC, Giunta RE. [Case report of frontobasal reconstruction and volume augmentation using a free gracilis muscle flap and autologous fat grafting: utilising the free flap as a scaffold for fat transplantation]. HANDCHIR MIKROCHIR P 2020; 52:330-334. [PMID: 32823367 DOI: 10.1055/a-1150-7601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
This case report shows the interdisciplinary treatment of a 28-year-old woman suffering from a pronounced frontal volume defect after severe craniocerebral trauma. The combination of cranioplasty using a polymethylmethacrylate (PMMA) implant, free gracilis muscle flap transfer for soft tissue coverage and serial autologous fat grafting into the muscle flap for subsequent contouring enabled both an adequate and aesthetic reconstruction. This example demonstrates the feasibility of treating increasingly complex composite defects in a multidisciplinary setting, when plastic surgeons are involved.
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Affiliation(s)
- Nicholas Möllhoff
- Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
| | - Konstantin Christoph Koban
- Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
| | - Timm Oliver Engelhardt
- Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
| | | | - Riccardo E Giunta
- Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
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11
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Botulinum Toxin A Improves Supramuscular Fat Graft Retention by Enhancing Angiogenesis and Adipogenesis. Dermatol Surg 2020; 46:646-652. [DOI: 10.1097/dss.0000000000002106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Aesthetic facial contouring procedures, particularly forehead augmentation, continue to increase in popularity in the Asian population. However, there are very few reports in the literature specifically examining the long-term outcomes of forehead fat grafting. In the present study, the authors aimed to objectively evaluate the efficacy of autologous forehead fat grafting through evaluation of facial proportions and patient-reported outcomes. METHODS Patients who underwent autologous fat grafting for forehead contouring procedures between July of 2011 and June of 2017 were recruited for participation in the study. Patient demographic and clinical variables were collected preoperatively and postoperatively. Facial proportion analysis was collected and compared from preoperative and postoperative photographs. Satisfaction with outcome was assessed by the patient, the surgeon, and a layperson postoperatively. A related-samples Wilcoxon signed rank test was used for statistical analysis. RESULTS Postoperative outcomes were evaluated in a total of 24 patients who underwent forehead autologous fat-grafting procedures. The average postoperative follow-up was 8.1 months. There were no intraoperative or postoperative complications. More than 50 percent of the postoperative results were evaluated as "satisfactory" by all three groups (i.e., patient, surgeon, and layperson) in terms of aesthetic contouring. Average forehead projection increased 0.24 U (ratio of horizontal distance from midforehead plane to cornea plane/cornea diameter) after one round of fat grafting (p = 0.01). Seven patients (29.2 percent) required more than a single round of fat grafting to achieve optimal results. CONCLUSIONS Autologous fat grafting remains a viable option for forehead contouring and augmentation. The findings of this study demonstrate that the operation is effective and offers stable satisfactory results after long-term follow-up. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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14
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Abstract
Facial fat grafting is a small-volume procedure and is primarily performed for facial rejuvenation, contouring, or regenerative surgery. The unsatisfying retention rate after fat grafting, however, led to unpredictable outcomes, subsequent multiple procedures, and even some complications. A variety of methods have been proposed to enhance the results of facial fat grafting, including several established surgical principles and many possible new techniques. Adding stem cells, fat preparations, and platelet concentrates may improve the survival after fat grafting but randomized controlled clinical studies are needed to determine their safety and efficacy as well as clinical indications for each technique.
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Affiliation(s)
- Shaoheng Xiong
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, No. 15 Changle Western Road, Xi'an, Shaanxi, China
| | - Chenggang Yi
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, No. 15 Changle Western Road, Xi'an, Shaanxi, China.
| | - Lee L Q Pu
- Division of Plastic Surgery, University of California Davis Medical Center, 2335 Stockton Boulevard, Suite 6008, Sacramento, CA 95817, USA.
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Lin TM, Huang SH, Lin YN, Lee SS, Kuo YR, Lin SD, Takahashi H. Fat Grafting for Facial Contouring (Nose and Chin). Clin Plast Surg 2019; 47:91-98. [PMID: 31739902 DOI: 10.1016/j.cps.2019.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The concept of microautologous fat transplantation (MAFT), proposed by Lin and colleagues in 2007, emphasized that the volume of each delivered parcel should be less than 0.01 mL to avoid potential fat grafting morbidities. The MAFT-GUN facilitates control of the parcel volume and therefore substantially avoids central necrosis and associated complications. In this article, the authors present a simple, reliable, and consistent procedure based on MAFT for profiloplasty. Favorable outcomes with sustainable long-term effectiveness were obtained, further confirming that the MAFT technique is an alternative for facial contouring in the nose and chin.
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Affiliation(s)
- Tsai-Ming Lin
- Charming Institute of Aesthetic and Regenerative Surgery (CIARS), 2F.-1, No. 172, Ziqiang 2nd Road, Qianjin District, Kaohsiung City 801, Taiwan; Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan.
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan; Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Hidenobu Takahashi
- Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan, Taiwan
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Huang SH, Lin YN, Lee SS, Huang YH, Takahashi H, Chou CK, Lin TY, Chen RF, Kuo YR, Lai CS, Lin SD, Lin TM. Three Simple Steps for Refining Transcutaneous Lower Blepharoplasty for Aging Eyelids: The Indispensability of Micro-Autologous Fat Transplantation. Aesthet Surg J 2019; 39:1163-1177. [PMID: 30668643 PMCID: PMC7643537 DOI: 10.1093/asj/sjz005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Lower blepharoplasty has been used for rejuvenating lower eyelids, and diverse modifications have been used to treat conjunct deformities at the tear trough/lid-cheek junction. Strategies for recontouring prominent tear trough/lid-cheek junctions, including orbital fat manipulation, have been reported with good results in the literature. Micro-autologous fat transplantation (MAFT) is a previously unevaluated, potentially advantageous approach to blending the prominent tear trough/lid-cheek junction. OBJECTIVES We determined the long-term results after 3-step transcutaneous lower blepharoplasty with MAFT for patients with aging eyelids and prominent tear trough/lid-cheek junctions. METHODS We evaluated 205 patients with aging lower eyelids who underwent transcutaneous lower blepharoplasty with MAFT between October 2010 and September 2016. The 3-step procedure involved a subciliary elliptical skin excision, resection of 3 orbital fat compartments, and MAFT for the tear trough/lid-cheek junction employing a MAFT-GUN under intravenous anesthesia. RESULTS The mean patient age was 52 years (range, 34-78 years). The mean operating time was 61 minutes. The mean fat volumes delivered to the tear trough/lid-cheek junctions were 2.80 mL and 2.76 mL for the left and right sides, respectively. The average weights of the 3 resected orbital fat compartments were 0.58 g for the left side and 0.56 g for the right side. Patients showed significant improvement and maintenance at an average follow-up of 60.2 months (range, 18-90 months). CONCLUSIONS Three-step transcutaneous lower blepharoplasty with MAFT is an effective, reliable, and promising method with high patient satisfaction and minimal risk of complications. Long-term results demonstrated its utility for aging lower eyelid treatment. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | - Hidenobu Takahashi
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | - Tsung-Ying Lin
- Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Rong-Fu Chen
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Sheng Lai
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Tsai-Ming Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Groen JW, Piatkowski AA, Sawor JH, Wilschut JA, Ritt MJPF, van der Hulst RRJW. European Survey Study Among Plastic/Breast Surgeons on the Use of and Opinion Toward Autologous Fat Transfer: With Emphasis on Breast Surgery. Surg Innov 2018; 25:602-615. [PMID: 30249166 PMCID: PMC6293441 DOI: 10.1177/1553350618799553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective. The aim of this study is to examine the experience of European surgeons on autologous fat transfer (AFT) and highlight differences between countries and levels of experience. Background Data. The popularity of AFT causes an increase in sophisticated scientific research and clinical implementation. While results from the former are well-documented, important aspects of the latter are far less recognized. Methods. An international survey study about surgeon background, besides AFT familiarity, technique, and opinion, was distributed among surgeons from 10 European countries. The differences between countries and levels of experience were analyzed using a logistic regression model. Results. The mean respondent age, out of the 358 completed questionnaires, was 46 years. Ninety-seven percent of the respondents were plastic surgeons, who practiced AFT mostly in breast surgery and considered themselves experienced with the technique. The thigh and abdomen were less favored harvest locations by the Belgium and French respondents, respectively, and both the French and Austrian respondents preferred manual aspiration over liposuction in harvesting the fat. Despite minor differences between countries and experience, the intraglandular space was injected in all subgroups. Conclusions. The expanding use of AFT in Europe will lead to more experience and heterogeneity regarding the technique. However, despite an obvious adherence to Coleman's method, deviations thereof become more apparent. An important example of such a deviation is the ongoing practice of intraglandular AFT despite being a contraindication in various European guidelines. These unsafe practices should be avoided until scientific clarification regarding oncological safety is obtained and should therefore be the focus of surgeon education in Europe.
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Affiliation(s)
- Jan-Willem Groen
- Department of Plastic, Reconstructive
and Hand Surgery/ GROW: School for Oncology and Developmental Biology, Maastricht
University Medical Center, Maastricht, Netherlands
- Department of Plastic, Reconstructive
and Hand Surgery, VU Medical Center, Amsterdam, Netherlands
| | - Andrzej A. Piatkowski
- Department of Plastic, Reconstructive
and Hand Surgery/ GROW: School for Oncology and Developmental Biology, Maastricht
University Medical Center, Maastricht, Netherlands
| | - John H. Sawor
- Department of Plastic, Reconstructive
and Hand Surgery/ GROW: School for Oncology and Developmental Biology, Maastricht
University Medical Center, Maastricht, Netherlands
| | - Janneke A. Wilschut
- Department of Plastic, Reconstructive
and Hand Surgery, VU Medical Center, Amsterdam, Netherlands
| | - Marco J. P. F. Ritt
- Department of Plastic, Reconstructive
and Hand Surgery, VU Medical Center, Amsterdam, Netherlands
| | - Rene R. J. W. van der Hulst
- Department of Plastic, Reconstructive
and Hand Surgery/ GROW: School for Oncology and Developmental Biology, Maastricht
University Medical Center, Maastricht, Netherlands
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Abstract
BACKGROUND Augmentative forehead contouring to create a full rounded smooth forehead is increasingly popular worldwide especially in East Asia where a flat and/or concave irregular forehead is considered unaesthetic. We present our outcomes performing fat transfer to the forehead in combination with botulinum toxin (Botox) corrugator-frontalis injection where indicated in East Asians. METHODS From 2013 to 2017, 62 consecutive patients with flat and/or concave irregular unaesthetic foreheads underwent forehead fat transfer using a microautologous fat transplantation gun. Concomitant Botox injection to minimize corrugator and frontalis contraction-mediated fat displacement was indicated in 23 patients (thin forehead skin and/or excessive forehead animation or rhytides) to prevent forehead vertical crease formation. Thirty-nine subjects with a mean follow-up of 16 months (range = 3-44 months) had their pregraft and postgraft forehead contours assessed on an aesthetic grading scale. Of these 39, 17 completed forehead fat graft volumetric analysis using preoperative and postoperative 3D photography. RESULTS Aesthetic results were durable at latest follow-up, and all patients were satisfied with their final appearance. The mean amount of fat transferred was 7.72 mL (range = 1.5-33 mL). One subject required a repeat fat grafting (with Botox) because of vertical crease formation after the index procedure (without Botox). Another 12 needed a second fat-grafting session to optimize the contour. All who received Botox did not develop vertical creases. The mean ± SD forehead contour grade improved from 2.29 ± 0.77 to 3.24 ± 0.67 (P < 0.001). The percentage mean ± SD retention of grafted fat was 46.71% ± 5.77% with Botox versus 39.12% ± 5.24% without Botox (P = 0.006). CONCLUSIONS Fat grafting to the forehead using our technique with selective Botox administration is an effective, simple, fast, inexpensive, and safe strategy for aesthetic forehead contouring especially for flat and/or concave foreheads. Forehead fat survival rate is objectively improved with simultaneous Botox injection. There is minimum downtime and long-lasting results with high patient satisfaction rates.
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19
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Huang SH, Huang YH, Lin YN, Lee SS, Chou CK, Lin TY, Takahashi H, Kuo YR, Lai CS, Lin SD, Lin TM. Micro-Autologous Fat Transplantation for Treating a Gummy Smile. Aesthet Surg J 2018; 38:925-937. [PMID: 29566216 PMCID: PMC6317576 DOI: 10.1093/asj/sjy069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background A gummy smile is treated using many techniques, including botulinum toxin injection and various surgical interventions. Micro-autologous fat transplantation (MAFT) is a potentially advantageous alternative approach that has not been previously evaluated. Objectives This study sought to determine the long-term results of MAFT in patients with a gummy smile. Methods Seven patients with gummy smiles were evaluated for MAFT treatment between October 2015 and April 2017. Centrifuged purified fat was micro-transplanted into the nasolabial groove, ergotrid, and upper lip areas using the MAFT-GUN while the patients were under total intravenous anesthesia. Results The mean age of the 7 patients was 31 years (range, 23-40 years). The mean operating time for MAFT was 52 minutes (range, 40-72 minutes), and the mean volume of fat delivered to the nasolabial groove, ergotrid, and upper lip was 16.1 mL. The mean decreases of gingival display in the right canine incisor, left canine incisor, right canine, and left canine teeth were 4.9, 4.6, 3.8, and 4.4 mm, respectively. The smiles of the 7 patients showed significant improvement at an average follow-up time of 12.9 months. Conclusions Gummy smile treatment using MAFT is an effective, reliable, and relatively simple method, with high patient satisfaction and minimal risk of complications. Level of Evidence: 4
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Affiliation(s)
- Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital and Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Tsung-Ying Lin
- Division of Traumatology, Department of Emergency, Kaohsiung Medical University
| | | | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Sheng Lai
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsai-Ming Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
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20
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Yun-Nan L, Shu-Hung H, Tsung-Ying L, Chih-Kang C, Yu-Hao H, Hidenobu T, Chung-Sheng L, Sin-Daw L, Tsai-Ming L. Micro-autologous fat transplantation for rejuvenation of the dorsal surface of the aging hand. J Plast Reconstr Aesthet Surg 2018; 71:573-584. [DOI: 10.1016/j.bjps.2017.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/06/2017] [Accepted: 09/12/2017] [Indexed: 11/17/2022]
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