The Past, Present, and Future of Facial Fat Grafting

Evaluating the Efficacy of Facial Scar Treatment Techniques Using Nanofat Grafting: A Case Series

Patient's psychological and aesthetic quality is affected by the appearance of scars since atrophic scars might be caused by infections or inflammations that resulted from preoperative procedures. Non-surgical methods have recently been developed to increase patient satisfaction and improve the appearance of scars. In our understanding, there has not been much published medical research assessing how well nanofat grafting techniques work in terms of treating facial scars. With a six-month follow-up after the intervention, this research intends to provide four cases where scars in the facial area were controlled utilizing these materials. Based on the cases shown, it can be seen that following the procedure, the scar's measurements were minimized, its color and texture improved, and there was no pain or itching. Given its safety and effectiveness, autologous nanofat grafting has become one of the most important and well-liked aesthetic procedures. It has been discussed how modifying injectable nanofat using fine needles has opened up new clinical applications for rejuvenating aesthetic medicine. Additionally, it was pointed out that injectable PRF has gained attention due to its high concentration of growth factors, which help to promote healing and improve the appearance of the skin. Furthermore, it can be efficiently shared with autogenous nanofat grafts, which support and enhance the efficacy of adipose-derived stem cells (ADSCs) and improve adipocyte blood circulation. The current use of modified nanofat in the treatment of facial scars is supported by the procedure's safety and low risk of injection-site problems. The consistent efficacy of modified-nanofat injection in the management of depression-related facial scars was validated by the outcomes of patient satisfaction surveys and physician evaluations.

Autologous Conditioned Serum Increases Fat Graft Viability More than Platelet-Rich Plasma in a Controlled Rat Model

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.

Efficacy study of the new polycaprolactone thread compared with other commercialized threads in a murine model

BACKGROUND

Polydioxanone (PDO) threads, poly-L-lactic acid (PLLA) threads, and polycaprolactone (PCL) threads have been used for lifting and antiaging purposes. The new PCL threads that have less residual monomer compared to the previous PCL are developed.

AIMS

The efficacy of threads regarding collagen synthesis and wrinkle improvement was evaluated in vivo model.

METHODS

In this study, threads were inserted into 30 six-week-old male SKH-1 hairless mice. One of four threads was implanted at either side of the spine of each mouse. Biopsy specimens obtained at 1, 4, and 8 weeks were examined using hematoxylin and eosin (H&E) and Herovici's stain. Additionally, immunoblot analysis was performed using primary antibody for collagen type III and transforming growth factor-β (TGF-β) and visualized by chemiluminescence and densitometric quantification. Finally, skin replicas were used to calculate total wrinkle area (mm2 ).

RESULTS

Neocollagenesis was significantly increased by 50% in the new PCL and pre-existing PCL groups at 8 weeks (p value < 0.001). Additionally, new-PCL-implanted mice showed a significant increase in collagen type III and TGF-β expressions at 8 weeks (p value < 0.001). The number of inflammatory cells was also increased in the skin of PCL-implanted mice at 8 weeks. Finally, wrinkles were reduced about 20% in the new PCL group at 8 weeks.

CONCLUSIONS

The new PCL thread exhibited a superior skin rejuvenation effect. This suggests that the material processing technology can be applied not only to the thread but also to various products such as dermal filler and cosmetics.

Decellularized adipose tissue: A key factor in promoting fat regeneration by recruiting and inducing mesenchymal stem cells

BACKGROUND

Decellularized adipose tissue (DAT) has attracted much attention due to its wide range of sources and adipose regeneration capacity. However, the lipogenic efficiency of DAT is still controversial due to its unclear mechanism. To this point, it is crucial to clarify the mechanism of DAT in promoting adipose regeneration Objective: This study aims to explore the mechanism of DAT promoting adipose regeneration and survival mechanism of DAT transplantation in vivo.

METHODS

DAT preparation by repeated freeze-thaw, enzymatic digestion, and isopropanol degreasing. Histology, DAPI, immunohistochemistry, immunofluorescence and scanning electron microscopy confirmed the efficacy and reproducibility of these approaches. BM-MSCs, ADSCs and UCMSCs were cocultured with DAT for 14 days and then stained with oil red O. Adipogenic genes of three MSCs were detected by RT-PCR. DAT and adipose tissue were transplanted subcutaneously into the back of nude mice to observe medium and long-term morphological changes, vascularization, and lipid-forming efficiency. Mass spectrometry (MS)-based proteomic to analyze the adipogenic protein contents of DAT and adipose tissue.

RESULTS

The DAT without any cellular components but with an abundance of collagen; neither DNA nor lipids were detected. Seeding experiments with MSCs indicated that the DAT provided an inductive microenvironment for adipogenesis, supporting the expression of the master regulators PPARγ. Within four months after transplantation, HE morphology of DAT was identical to adipose cells. Immunofluorescence markers CD31 and perilipin were increased in DAT, while the retention rate gradually decreased over time, eventually accounting for 33.7% of the original volume. MS-based proteomic analyses identified 1013 types of proteins in adipose tissue and 29 proteins in the DAT. Analyses of GO and KEGG databases suggested that DAT contained a variety of proteins involved in fat metabolism.

CONCLUSIONS

DAT can interact with different types of MSCs and ultimately achieve adipose regeneration. The presence of multiple adipogenic proteins in DAT make it play a vital role in adipose regeneration. DAT is expected to be an ideal bio-derived scaffold for adipose tissue engineering.

Efficacy and Safety of Subcutaneous Temporal Autologous Micro-fat Augmentation

BACKGROUND

Autologous fat grafting is a rapidly developing soft tissue filling technique that has been playing an increasingly important role in facial contouring and rejuvenation surgeries. However, this technique is accompanied by many side effects and risks. In particular, there is still much room for improvement in regard to the surgical method of temporal augmentation with autologous fat, which is highly popular among Chinese people. Better surgical methods can achieve better outcomes while curbing surgical risks.

DESIGN AND METHODOLOGY

We reviewed 39 patients who consecutively underwent subcutaneous temporal autologous micro-fat argumentation surgery at Peking University People's Hospital from February 19, 2016, to May 13, 2019, to correct temporal hollowness. Each patient's Visual Analogue Scale (VAS) satisfaction score and Hollowness Severity Rating Scale (HSRS) score before and after surgery were precisely recorded, and any complaints about perioperative complications were meticulously collected to assess the efficacy and safety profile of the novel technique.

RESULTS

All 39 patients included in this study were female. We performed 86 subcutaneous temporal autologous micro-fat argumentation surgeries, with an average follow-up of 20.4 ± 9.6 months. The average fat filling volume in the right temporal region was 6.29 ± 2.55 mL, and that in the left temporal region was 6.34 ± 2.71 mL. The average VAS satisfaction score increased from 4.44 ± 1.33 before the surgery to 8.08 ± 0.77 after the surgery, and the average HSRS score dropped from 1.82 ± 0.72 before the surgery to 0.36 ± 0.49 after the surgery. Four patients were encountered with minor complications of intraoperative bleeding and congestion, which were all completely ameliorated after conservative therapies.

CONCLUSION

In the present study, we found that the reported surgical method of subcutaneous temporal autologous micro-fat augmentation successfully improved the temporal hollowness of the patients, boasting good surgical results and high patient satisfaction with minimal short- and long-term complications, illustrating that it is an effective, safe and promising novel surgical technique worthy of wider clinical application.

LEVEL OF EVIDENCE IV

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