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Ahmad N, Anker A, Klein S, Dean J, Knoedler L, Remy K, Pagani A, Kempa S, Terhaag A, Prantl L. Autologous Fat Grafting-A Panacea for Scar Tissue Therapy? Cells 2024; 13:1384. [PMID: 39195271 DOI: 10.3390/cells13161384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 08/04/2024] [Accepted: 08/05/2024] [Indexed: 08/29/2024] Open
Abstract
Scars may represent more than a cosmetic concern for patients; they may impose functional limitations and are frequently associated with the sensation of itching or pain, thus impacting both psychological and physical well-being. From an aesthetic perspective, scars display variances in color, thickness, texture, contour, and their homogeneity, while the functional aspect encompasses considerations of functionality, pliability, and sensory perception. Scars located in critical anatomic areas have the potential to induce profound impairments, including contracture-related mobility restrictions, thereby significantly impacting daily functioning and the quality of life. Conventional approaches to scar management may suffice to a certain extent, yet there are cases where tailored interventions are warranted. Autologous fat grafting emerges as a promising therapeutic avenue in such instances. Fundamental mechanisms underlying scar formation include chronic inflammation, fibrogenesis and dysregulated wound healing, among other contributing factors. These mechanisms can potentially be alleviated through the application of adipose-derived stem cells, which represent the principal cellular component utilized in the process of lipofilling. Adipose-derived stem cells possess the capacity to secrete proangiogenic factors such as fibroblast growth factor, vascular endothelial growth factor and hepatocyte growth factor, as well as neurotrophic factors, such as brain-derived neurotrophic factors. Moreover, they exhibit multipotency, remodel the extracellular matrix, act in a paracrine manner, and exert immunomodulatory effects through cytokine secretion. These molecular processes contribute to neoangiogenesis, the alleviation of chronic inflammation, and the promotion of a conducive milieu for wound healing. Beyond the obvious benefit in restoring volume, the adipose-derived stem cells and their regenerative capacities facilitate a reduction in pain, pruritus, and fibrosis. This review elucidates the regenerative potential of autologous fat grafting and its beneficial and promising effects on both functional and aesthetic outcomes when applied to scar tissue.
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Affiliation(s)
- Nura Ahmad
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
| | - Alexandra Anker
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
| | - Silvan Klein
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
| | - Jillian Dean
- School of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Leonard Knoedler
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
| | - Katya Remy
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Andrea Pagani
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
| | - Sally Kempa
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
| | - Amraj Terhaag
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß Allee 11, 93053 Regensburg, Germany
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Tiryaki KT, Canikyan S, Woods J, Sterodimas A, Gentile P, Cohen S, Andjelkov K, Schlaudraff KU, Siolo E, Kul Y, Duyan C. AI-enhanced "Two-thirds Guidelines" for Lipolifting: Addressing Multiple Hallmarks of Facial Aging. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e6060. [PMID: 39171244 PMCID: PMC11338263 DOI: 10.1097/gox.0000000000006060] [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: 02/20/2024] [Accepted: 06/10/2024] [Indexed: 08/23/2024]
Abstract
Background Facial aging involves complex changes such as volume loss, ligament weakening, and skin quality alterations. The "two-thirds guidelines" emerge as a novel strategy to combat these aging signs, drawing from an extensive analysis of 2800 facial fat grafting procedures conducted over two decades. Methods Guided by facial lipolifting data, including patient age, fat type (microfat and nanofat), and injection depth, this study devises a systematic framework for multilayer fat rejuvenation and ligament restoration. The two-thirds guidelines advocate injecting two-thirds of the patient's age for microfat and one-third for nanofat, with specific injection codes for lower, middle, and upper facial regions. Results A prospective study involving 400 patients confirms the efficacy of the two-thirds guidelines. However, applicability may vary for patients outside SD ranges, particularly concerning facial proportions and body mass index. Patients within the golden ratio range (1.4-1.9) report high satisfaction rates and a 50% fat graft uptake, with minimal complications. For patients outside this range, an artificial intelligence (AI) program was implemented. Conclusions The two-thirds guidelines offer a comprehensive approach to facial rejuvenation, addressing volume loss, ligament weakening, and skin quality. They are applicable in early aging stages, promising enduring and natural outcomes while mitigating effects of weight fluctuations. These guidelines provide a safe, replicable, and adaptable approach to facial fat grafting, either standalone or in combination with facelift techniques, with minimized overfilling risks. A dataset obtained from 2800 patients serves as the foundation for developing an AI program tailored to aid doctors in diagnosing and treating similar cases.
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Affiliation(s)
- Kemal Tunç Tiryaki
- From the Department of Plastic and Reconstructive Surgery, Cadogan Clinic, London, United Kingdom
| | - Serli Canikyan
- Department of Genetics and Bioengineering, Yeditepe University, Istanbul, Turkey
| | - Jack Woods
- From the Department of Plastic and Reconstructive Surgery, Cadogan Clinic, London, United Kingdom
| | - Aris Sterodimas
- Plastic and Reconstructive Surgery Department, Metropolitan General Hospital, Athens, Greece
| | - Pietro Gentile
- Department of Plastic and Reconstructive Surgery, University “Tor Vergata,” Rome, Italy
| | - Steven Cohen
- Department of Plastic Surgery, University of California, San Diego, Calif
| | - Katarina Andjelkov
- Faculty of Medicine, University of Belgrade and BelPrime Clinic, Belgrade Serbia
| | - Kai-Uwe Schlaudraff
- Department of Plastic and Reconstructive Surgery, Concept-Clinic, Geneva, Switzerland
| | - Eva Siolo
- Private Wellness Practice, Johannesburg, South Africa
| | - Yaren Kul
- Department of Bioengineering, Yildiz Technical University, Istanbul, Turkey
| | - Ceren Duyan
- Department of Research and Development, Lipocube Biotechnology, Istanbul, Turkey
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Yang Z, Jin S, Huang S, Yan R, Lei Z. Concentrated Deoiled Fat: A Novel Method of Fat Processing to Improve Fat Graft Survival-A Basic Research. Aesthetic Plast Surg 2024:10.1007/s00266-024-04159-y. [PMID: 39014232 DOI: 10.1007/s00266-024-04159-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/21/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Oil compromises graft outcomes via inflammation, which accounts for the unpredictability of volume retention rates as low as 20%. Existing techniques for oil removal are relatively inefficient. In this study, a novel approach was taken to prepare concentrated deoiled fat (CDF) by utilizing flocculation and centrifugation to remove the oil. The hypothesis put forward in this study was that CDF would exhibit improved volume retention and quality by enhancing purification efficiency and reducing inflammation. METHODS This basic research involved both in vitro and in vivo experiments using samples obtained from women who underwent abdominal liposuction. The CDF was prepared by flocculation and centrifugation. In the vitro experiments, the microstructure of fat was assessed using Calcein acetoxymethyl ester (AM) staining for living cells and propidium iodide (PI) staining for dead nuclei in two groups: Coleman fat group and CDF group. Additionally, the glucose uptake capacity of these two groups was evaluated using the glucose transport test (GTT). In the vivo experiments, the study included three groups: two experimental groups (low-volume concentrated deoiled fat, LCDF; high-volume concentrated deoiled fat, HCDF) and one control group (Coleman fat), with 10 healthy female BALB/c nude mice in each group, 1ml of the graft was injected subcutaneously to each mouse. After 8 weeks, the fat grafts were harvested and subjected to volume evaluation, HE staining and immunostaining for perilipin to assess graft outcomes. RESULTS In the vitro experiments, the concentration rate of the CDF was found to be 79.6% that of Coleman fat, with 15.1% more oil separated. Cell viability, as assessed by AM/PI staining, did not show a significant difference between the two grafts, but the results of the GTT showed that the tissue viability of the CDF was higher than that of Coleman fat. In the vivo experiments, the CDF had higher volume retention than Coleman fat, as measured by water displacement. Histopathologic scoring indicated that HCDF group and LCDF group had a more intact fat structure with fewer vacuoles, inflammation, and fibrosis compared to Coleman fat. Additionally, the percentages of perilipin-positive area in the LCDF group and HCDF group were higher than in the Coleman group, indicating improved graft quality and outcome with the use of concentrated deoiled fat. CONCLUSIONS "Concentrated deoiled fat" refers to an autologous fat graft from which oil has been removed by flocculation and centrifugation. This process increases volume retention and viable cells and decreases infiltrated inflammatory cells. LEVEL OF EVIDENCE V 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)
- Zhibin Yang
- Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China
| | - Shengyang Jin
- Center of Scar and Wound Treatment, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33, Badachu Road, Shijingshan District, Beijing, 100000, China
| | - Shuqing Huang
- Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China
| | - Rongshuai Yan
- Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China
| | - Zeyuan Lei
- Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China.
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Fisher SM, Borab Z, Weir D, Rohrich RJ. The emerging role of biostimulators as an adjunct in facial rejuvenation: A systematic review. J Plast Reconstr Aesthet Surg 2024; 92:118-129. [PMID: 38518624 DOI: 10.1016/j.bjps.2024.02.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/09/2024] [Accepted: 02/27/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION Facial aging has long been an area of focus in esthetic surgery. It is the consequence of physiologic and environmental factors, with a trend toward non-surgical modalities. Although volume augmentation has long been a focus of non-surgical facial rejuvenation, there is emerging interest in the use of biostimulators to induce physiologic changes in the skin. This article aimed to provide an overview of this class of therapies. METHODS A systematic review regarding the clinical use of biostimulatory agents including platelet-rich plasma (PRP), platelet-rich fibrin (PRF), poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) in facial rejuvenation was performed using PubMed databases. The protocol was developed following the preferred reporting for items for systematic reviews-protocols guidelines. Included studies matched predetermined criteria according to the employed intervention and outcomes. RESULTS The systematic review was performed in September 2023, with the primary search yielding 464 articles. Abstract review resulted in 73 articles of potential relevance. Comprehensive review of the articles and manual reference checks were performed, independently, by 2 authors. This yielded a total of 45 articles that met the inclusion criteria. CONCLUSIONS There is an increasing role for non-surgical modalities in facial rejuvenation. Biostimulatory agents may be used as an alternative, or act as an adjunct, to other non-surgical modalities. These agents induce physiologic changes that mitigate facial aging. There is limited, quantifiable data, which fully illustrate the effect in these products. Although these agents are known to illicit inflammatory changes, more controlled studies are needed to better elucidate the biostimulatory capacity of such non-surgical treatments.
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Affiliation(s)
- Sean M Fisher
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA
| | - Zachary Borab
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA
| | - David Weir
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA
| | - Rod J Rohrich
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA.
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Mormone E, Cisternino A, Capone L, Caradonna E, Sbarbati A. The Model of Interstitial Cystitis for Evaluating New Molecular Strategies of Interstitial Regeneration in Humans. Int J Mol Sci 2024; 25:2326. [PMID: 38397003 PMCID: PMC10889234 DOI: 10.3390/ijms25042326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Given the recent evidence in the clinical application of regenerative medicine, mostly on integumentary systems, we focused our interests on recent bladder regeneration approaches based on mesenchymal stem cells (MSCs), platelet-rich plasma (PRP), and hyaluronic acid (HA) in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) in humans. IC/BPS is a heterogeneous chronic disease with not-well-understood etiology, characterized by suprapubic pain related to bladder filling and urothelium dysfunction, in which the impairment of immunological processes seems to play an important role. The histopathological features of IC include ulceration of the mucosa, edema, denuded urothelium, and increased detection of mast cells and other inflammatory cells. A deeper understanding of the molecular mechanism underlying this disease is essential for the selection of the right therapeutic approach. In fact, although various therapeutic strategies exist, no efficient therapy for IC/BPS has been discovered yet. This review gives an overview of the clinical and pathological features of IC/BPS, with a particular focus on the molecular pathways involved and a special interest in the ongoing few investigational therapies in IC/BPS, which use new regenerative medicine approaches, and their synergetic combination. Good knowledge of the molecular aspects related to stem cell-, PRP-, and biomaterial-based treatments, as well as the understanding of the molecular mechanism of this pathology, will allow for the selection of the right and best use of regenerative approaches of structures involving connective tissue and epithelia, as well as in other diseases.
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Affiliation(s)
- Elisabetta Mormone
- Intitute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBReMIT), Fondazione IRCCS Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, 71013 San Giovanni Rotondo, Italy
| | - Antonio Cisternino
- Santa Maria di Bari Hospital, Via Antonio de Ferraris 22, 70124 Bari, Italy;
| | - Lorenzo Capone
- Department of Urology, Fondazione IRCCS Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, 71013 San Giovanni Rotondo, Italy;
| | | | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, Human Anatomy and Histology Section, University of Verona, 37129 Verona, Italy;
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Liu M, Lu F, Feng J. Therapeutic potential of adipose tissue derivatives in skin photoaging. Regen Med 2023; 18:869-883. [PMID: 37743749 DOI: 10.2217/rme-2023-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Photoaging, the primary cause of exogenous skin aging and predominantly caused by ultraviolet radiation, is an essential type of skin aging characterized by chronic skin inflammation. Recent studies have shown that oxidative stress, inflammation, skin barrier homeostasis, collagen denaturation and pigmentation are the main contributors to it. As a composite tissue rich in matrix and vascular components, adipose tissue derivatives have been recently gaining attention as potential therapeutic agents for various human diseases with fat-processing technology upgrades. This review analyzes both 'minimally treated' and 'nonminimally treated' fat derivatives to give an overview of the preclinical and clinical relevance of adipose tissue derivatives for antiphotoaging application, highlighting their good clinical prospects as well as discussing their safety and potential risks.
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Affiliation(s)
- Meiqi Liu
- Department of Plastic & Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515, PR China
| | - Feng Lu
- Department of Plastic & Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515, PR China
| | - Jingwei Feng
- Department of Plastic & Cosmetic Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong 510515, PR China
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Derafsh E, Ebrahimzadeh F, Kahrizi MS, Kayedi M, Shojaei N, Rahimi S, Alesaeidi S, Ghafouri K. The therapeutic effects of mesenchymal stem cell (MSCs) exosomes in covid-19 disease; Focusing on dexamethasone therapy. Pathol Res Pract 2023; 251:154815. [PMID: 37797382 DOI: 10.1016/j.prp.2023.154815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 10/07/2023]
Abstract
The study of diseases, specifically their aetiologies, their step-by-step progressions (pathogenesis), and their impact on normal structure and function, is the focus of pathology, a branch of science and medicine. In therapeutic fields, it is critical to decrease significantly elevated levels of proinflammatory cytokines. The immunomodulatory drugs such as dexamethasone have been used in several of inflammatory diseases such as Covid-19. The use of dexamethasone alone or in combination with other drugs or method such as mesenchymal stem cell (MSC) is one of the most up-to-date discussions about Covid-19. In this review, we first examined the effects of dexamethasone as monotherapy on inflammatory cytokines and then examined studies that used combination therapy of dexamethasone and other drugs such as Baricitinib, Tofacitinib and tocilizumab. Also, therapeutic aspects of MSCs are examined in this review.
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Affiliation(s)
- Ehsan Derafsh
- Department of Basic Medical Science, Windsor University School of Medicine, Brighton's Estate, Cayton, Saint Kitts and Nevis
| | - Farnoosh Ebrahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, lran
| | | | - Mehrdad Kayedi
- Department of radiology. Shiraz university of medical sciences, Shiraz, iran
| | - Niloofar Shojaei
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Shiva Rahimi
- School of medicine,fasa university of medical sciences,Fasa, Iran
| | - Samira Alesaeidi
- Department of Internal medicine and rheumatology, ⁎Rheumatology Research Center⁎, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kimia Ghafouri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Al-Dhalimy AMB, Salim HM, Shather AH, Naser IH, Hizam MM, Alshujery MK. The pathological and therapeutically role of mesenchymal stem cell (MSC)-derived exosome in degenerative diseases; Particular focus on LncRNA and microRNA. Pathol Res Pract 2023; 250:154778. [PMID: 37683391 DOI: 10.1016/j.prp.2023.154778] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/17/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023]
Abstract
By releasing exosomes, which create the ideal milieu for the resolution of inflammation, mesenchymal stem cells (MSCs) enhance tissue healing and have strong immunomodulatory capabilities. MSCs-derived exosome also can affect tumor progress by a myriad of mechanisms. Exosomes function as a cell-cell communication tool to affect cellular activity in recipient cells and include an array of efficient bioactive chemicals. Understanding the fundamental biology of inflammation ablation, tissue homeostasis, and the creation of therapeutic strategies is particularly interested in the horizontal transfer of exosomal long non-coding RNAs (lncRNA) and microRNAs (miRNAs) to recipient cells, where they affect target gene expression. Herein, we propose an exosomal lncRNA and microRNA profile in neurological, renal, cardiac, lung, and liver diseases as well as skin wounds and arthritis.
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Affiliation(s)
| | - Haitham Mukhlif Salim
- Ministry of Health, Directorat of the Public Health, Health Promotion Departments, Baghdad, Iraq
| | - A H Shather
- Department of Computer Engineering Technology, Al Kitab University, Altun Kopru, Kirkuk 00964, Iraq
| | - Israa Habeeb Naser
- Medical Laboratories Techniques Department, AL-Mustaqbal University, 51001 Hillah, Babil, Iraq
| | - Manar Mohammed Hizam
- Collage of Pharmacy, National University of Science and Technology, Dhi Qar, Iraq
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Josh F, Soekamto T, Windura C. The Combination of Stromal Vascular Fraction Cells and Platelet-Rich Plasma Increases Fibroblast Growth Factor 7 and Promotes Angiogenesis in Full Thickness Burn Injury: Rat Experimental Study. ANNALS OF BURNS AND FIRE DISASTERS 2023; 36:234-242. [PMID: 38680441 PMCID: PMC11042045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/22/2022] [Indexed: 05/01/2024]
Abstract
Our previous study on how the combination of stromal vascular fraction cells (SVFs) and platelet-rich plasma (PRP) affect deep dermal burn healing showed promising results. In this study, we assessed the effect on full-thickness burns by evaluating FGF7 serum level and capillary count. Forty-eight Wistar rats were divided into four major groups: (1) locally injected with combined SVFs and PRP; (2) topically applied Vaseline; (3) locally injected with placebo; (4) and rats without burns. These groups were divided further into smaller groups based on the day of euthanasia (8th hour, 4th day, 7th day, 14th day, and 21st day). FGF7 serum level was measured using ELISA, and capillaries were counted using a microscope. A one-way ANOVA test, post hoc, and regression tests were used. On day 4, both FGF7 and capillary counts showed significant differences between groups (p=0.000 and 0.048, respectively). On day 7, only FGF7 result showed a significant difference (p=0.000). On day 14, FGF7 and capillary counts showed significant differences (p=0.000, 0.018 respectively). The SVFs and PRP-treated groups showed superior results compared to other groups. The injection of combined SVFs and PRP increased FGF7 and capillary counts.
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Affiliation(s)
- F. Josh
- Divison of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - T.H. Soekamto
- Divison of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - C.A. Windura
- Divison of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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Czop JK, Jałowska M. Stem cells in plastic surgery and aesthetic medicine. Postepy Dermatol Alergol 2023; 40:504-509. [PMID: 37692263 PMCID: PMC10485752 DOI: 10.5114/ada.2023.130498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/06/2023] [Indexed: 09/12/2023] Open
Abstract
Stem cells (SCs) have multiple applications in today's medicine including aesthetic dermatology and plastic surgery. The purpose of this paper is to review some clinical use of mesenchymal SCs. The main focus was put on adipose tissue-derived stem cells (ADSCs) as these cells are easy to harvest and because of their properties showed great potential in many studies, where they proved to accelerate wound healing, reduce scars, cause hair regrowth, or rejuvenate skin. Furthermore, when added to lipofilling procedures, such as breast augmentation they enhance fat graft survival and provide satisfying results. Currently, many different strategies for using SCs in treatments are developed with great efficacy, however, there are still many limitations and concerns regarding their clinical use.
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Affiliation(s)
- Julia Katarzyna Czop
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Jałowska
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
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Ichihashi M, Tanaka M, Iizuka T, Totsuka H, Tominaga E, Hitomi Y, Ando H, Nishikata T, Mizutani KI. A Single Intradermal Injection of Autologous Adipose-Tissue-Derived Stem Cells Rejuvenates Aged Skin and Sharpens Double Eyelids. J Pers Med 2023; 13:1162. [PMID: 37511775 PMCID: PMC10381540 DOI: 10.3390/jpm13071162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Facial skin aging is the most visible manifestation of aging in the body. In this study, we aimed to rejuvenate aging skin via a one-time intradermal injection of autologous adipose-derived stem cells (ADSCs). Eight patients were enrolled for study. Photographs of patients taken immediately before and 1, 3, 6, and 12 months after ADSC injections were comparatively evaluated for visible skin manifestations. ADSCs were cultured from the abdominal-skin-derived subcutaneous fat tissue, and 1 × 108 cultured ADSCs were injected intradermally into the facial skin. Cultured myoblasts were incubated with the supernatant derived from ADSCs, and the effect was evaluated via glucose consumption and lactic acid production in the medium. Eight cases showed the shallowing and disappearance of wrinkles, including those of the glabella, lower eyelids, crow`s feet, and forehead and nasolabial grooves, a month to several months after treatment. Double eyelids became prominent, and facial pores significantly reduced in size. These effects lasted for over one year. Myoblasts cultured in the presence of an ADSC-derived exosome were activated compared to that of ADSCs cultured without supernatant. The result supports the role of muscle in ADSC skin rejuvenation. The present study first reports that a single intradermal administration of cultured ADSCs rejuvenates aged facial skin over the course of one year. Further, patients exhibited definite double eyelids and pore shrinkage, strongly indicating the active involvement of muscle, which was supported by an in vitro study. Our study also suggested the important role of biological factors delivered from injected stem cells, although the detailed mechanism of rejuvenation effects of ADSC skin injection remains to be clarified.
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Affiliation(s)
- Masamitsu Ichihashi
- Kobe University, Kobe 657-8501, Japan
- Arts Ginza Clinic, Tokyo 105-0004, Japan
| | | | | | | | | | | | - Hideya Ando
- Department of Applied Chemistry and Biotechnology, Okayama University of Science, Okayama 700-0005, Japan
| | - Takahiro Nishikata
- Frontier of Innovative Research in Science and Technology, Konan University, Kobe 658-8501, Japan
| | - Ken-Ichi Mizutani
- Laboratory of Stem Cell Biology, Graduate School of Pharmaceutical Science, Kobe Gakuin University, Kobe 650-8586, Japan
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Kelishadi S. Commentary on: Autologous Fat Grafting in Female Genital Area Improves Sexual Function by Increasing Collagenesis, Angiogenesis, and Estrogen Receptors. Aesthet Surg J 2023; 43:885-886. [PMID: 37082936 DOI: 10.1093/asj/sjad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023] Open
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Lai YW, Wu SH, Chou PR, Lin C, Yeh JL, Lin TM, Chai CY, Hsieh MCW, Huang SH. Autologous Fat Grafting in Female Genital Area Improves Sexual Function by Increasing Collagenesis, Angiogenesis, and Estrogen Receptors. Aesthet Surg J 2023; 43:872-884. [PMID: 36849597 DOI: 10.1093/asj/sjad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Vulvovaginal laxity, atrophic vaginitis, and orgasmic dysfunction are not only aesthetic but also sexual problems. Autologous fat grafting (AFG) facilitates tissue rejuvenation through the effects of adipose-derived stem cells; the fat grafts serve as soft-tissue filler. However, few studies have reported the clinical outcomes of patients undergoing vulvovaginal AFG. OBJECTIVES The aim of this study was to describe a new technique, micro-autologous fat transplantation (MAFT), for AFG in the vulvovaginal area. Posttreatment histologic changes in the vaginal canal that imply improved sexual function were assessed. METHODS This retrospective study enrolled females who underwent vulvovaginal AFG performed through MAFT between June 2017 and 2020. Assessments were based on the Female Sexual Function Index (FSFI) questionnaire and on histologic and immunohistochemical staining. RESULTS In total, 20 female patients (mean age, 38.1 years) were included. On average, 21.9 mL of fat was injected into the vagina and 20.8 mL in the vulva and mons pubis area. Six months afterwards, the patients' mean total FSFI score (68.6) was significantly higher than that at baseline (43.8; P < .001). Histologic and immunohistochemical staining of vaginal tissues revealed substantially increased levels of neocollagenesis, neoangiogenesis, and estrogen receptors. By contrast, the level of protein gene product 9.5, which is associated with neuropathic pain, was considerably lower after AFG. CONCLUSIONS AFG performed through MAFT in the vulvovaginal area may help manage sexual function-related problems in females. In addition, this technique improves aesthetics, restores tissue volume, alleviates dyspareunia with lubrication, and reduces scar tissue pain.
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La Padula S, Ponzo M, Lombardi M, Iazzetta V, Errico C, Polverino G, Russo F, D'Andrea L, Hersant B, Meningaud JP, Salzano G, Pensato R. Nanofat in Plastic Reconstructive, Regenerative, and Aesthetic Surgery: A Review of Advancements in Face-Focused Applications. J Clin Med 2023; 12:4351. [PMID: 37445386 DOI: 10.3390/jcm12134351] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/19/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Nanofat is a relatively novel technique in fat grafting that has gained significant interest in the fields of regenerative medicine, aesthetic and translational research. It involves the extraction of autologous fat from a patient, which is then transformed into "nanofat", consisting of small fat particles with a diameter of less than 0.1 mm and containing high concentrations of stem cells and growth factors. This article focuses on the use of nanofat in facial rejuvenation and its potential for lipomodelling. Fat tissue is a "stem cell depot" and nanofat contains many stem cells that can differentiate into various cell types. The Lipogem technology, developed in 2013, enables the isolation of nanofat with an intact perivascular structure, utilizing the high concentration of mesenchymal stromal cells near the pericytes of the adipose vascular system. Nowadays nanofat is used primarily for cosmetic purposes particularly in rejuvenating and improving the appearance of the skin, especially the face. Indeed, it has wide applicability; it can be used to treat fine lines, wrinkles, acne scars, sun-damaged skin, scar repair, and as an alopecia treatment. However, further studies are needed to assess the long-term efficacy and safety of this technique. In conclusion, nanofat is a safe and minimally invasive option for tissue regeneration with considerable therapeutic potential. This study reviews the application and effects of nanofat in regenerative medicine and facial cosmetic surgery.
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Affiliation(s)
- Simone La Padula
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Martina Ponzo
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Mariagiovanna Lombardi
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Vincenzo Iazzetta
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Concetta Errico
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Gianmarco Polverino
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Francesca Russo
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Luca D'Andrea
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Barbara Hersant
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Jean Paul Meningaud
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Federico II University of Naples, 80131 Naples, Italy
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
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15
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Shin SH, Lee YH, Rho NK, Park KY. Skin aging from mechanisms to interventions: focusing on dermal aging. Front Physiol 2023; 14:1195272. [PMID: 37234413 PMCID: PMC10206231 DOI: 10.3389/fphys.2023.1195272] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
Skin aging is a multifaceted process that involves intrinsic and extrinsic mechanisms that lead to various structural and physiological changes in the skin. Intrinsic aging is associated with programmed aging and cellular senescence, which are caused by endogenous oxidative stress and cellular damage. Extrinsic aging is the result of environmental factors, such as ultraviolet (UV) radiation and pollution, and leads to the production of reactive oxygen species, ultimately causing DNA damage and cellular dysfunction. In aged skin, senescent cells accumulate and contribute to the degradation of the extracellular matrix, which further contributes to the aging process. To combat the symptoms of aging, various topical agents and clinical procedures such as chemical peels, injectables, and energy-based devices have been developed. These procedures address different symptoms of aging, but to devise an effective anti-aging treatment protocol, it is essential to thoroughly understand the mechanisms of skin aging. This review provides an overview of the mechanisms of skin aging and their significance in the development of anti-aging treatments.
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Affiliation(s)
- Sun Hye Shin
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yoon Hwan Lee
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Nark-Kyoung Rho
- Leaders Aesthetic Laser & Cosmetic Surgery Center, Seoul, Republic of Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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16
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Khetpal S, Ghosh D, Roostaeian J. Innovations in Skin and Soft Tissue Aging-A Systematic Literature Review and Market Analysis of Therapeutics and Associated Outcomes. Aesthetic Plast Surg 2023:10.1007/s00266-023-03322-1. [PMID: 37154849 PMCID: PMC10390368 DOI: 10.1007/s00266-023-03322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/13/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Skin and soft tissue aging has been an important topic of discussion among plastic surgeons and their patients. While botulinum toxin, facial fillers, chemical peels, and surgical lifts preside as the mainstay of treatment to restore appearance of youth, emergent technologies, such as CRISPR-Cas9, proteostasis, flap biology, and stem cell therapies, have gained traction in addressing the aging process of skin and soft tissue. Several studies have introduced these advancements, but it remains unclear how safe and effective these therapeutics are in facial rejuvenation, and how they may fit in the existent treatment workflow for soft tissue aging. MATERIALS/METHODS A systematic literature review was conducted to identify and assess therapeutics utilized in addressing skin and soft tissue aging. Variables collected included year of publication, journal, article title, organization of study, patient sample, treatment modality, associated outcomes. In addition, we performed a market analysis of companies involved in promoting technologies and therapeutics within this space. PitchBook (Seattle, WA), a public market database, was utilized to classify companies, and record the amount of venture capital funding allocated to these categories. RESULTS Initial review yielded four hundred and two papers. Of these, thirty-five were extracted after applying inclusion and exclusion criteria. Though previous literature regards CRISPR-Cas9 technology as the most favorable anti-aging innovation, after reviewing the current literature, stem cell therapies utilizing recipient chimerism appeared to be the superior skin anti-aging technique when accounting for possible disadvantages of various techniques. The psychosocial and cosmetic outcomes from using cell therapy to modulate allograft survival and tolerance may confer more long-term proposed benefits than the technologies in CRISPR-Cas9, flap biology innovations, and autologous platelet-rich plasma use. Market analysis yielded a total of 87 companies, which promoted innovations in technology, biotechnology, biopharmaceuticals, cell-based therapies, and genetic therapy. CONCLUSION This review provides physicians and patients with relevant, usable information regarding how therapeutics can impact treatment regimen for facial aesthetics and skin rejuvenation. Furthermore, the goal of this research is to elucidate the varying therapeutics to restore appearance of youth, present associated outcomes, and in doing so, present plastic surgeons and their colleagues with greater insight on the role of these therapeutics and technologies in clinical practice. Future studies can further assess the safety and efficacy of these innovations and discuss how these may fit within surgical plans among patients seeking rejuvenation procedures. LEVEL OF EVIDENCE III 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)
- Sumun Khetpal
- Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California Los Angeles, 200 Medical Plaza, Suite 460, Los Angeles, CA, 90095, USA
| | - Durga Ghosh
- Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California Los Angeles, 200 Medical Plaza, Suite 460, Los Angeles, CA, 90095, USA
| | - Jason Roostaeian
- Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California Los Angeles, 200 Medical Plaza, Suite 460, Los Angeles, CA, 90095, USA.
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17
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Li X, Gao J, Zheng H, Zou C, Yu Z, Wu Z, Zhang J. Study of platelet-rich plasma application for skin and plastic surgery in recent 20 years: A bibliometric analysis. J Cosmet Dermatol 2023; 22:1852-1862. [PMID: 36762408 DOI: 10.1111/jocd.15653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND In recent years, platelet-rich plasma (PRP) has been used in plastic surgery, dermatology, and other treatment procedures worldwide. Since the number of scientific writings has been significantly increasing, it is challenging to generate a manual compilation and systematic review of PRP's therapeutic applications in dermatology and plastic surgeries. This study aimed to make a bibliometric analysis of the literature in the field and evaluate research hotspots and frontiers in this field in the past 20 years. METHODS Using the Academic Search Premier and ScienceDirect defined search terms, we searched the Web of Science Core Collection (WoSCC) and Scopus databases. All data were analyzed using CiteSpace 5.8.R3 and VOSviewer, including countries, institutions, authors, keywords, cited authors, cited journals, cited references, discovered research hotspots, and frontiers. RESULTS A total of 1931 studies were retrieved. The number of publications on PRP application in dermatology and plastic surgeries showed a yearly increase. The United States was the most significant contributor to this field, while Italy's contribution was noteworthy. The journal with the highest number of relevant articles in dermatology and plastic surgery included the Journal of Cosmetic Dermatology. However, the Wound Repair and Regeneration and International Journal of Molecular Sciences were the leading journals that should be paid attention to in the future. Author Anitua E from the Tor Vergata University of Rome published the most publications in this field. In the keyword co-occurrence analysis, all keywords were divided into six clusters, and the most common one in recent years was "PRP for facial beauty." Facial rejuvenation, scar, and alopecia were the main hotspots and research trends in this field. CONCLUSIONS Based on the current global trends, the use of PRP in cosmetics and skin care is receiving increasing attention from researchers and clinicians. Recently, an increasing number of articles on PRP's application in skin tissue repair have been published in the United States and Italy. The number of studies on hair loss, facial rejuvenation, and scar management is increasing, suggesting that these subjects may become research hotspots for PRP in dermatology and cosmetic surgeries in recent years.
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Affiliation(s)
- Xianhui Li
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junqing Gao
- Affiliated Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, China
| | - Haishan Zheng
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chengyou Zou
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhuoan Yu
- The Eighth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zouping Wu
- The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiasheng Zhang
- Affiliated Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, China
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18
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Qian H, Shan Y, Gong R, Lin D, Zhang M, Wang C, Wang L. Mechanism of action and therapeutic effects of oxidative stress and stem cell-based materials in skin aging: Current evidence and future perspectives. Front Bioeng Biotechnol 2023; 10:1082403. [PMID: 36698629 PMCID: PMC9868183 DOI: 10.3389/fbioe.2022.1082403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
Aging is associated with multiple degenerative diseases, including atherosclerosis, osteoporosis, and Alzheimer's disease. As the most intuitive manifestation of aging, skin aging has received the most significant attention. Skin aging results from various intrinsic and extrinsic factors. Aged skin is characterized by wrinkles, laxity, elastosis, telangiectasia, and aberrant pigmentation. The underlying mechanism is complex and may involve cellular senescence, DNA damage, oxidative stress (OS), inflammation, and genetic mutations, among other factors. Among them, OS plays an important role in skin aging, and multiple antioxidants (e.g., vitamin C, glutathione, and melatonin) are considered to promote skin rejuvenation. In addition, stem cells that exhibit self-replication, multi-directional differentiation, and a strong paracrine function can exert anti-aging effects by inhibiting OS. With the further development of stem cell technology, treatments related to OS mitigation and involving stem cell use may have a promising future in anti-skin aging therapy.
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Affiliation(s)
- Huan Qian
- Department of Plastic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China,*Correspondence: Huan Qian, ; Lu Wang,
| | - Yihan Shan
- Wenzhou Medical University, Wenzhou, China
| | | | - Danfeng Lin
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengwen Zhang
- Department of Plastic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Wang
- Department of Plastic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Wang
- Starbody plastic surgery Clinic, Hangzhou, China,*Correspondence: Huan Qian, ; Lu Wang,
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19
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Schipper JAM, Vriend L, Tuin AJ, Dijkstra PU, Schepers RH, van der Lei B, Jansma J, Harmsen MC. Supplementation of Facial Fat Grafting to Increase Volume Retention: A Systematic Review. Aesthet Surg J 2022; 42:NP711-NP727. [PMID: 35576617 PMCID: PMC9750673 DOI: 10.1093/asj/sjac122] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND For decades, facial fat grafting has been used in clinical practice for volume restoration. The main challenge of this technique is variable volume retention. The addition of supplements to augment fat grafts and increase volume retention has been reported in recent years. OBJECTIVES The aim of this systematic review was to investigate which supplements increase volume retention in facial fat grafting as assessed by volumetric outcomes and patient satisfaction. METHODS Embase, Medline, Ovid, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar were searched up to November 30, 2020. Only studies assessing volume after facial fat grafting with supplementation in human subjects were included. Outcomes of interest were volume or patient satisfaction. The quality of the studies was assessed with the Effective Public Health Practice Project tool. RESULTS After duplicates were removed 3724 studies were screened by title and abstract. After reading 95 full-text articles, 27 studies were eligible and included for comparison. Supplementation comprised of platelet-rich plasma, platelet-rich fibrin, adipose tissue-derived stromal cells or bone marrow-derived stromal cells, cellular or tissue stromal vascular fraction, or nanofat. In 13 out of 22 studies the supplemented group showed improved volumetric retention and 5 out of 16 studies showed greater satisfaction. The scientific quality of the studies was rated as weak for 20 of 27 studies, moderate for 6 of 27 studies, and strong for 1 study. CONCLUSIONS It remains unclear if additives contribute to facial fat graft retention and there is a need to standardize methodology. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Jan Aart M Schipper
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Linda Vriend
- Department of Plastic and Reconstructive Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Aartje J Tuin
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Pieter U Dijkstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Rutger H Schepers
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Berend van der Lei
- Department of Plastic and Reconstructive Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Johan Jansma
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Martin C Harmsen
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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20
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Platelet-Rich Stroma (PRS) Injection Provides Great Improvement in Depressed Scars. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03588-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Akasaka Y. The Role of Mesenchymal Stromal Cells in Tissue Repair and Fibrosis. Adv Wound Care (New Rochelle) 2022; 11:561-574. [PMID: 34841889 DOI: 10.1089/wound.2021.0037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Significance: The present review covers an overview of the current understanding of biology of mesenchymal stromal cells (MSCs) and suggests an important role of their differential potential for clinical approaches associated with tissue repair and fibrosis. Recent Advances: Genetic lineage tracing technology has enabled the delineation of cellular hierarchies and examination of MSC cellular origins and myofibroblast sources. This technique has led to the characterization of perivascular MSC populations and suggests that pericytes might provide a local source of tissue-specific MSCs, which can differentiate into tissue-specific cells for tissue repair and fibrosis. Autologous adipose tissue MSCs led to the advance in tissue engineering for regeneration of damaged tissues. Critical Issues: Recent investigation has revealed that perivascular MSCs might be the origin of myofibroblasts during fibrosis development, and perivascular MSCs might be the major source of myofibroblasts in fibrogenic disease. Adipose tissue MSCs combined with cytokines and biomaterials are available in the treatment of soft tissue defect and skin wound healing. Future Directions: Further investigation of the roles of perivascular MSCs may enable new approaches in the treatment of fibrogenic disease; moreover, perivascular MSCs might have potential as an antifibrotic target for fibrogenic disease. Autologous adipose tissue MSCs combined with cytokines and biomaterials will be an alternative method for the treatment of soft tissue defect and skin wound healing.
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Affiliation(s)
- Yoshikiyo Akasaka
- Division of Research Promotion and Development, Advanced Research Center, Toho University Graduate School of Medicine, Ota-ku, Japan.,Department of Pathology, Toho University School of Medicine, Ota-ku, Japan
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22
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Buzalaf MAR, Levy FM. Autologous platelet concentrates for facial rejuvenation. J Appl Oral Sci 2022; 30:e20220020. [PMID: 36074433 PMCID: PMC9444188 DOI: 10.1590/1678-7757-2022-0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/02/2022] [Indexed: 12/04/2022] Open
Abstract
Autologous platelet concentrates (APCs) are promising therapeutic agents in facial rejuvenation since they are a great source of cytokines, growth factors and other biologically active substances. Obtained from the patient’s blood, they have the advantages of reducing immunological reactions, making the procedure safer, well tolerated, with minimal adverse effects and lower cost. Currently, they are used for facial rejuvenation both in combination with microneedling and in mesotherapy techniques, as well as to treat facial acne scars, melasma and wounds after laser ablative treatments. This review summarizes current knowledge on the use of APCs, ranging from basic concepts related to their composition and mechanisms of action to up-to-date information on their clinical efficacy.
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Affiliation(s)
- Marília Afonso Rabelo Buzalaf
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Flávia Mauad Levy
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
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23
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Margiana R, Markov A, Zekiy AO, Hamza MU, Al-Dabbagh KA, Al-Zubaidi SH, Hameed NM, Ahmad I, Sivaraman R, Kzar HH, Al-Gazally ME, Mustafa YF, Siahmansouri H. Clinical application of mesenchymal stem cell in regenerative medicine: a narrative review. Stem Cell Res Ther 2022; 13:366. [PMID: 35902958 PMCID: PMC9330677 DOI: 10.1186/s13287-022-03054-0] [Citation(s) in RCA: 100] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 12/16/2022] Open
Abstract
The multipotency property of mesenchymal stem cells (MSCs) has attained worldwide consideration because of their immense potential for immunomodulation and their therapeutic function in tissue regeneration. MSCs can migrate to tissue injury areas to contribute to immune modulation, secrete anti-inflammatory cytokines and hide themselves from the immune system. Certainly, various investigations have revealed anti-inflammatory, anti-aging, reconstruction, and wound healing potentials of MSCs in many in vitro and in vivo models. Moreover, current progresses in the field of MSCs biology have facilitated the progress of particular guidelines and quality control approaches, which eventually lead to clinical application of MSCs. In this literature, we provided a brief overview of immunoregulatory characteristics and immunosuppressive activities of MSCs. In addition, we discussed the enhancement, utilization, and therapeutic responses of MSCs in neural, liver, kidney, bone, heart diseases, and wound healing.
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Affiliation(s)
- Ria Margiana
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.,Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.,Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Alexander Markov
- Tyumen State Medical University, Tyumen, Russian Federation.,Tyumen Industrial University, Tyumen, Russian Federation
| | - Angelina O Zekiy
- Department of Prosthetic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | | | | | - Noora M Hameed
- Anesthesia Techniques, Al-Nisour University College, Baghdad, Iraq
| | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - R Sivaraman
- Department of Mathematics, Dwaraka Doss Goverdhan Doss Vaishnav College, Arumbakkam, University of Madras, Chennai, India
| | - Hamzah H Kzar
- Veterinary Medicine College, Al-Qasim Green University, Al-Qasim, Iraq
| | | | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, 41001, Iraq
| | - Homayoon Siahmansouri
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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24
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Hasiba-Pappas SK, Tuca AC, Luze H, Nischwitz SP, Zrim R, Geißler JC, Lumenta DB, Kamolz LP, Winter R. Platelet-Rich Plasma in Plastic Surgery: A Systematic Review. Transfus Med Hemother 2022; 49:129-142. [PMID: 35813605 PMCID: PMC9210026 DOI: 10.1159/000524353] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION Platelet-rich plasma (PRP) is gaining popularity and is applied in a variety of clinical settings. This review aims to present and evaluate available evidence regarding the use of PRP in various applications in plastic surgery. METHODS PubMed, Web of Science, Medline, and Embase were searched using predefined MeSH terms to identify studies concerning the application of PRP alone or in combination with fat grafting for plastic surgery. The search was limited to articles in English or German. Animal studies, in vitro studies, case reports, and case series were excluded. RESULTS Of 50 studies included in this review, eleven studies used PRP for reconstruction or wound treatment, eleven for cosmetic procedures, four for hand surgery, two for burn injuries, five for craniofacial disorders, and 17 as an adjuvant to fat grafting. Individual study characteristics were summarized. Considerable variation in preparation protocols and treatment strategies were observed. Even though several beneficial effects of PRP therapy were described, significance was not always demonstrated, and some studies yielded conflicting results. Efficacy of PRP was not universally proven in every field of application. CONCLUSION This study presents an overview of current PRP treatment options and outcomes in plastic surgery. PRP may be beneficial for some indications explored in this review; however, currently available data are insufficient and systematic evaluation is limited due to high heterogeneity in PRP preparation and treatment regimens. Further randomized controlled trials employing standardized protocols are warranted.
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Affiliation(s)
- Sophie K. Hasiba-Pappas
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Alexandru Cristian Tuca
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Hanna Luze
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Sebastian P. Nischwitz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Robert Zrim
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Judith C.J. Geißler
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - David Benjamin Lumenta
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Lars-P. Kamolz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
- COREMED − Cooperative Centre for Regenerative Medicine, Joanneum Research GmbH, Graz, Austria
| | - Raimund Winter
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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Teraoka S, Honda M, Makishima K, Shimizu R, Tsounapi P, Yumioka T, Iwamoto H, Li P, Morizane S, Hikita K, Hisatome I, Takenaka A. Early effects of an adipose-derived stem cell sheet against detrusor underactivity in a rat cryo-injury model. Life Sci 2022; 301:120604. [DOI: 10.1016/j.lfs.2022.120604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 11/25/2022]
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Verdura V, Guastafierro A, Di Pace B, Faenza M, Nicoletti GF, Rubino C. Optimizing Fat Grafting Using a Hydraulic System Technique for Fat Processing: A Time and Cost Analysis. Arch Plast Surg 2022; 49:266-274. [PMID: 35832664 PMCID: PMC9045492 DOI: 10.1055/s-0042-1744361] [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] [Indexed: 11/28/2022] Open
Abstract
Background
Many authors have researched ways to optimize fat grafting by looking for a technique that offers safe and long-term fat survival rate. To date, there is no standardized protocol. We designed a “hydraulic system technique” optimizing the relationship among the quantity of injected fat, operative time, and material cost to establish fat volume cutoffs for a single procedure.
Methods
Thirty-six patients underwent fat grafting surgery and were organized into three groups according to material used: standard, “1-track,” and “2-tracks” systems. The amount of harvested and grafted fat as well as material used for each procedure was collected. Operating times were recorded and statistical analysis was performed to establish the relationship with the amount of treated fat.
Results
In 15 cases the standard system was used (mean treated fat 72 [30–100] mL, mean cost 4.23 ± 0.27 euros), in 11 cases the “1-track” system (mean treated fat 183.3 [120–280] mL, mean cost 7.63 ± 0.6 euros), and in 10 cases the “2-tracks” one (mean treated fat 311[220–550] mL, mean cost 12.47 ± 1 euros). The mean time difference between the standard system and the “1-track” system is statistically significant starting from three fat syringes (90 mL) in 17.66 versus 6.87 minutes. The difference between the “1-track” system and “2-tracks” system becomes statistically significant from 240 mL of fat in 15 minutes (“1-track”) versus 9.3 minutes for the “2-tracks” system.
Conclusion
Data analysis would indicate the use of the standard system, “1-track,” and “2-tracks” to treat an amount of fat < 90 mL of fat, 90 ÷ 240 mL of fat, and ≥ 240 mL of fat, respectively.
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Affiliation(s)
- Vincenzo Verdura
- Multidisciplinary Department of Medical Surgical and Dental Specialties, Plastic Surgery Unit, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Antonio Guastafierro
- Multidisciplinary Department of Medical Surgical and Dental Specialties, Plastic Surgery Unit, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Bruno Di Pace
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” PhD School of Translational Medicine of Development and Active Aging, University of Salerno, Salerno, Italy
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Anglia Ruskin University School of Medicine, Cambridge and Chelmsford, United Kingdom
| | - Mario Faenza
- Multidisciplinary Department of Medical Surgical and Dental Specialties, Plastic Surgery Unit, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Giovanni Francesco Nicoletti
- Multidisciplinary Department of Medical Surgical and Dental Specialties, Plastic Surgery Unit, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Corrado Rubino
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
- Plastic Surgery Unit, Department of Oncology and Haematology, University Hospital Trust of Sassari, Sassari, Italy
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Cohen SR, Wesson J, Willens S, Nadeau T, Hillman C, Dobke M, Tiryaki T. Standardized Anatomic and Regenerative Facial Fat Grafting: Objective Photometric Evaluation 1 to 19 Months After Injectable Tissue Replacement and Regeneration. Aesthet Surg J 2022; 42:327-339. [PMID: 34724035 DOI: 10.1093/asj/sjab379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A standardized technique for facial fat grafting, injectable tissue replacement and regeneration (ITR2), incorporating new regenerative approaches, was developed to address anatomic volume losses in superficial and deep fat compartments as well as skin aging. OBJECTIVES The aim of this study was to track the short- and long-term effects of facial fat grafting by ITR2 in the midfacial zone over 19 months. METHODS Twenty-nine females were analyzed for midfacial volume changes after autologous fat transfer with ITR2 with varying fat parcel sizes. Volumes were evaluated with an imaging system to calculate differences between a predefined, 3-dimensional midfacial zone measured preoperatively and after fat grafting. RESULTS Patient data were analyzed collectively and by age (<55 and >55 years). Collective analysis revealed a trend of initial volume loss during Months 1 to 7 followed by an increase during Months 8 to 19, averaging 56.6% postoperative gain, and ending at an average of 52.3% gain in volume by 14 to 19 months. A similar trend was observed for patients <55 years of age, with a 54.1% average postoperative gain and a greater final average of 75.2%. Conversely, patients >55 years of age revealed a linear decay from 60.6% to 29.5%. Multiple regression analysis revealed no statistically significant influence of weight change throughout the study. CONCLUSIONS A dynamic change in facial volume was observed, with an initial decrease in facial volume followed by a rebound effect, by 19 months after treatment, of improved facial volume regardless of the amount of fat injected. Volume improvement was greater in patients <55 years old, whereas in patients >55 years old, volume gradually decreased. This study represents the first time that progressive improvement in facial volume has been shown 19 months after treatment. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Steven R Cohen
- plastic surgeon in private practice in San Diego, CA, USA
| | - Jordan Wesson
- University of California, Los Angeles, Los Angeles, CA, USA
| | - Sierra Willens
- Stanford University School of Medicine, Stanford, CA, USA
| | - Taylor Nadeau
- University of California, San Diego, San Diego, CA, USA
| | | | - Marek Dobke
- Department of Surgery, Division of Plastic Surgery, University of California, San Diego, San Diego, CA, USA
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Kim J, Eom MR, Ji Jeong E, Choi JS, Kwon SK. Multiple stimulation with spheroids comprising salivary gland and adipose-derived stem cells enhances regeneration of radiation-damaged salivary glands. J IND ENG CHEM 2022. [DOI: 10.1016/j.jiec.2021.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Combined Surgical-Orthodontic Treatment of Patients With Severe Parry-Romberg Syndrome. J Craniofac Surg 2022; 33:e564-e569. [DOI: 10.1097/scs.0000000000008572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/11/2022] [Indexed: 11/26/2022] Open
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Abstract
BACKGROUND Regenerative aesthetics is an emerging branch of regenerative medicine with therapies aimed at recapturing youthful structure and function using the body's own systems. OBJECTIVE To introduce the field of regenerative aesthetics, and to explore themes and evidence surrounding current and emerging therapies in the field. MATERIALS AND METHODS A review of the literature was performed for each of the 3 pillars of regeneration; namely, stem cells, biochemical cues, and scaffolds. RESULTS Herein, we provide an overview of the field of regenerative aesthetics, a discussion surrounding the 3 pillars of regeneration, and an overview of the evidence supporting current and emerging therapeutic modalities that could play a pivotal role in the future of aesthetic treatments. CONCLUSION An enhanced understanding of this field can serve to further enhance our awareness about the regenerative effects of therapies we already offer, in addition to providing inspiration for future innovation.
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Atiyeh B, Ghieh F, Oneisi A. Nanofat Cell-Mediated Anti-Aging Therapy: Evidence-Based Analysis of Efficacy and an Update of Stem Cell Facelift. Aesthetic Plast Surg 2021; 45:2939-2947. [PMID: 34085105 DOI: 10.1007/s00266-021-02353-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/09/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Fat grafting has been extensively applied as natural filler and has been very promising in restoring volume loss. Lipografting has also been credited to reduce age-related skin changes due to the regenerative potential of adipose derived stem cells. Cell-mediated therapies in plastic surgery are rapidly evolving with growing applications. Nanofat, a bio-regenerative liquid suspension rich in stromal vascular fraction cells without viable adipocytes, has been described as an efficient cutaneous anti-aging therapy. We have published in 2013 a review entitled "stem cell facelift: between reality and fiction." Available clinical evidence at that time did not substantiate marketing and promotional claims of "stem cell facelift". The same year, the report about nanofat was published demonstrating striking clinical outcome. The current literature search is aimed at reviewing any evidence that has emerged since then regarding clinical efficacy of this modality. METHODS A thorough PICO tool-based comprehensive literature search of PubMed database for "the efficacy of nanofat cell-mediated anti-aging therapy" was conducted with a time frame from 2013 till present. RESULTS Despite apparent increasing popularity of stem cell rejuvenation, well-controlled clinical studies about this modality are surprisingly very scarce. Only seven papers published after 2013 were identified and were included in this review CONCLUSION: Though considered to be a safe procedure, and despite documented histologic improvement and striking clinical outcome in some reports, available evidence can hardly support clinical improvement of skin quality. Before cell-mediated aesthetic rejuvenation applications can be routinely undertaken, more robust evidence with well-defined primary outcome end points and objective outcome measures is required. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Bishara Atiyeh
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Ghieh
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmad Oneisi
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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Verpaele A, Tonnard P, Ghiasloo M. Invited Discussion on: "Nanofat Cell-Mediated Anti-Aging Therapy: Evidence-Based Analysis of Efficacy and an Update of Stem Cell Facelift" by Bishara Atiyeh, Fadi Ghieh, Ahmad Oneisi. Aesthetic Plast Surg 2021; 45:2948-2951. [PMID: 34529105 DOI: 10.1007/s00266-021-02572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Alexis Verpaele
- Tonnard and Verpaele Plastic Surgery Associates, Coupure 164 c/d, 9000, Ghent, Belgium.
| | - Patrick Tonnard
- Tonnard and Verpaele Plastic Surgery Associates, Coupure 164 c/d, 9000, Ghent, Belgium
| | - Mohammad Ghiasloo
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Corneel Heymanslaan 10, Entrance 12, Route 1281, 9000, Ghent, Belgium
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Xiao H, Xu D, Mao R, Xiao M, Fang Y, Liu Y. Platelet-Rich Plasma in Facial Rejuvenation: A Systematic Appraisal of the Available Clinical Evidence. Clin Cosmet Investig Dermatol 2021; 14:1697-1724. [PMID: 34819739 PMCID: PMC8606573 DOI: 10.2147/ccid.s340434] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/04/2021] [Indexed: 11/23/2022]
Abstract
Purpose Platelet-rich plasma (PRP) is a promising noninvasive technique for facial rejuvenation. This systematic literature review aims to appraise the nature and quality of published evidence evaluating the effectiveness and safety of PRP in facial rejuvenation. Patients and Methods A systematic literature review was conducted with the search string “Platelet-rich plasma AND Facial rejuvenation” in PubMed and Embase. Clinical studies evaluating the outcomes after PRP-based facial rejuvenation either as monotherapy or in combination with other treatment modalities were included. Studies evaluating wound-healing properties of PRP were excluded. The outcomes included both patient-reported and physician-assessed outcomes. Nonstatistical synthesis of evidence was performed by qualitative assessment. The results are reported by the Synthesis Without Meta-analysis (SWiM) reporting standard. Results A total of 36 studies that included a total of 3172 patients were considered for the evidence synthesis. The number of patients in the included studies ranging from 11 to 2005 with a median of 27.5 patients that reflects the challenges in clinically assessing the aesthetic outcomes after PRP-based facial rejuvenation. Among the 36 studies, 17 were observational studies and 18 were interventional studies with 1 being case report PRP was evaluated either alone or in combination with hyaluronic acid, lipofilling, micro-needling technique, and laser-based interventions. Among the studies, 1 study reported the enhanced platelet concentrate in a fibrin matrix to be relatively safe and effective with a maximum benefit observed at 12 weeks suggesting the platelet-rich fibrin matrix may provide desired aesthetic outcomes and it requires further studies to substantiate. Conclusion The results suggest very limited clinical evidence, and further clinical studies are warranted to establish the effectiveness of PRP in facial rejuvenation. Furthermore, a consensus for end points used for establishing clinical utility in patients requiring facial rejuvenation is warranted.
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Affiliation(s)
- Hong Xiao
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China
| | - Dan Xu
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China
| | - Rui Mao
- School of Stomatology, Kunming Medical University, Kunming, Yunnan, People's Republic of China
| | - Minqin Xiao
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China
| | - Yang Fang
- Wushi Jiamei Beauty Hospital, Kunming, Yunnan, People's Republic of China
| | - Yin Liu
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China
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Sharma S, Muthu S, Jeyaraman M, Ranjan R, Jha SK. Translational products of adipose tissue-derived mesenchymal stem cells: Bench to bedside applications. World J Stem Cells 2021; 13:1360-1381. [PMID: 34786149 PMCID: PMC8567449 DOI: 10.4252/wjsc.v13.i10.1360] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/02/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023] Open
Abstract
With developments in the field of tissue engineering and regenerative medicine, the use of biological products for the treatment of various disorders has come into the limelight among researchers and clinicians. Among all the available biological tissues, research and exploration of adipose tissue have become more robust. Adipose tissue engineering aims to develop by-products and their substitutes for their regenerative and immunomodulatory potential. The use of biodegradable scaffolds along with adipose tissue products has a major role in cellular growth, proliferation, and differentiation. Adipose tissue, apart from being the powerhouse of energy storage, also functions as the largest endocrine organ, with the release of various adipokines. The progenitor cells among the heterogeneous population in the adipose tissue are of paramount importance as they determine the capacity of regeneration of these tissues. The results of adipose-derived stem-cell assisted fat grafting to provide numerous growth factors and adipokines that improve vasculogenesis, fat graft integration, and survival within the recipient tissue and promote the regeneration of tissue are promising. Adipose tissue gives rise to various by-products upon processing. This article highlights the significance and the usage of various adipose tissue by-products, their individual characteristics, and their clinical applications.
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Affiliation(s)
- Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
- Indian Stem Cell Study Group, Lucknow, Uttar Pradesh 226010, India
| | - Sathish Muthu
- Indian Stem Cell Study Group, Lucknow, Uttar Pradesh 226010, India
- Department of Orthopaedics, Government Medical College and Hospital, Dindigul, Tamil Nadu 624304, India
- Research Scholar, Department of Biotechnology, School of Engineering and Technology, Greater Noida, Sharda University, Uttar Pradesh 201306, India
| | - Madhan Jeyaraman
- Indian Stem Cell Study Group, Lucknow, Uttar Pradesh 226010, India
- Research Scholar, Department of Biotechnology, School of Engineering and Technology, Greater Noida, Sharda University, Uttar Pradesh 201306, India
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh 201306, India
| | - Rajni Ranjan
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh 201306, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh 201306, India
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Warren RJ. Commentary on: Regen Fat Code: A Standardized Protocol for Facial Volumetry and Rejuvenation. Aesthet Surg J 2021; 41:NP1405-NP1407. [PMID: 33825812 DOI: 10.1093/asj/sjab007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Charles-de-Sá L, Gontijo-de-Amorim NF, Coleman S, Rigotti G. Regen Fat Code: A Standardized Protocol for Facial Volumetry and Rejuvenation. Aesthet Surg J 2021; 41:NP1394-NP1404. [PMID: 33453100 DOI: 10.1093/asj/sjab016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Facial aging is a degenerative process that impairs contour and angle prominence. Rejuvenation is based on tissue replacement, volumization of the atrophic areas, and improving flaccidity and cutaneous photoaging. OBJECTIVES The aim of this study was to apply structural fat grafting to manage volumetric deficits of the face, following a new systematic protocol called "Regen Fat Code" (RF Code) that was created to standardize structural lipotransfer methods. METHODS This is a prospective clinical trial involving 80 healthy candidates for facial rejuvenation who were split into 2 groups. Group A underwent only structural lipotransfer; Group B underwent replacement of deep facial structures by face-lifting plus structural lipotransfer. Structural lipotransfer followed the protocol "RF Code" and 3 clinical tools were adopted for pre- and postoperative facial volumetric analysis. RESULTS Total volume (mL) of lipotransfer in Groups A and B ranged between 1 and 20 mL (mean [standard deviation], 12 [5] mL), distributed to the different areas as follows: nasolabial fold, 3.32 [0.92] mL; superior lip, 2.0 [0.62] mL; inferior lip, 2.76 [0.71] mL; malar, 8.51 [5.25] mL; inferior eyelid, 1.2 [0.54] mL; and chin, 7.18 [1.99] mL. Areas with less mobility showed a lower absorption index than dynamic areas. CONCLUSIONS The development of the RF Code protocol demonstrated the potential of grouping many parameters based on the lipotransfer method used to volumize and regenerate atrophic areas of the face. The protocol is easy to apply, and allows different volumizing and regenerative effects to be proposed, according to the demands of each surgical area. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Luiz Charles-de-Sá
- Department of Plastic, Reconstructive and Aesthetic Surgery, Training and Research State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Sydney Coleman
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Gino Rigotti
- Regenerative Medicine Department of San Francesco Hospital, Verona, Italy
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Fan P, Fang M, Li J, Solari MG, Wu D, Tan W, Wang Y, Yang X, Lei S. A Novel Fat Making Strategy With Adipose-Derived Progenitor Cell-Enriched Fat Improves Fat Graft Survival. Aesthet Surg J 2021; 41:NP1228-NP1236. [PMID: 34387330 DOI: 10.1093/asj/sjab216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND A low survival rate is one of the main challenges in fat grafting. OBJECTIVES This study aimed to evaluate whether microfat obtained by a novel strategy promoted the survival and retention of fat grafts. METHODS A 5-mm-diameter blunt tip cannula with large side holes (~30 mm2/hole) was used to obtain macrofat. A novel strategy based on a newly invented extracorporeal cutting device was then used to cut the macrofat into microfat, which was named adipose-derived progenitor cell enrichment fat (AER fat); Coleman fat was used as the control. Aliquots (0.5 mL) of both types of fat were transplanted into 10 nude mice and analyzed 10 weeks later. Western blotting, flow cytometry, and immunofluorescence were performed to assess the AER fat characteristics and underlying mechanisms. RESULTS The retention rate of fat grafts in AER fat-treated animals was significantly higher than that in the Coleman group (mean [standard deviation] 54.6% [13%] vs 34.8% [9%]; P < 0.05) after 10 weeks. AER fat contained more dipeptidyl peptidase-4-expressing progenitor cells (3.3 [0.61] × 103 vs 2.0 [0.46] × 103 cells/mL; P < 0.05), adipose-derived plastic-adherent cells (6.0 [1.10] × 104 vs 2.6 [0.17] × 104 cells/mL; P < 0.001), and viable adipocytes than Coleman fat. Moreover, histologic analysis showed that AER fat grafts had better histologic structure and higher capillary density. CONCLUSIONS AER fat transplantation is a potential strategy to improve the survival and long-term retention of fat grafts. AER fat contained more dipeptidyl peptidase-4-expressing progenitor cells.
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Affiliation(s)
- Pengju Fan
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Man Fang
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Jingjing Li
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Mario G Solari
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Dingyu Wu
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Wuyuan Tan
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Yongjie Wang
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Xinghua Yang
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Shaorong Lei
- Department of Burn and Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P. R. China
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Crowley JS, Liu A, Dobke M. Regenerative and stem cell-based techniques for facial rejuvenation. Exp Biol Med (Maywood) 2021; 246:1829-1837. [PMID: 34102897 PMCID: PMC8381699 DOI: 10.1177/15353702211020701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This review discusses the most novel ideas and modalities being incorporated into facial rejuvenation. Recent innovative techniques include the use of regenerative stem cell techniques and regeneration supportive modalities such as nano-technology or gene therapies. This review aims to investigate approaches that are less well known and lacking established evidence in order to proactively study these techniques prior to them becoming popularized. These applications and relevant research were reviewed in the context of both surgical and non-surgical modalities in clinical practice. Future directions include the concept of "precision cosmetic medicine" utilizing gene editing and cellular therapies to tailor rejuvenation techniques based on each individual's genetic make-up and therefore needs.
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Affiliation(s)
- J Sarah Crowley
- Department of Surgery, Division of Plastic Surgery,
UC San Diego School of Medicine, San Diego, CA 92103-8890
| | - Amy Liu
- Department of Surgery, Division of Plastic Surgery,
UC San Diego School of Medicine, San Diego, CA 92103-8890
| | - Marek Dobke
- Department of Surgery, Division of Plastic Surgery,
UC San Diego School of Medicine, San Diego, CA 92103-8890
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van Dongen JA, Boxtel JV, Willemsen JC, Brouwer LA, Vermeulen KM, Tuin AJ, Harmsen MC, van der Lei B, Stevens HP. The Addition of Tissue Stromal Vascular Fraction to Platelet-Rich Plasma Supplemented Lipofilling Does Not Improve Facial Skin Quality: A Prospective Randomized Clinical Trial. Aesthet Surg J 2021; 41:NP1000-NP1013. [PMID: 33687052 DOI: 10.1093/asj/sjab109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Lipofilling has become popular as a treatment to improve aging-related skin characteristics (eg, wrinkles, pigmentation spots, pores, or rosacea). Different additives such as platelet-rich plasma (PRP) or stromal vascular fraction (SVF) have been combined with lipofilling to increase the therapeutic effect of adipose-derived stromal cells (ASCs). OBJECTIVES The aim of this study was to examine the hypothesis that mechanically isolated SVF augments the therapeutic effect of PRP-supplemented lipofilling to improve facial skin quality. METHODS This prospective, double-blind, placebo-controlled, randomized trial was conducted between 2016 and 2019. In total, 28 female subjects were enrolled; 25 completed the follow-up. All patients received PRP-supplemented lipofilling with either mechanically isolated SVF or saline. SVF was isolated by fractionation of adipose tissue (tSVF). Results were evaluated by changes in skin elasticity and transepidermal water loss, changes in skin-aging-related features, ie, superficial spots, wrinkles, skin texture, pores, vascularity, and pigmentation, as well as patient satisfaction (FACE-Q), recovery, and number of complications up to 1 year postoperative. RESULTS The addition of tSVF to PRP-supplemented lipofilling did not improve skin elasticity, transepidermal water loss, or skin-aging-related features. No improvement in patient satisfaction with overall facial appearance or facial skin quality was seen when tSVF was added to PRP-supplemented lipofilling. CONCLUSIONS In comparison to PRP-supplemented lipofilling, PRP-supplemented lipofilling combined with tSVF does not improve facial skin quality or patient satisfaction in a healthy population. PRP-supplemented lipofilling combined with tSVF can be considered a safe procedure. LEVEL OF EVIDENCE: 2
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Affiliation(s)
| | - Joeri V Boxtel
- Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Joep C Willemsen
- Albert Schweitzer Hospital Dordrecht, Dordrecht, the Netherlands
| | - Linda A Brouwer
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Aartje Jorien Tuin
- Department of Maxillofacial Surgery, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Martin C Harmsen
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Berend van der Lei
- Department of Plastic Surgery, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
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Nilforoushzadeh MA, Heidari-Kharaji M, Alavi S, Nouri M, Nikkhah N, Jahangiri F, Mahmoudbeyk M, Peyrovan A, Baiat Tork B, Torkamaniha E, Zare S. Transplantation of autologous fat, stromal vascular fraction (SVF) cell, and platelet-rich plasma (PRP) for cell therapy of atrophic acne scars: Clinical evaluation and biometric assessment. J Cosmet Dermatol 2021; 21:2089-2098. [PMID: 34228901 DOI: 10.1111/jocd.14333] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/13/2021] [Accepted: 07/02/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Scarring is an unfortunate result of acne because it causes the psychological and cosmetic problems for the patients. Unfortunately, no single treatment is suitable, and using multiple methods may have a better result. The autologous fat and stromal vascular fraction (SVF) cells and their secretory factors can enhance the angiogenesis, collagen synthesis, and migration of fibroblasts, therefore regenerate hurt tissues. Moreover, other treatments for acne scarring, such as platelet-rich plasma (PRP), induce the increase in scare. AIMS This study aimed to verify the effectiveness of transplantation of autologous fat, SVF cells, and PRP as cell therapy techniques on atrophic acne scars. PATIENTS/METHODS This study included 9 adult patients with atrophic acne scars on face. All patients received the transplantation of autologous fat, stromal vascular fraction (SVF) cells, and PRP. The treatment outcome was measured by biometric assessment (VisioFace 1000 D, Colorimeter, multi-probe adapter Cutometer, Tewameter, Mexameter, and skin ultrasound imaging system), and also, the satisfaction of patients was evaluated. The patients were followed 6 months after the treatment. RESULTS There was a significant improvement in the skin pores, spots, skin lightness and melanin content of skin, skin elasticity, and TEWL (transepidermal water loss) after 6 months of the treatment. Furthermore, denser skin layers were observed both in the epidermis and in the dermis. Moreover, 66.6% of patients showed good satisfaction after the treatment. CONCLUSION In brief, the transplantation of autologous fat, SVF cells, and PRP is an effective cell therapy for atrophic acne scars.
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Affiliation(s)
- Mohammad Ali Nilforoushzadeh
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
| | - Maryam Heidari-Kharaji
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
| | - Shiva Alavi
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nouri
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Nikkhah
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Jahangiri
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Mahmoudbeyk
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aisan Peyrovan
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Batool Baiat Tork
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Torkamaniha
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Jordan Dermatology and Hair Transplantation Center, Tehran, Iran
| | - Sona Zare
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
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41
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Görgü M, Gökkaya A, Karanfil E. What Is the Adequate PRP Dose for an Effective Treatment? An In Vitro Experimental Study on the Skin. Aesthet Surg J 2021; 41:NP887-NP901. [PMID: 33493280 DOI: 10.1093/asj/sjab043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The clinical results of many studies on platelet-rich plasma (PRP) differ due to a lack of standardization in PRP preparation and administration as well as many variables such as PRP preparation methods, platelet concentration, and platelet activation. OBJECTIVES The authors sought to investigate a different variable that will affect PRP application results. How much PRP should be injected into the unit area of tissue for an effective PRP treatment? METHODS The study was performed on fresh surplus tissues of 20 patients that were discarded in abdominoplasty and mammoplasty operations. Nine areas of 4 cm2 were marked on the skin. Fluorescein-stained PRP was injected intradermally with 3 different gauge needles at 3 different doses (0.01, 0.03, and 0.05 mL). After injections, spreads of the fluorescent dye-covered areas in horizontal and vertical planes were measured and compared. For the horizontal plane measurements, the dye spread was measured first from the surface of the skin and second from the dermal surface of the skin. In addition, the width and depth of the dye spread in the dermis were measured from vertical sections. RESULTS Changing the needle diameter does not affect the width or depth (thickness) of the PRP spread in the dermis. Increasing the applied dose to 0.03 mL increases the spread to the width and depth (thickness). CONCLUSIONS In research evaluating the effectiveness of PRP treatments, it is necessary to report the volume of PRP to be applied per unit of tissue.
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Affiliation(s)
- Metin Görgü
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Gölköy, Bolu, Turkey
| | - Ali Gökkaya
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Gölköy, Bolu, Turkey
| | - Ertuğrul Karanfil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, Gölköy, Bolu, Turkey
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42
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Banihashemi M, Zabolinejad N, Salehi M, Hamidi Alamdari D, Nakhaizadeh S. Platelet-rich Plasma use for facial rejuvenation: a clinical trial and review of current literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021187. [PMID: 33988167 PMCID: PMC8182581 DOI: 10.23750/abm.v92i2.9687] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022]
Abstract
Background and aim of the work: Several studies have shown beneficial effects for Platelet-rich plasma (PRP). We aimed to assess the efficacy of pure PRP injection for facial rejuvenation in Iran. Methods: 30 female consecutive participants were injected with PRP in two sessions with 3 month interval. Evaluations were performed by comparing the pre- and post-improvement measurements of skin scan, before after photography by participants, therapeutic physician and blindly by a second dermatologist. Results: In 3 and 6 months follow-ups respectively, moderate to excellent improvement in periorbital dark circles (47.8,60.9%), periorbital wrinkles (73.9%,78.3%), nasolabial fold (52.2%,56.6%) and skin rigidity (52.3%,60.9%) reported by patients, was statistically significant only for dark circle(P value 0.031). Moderate to good improvement in periorbital dark circles (47.9%,74%), periorbital wrinkles (39.1%,43.5%)and nasolabial folds (4.3% ,13.1%) demonstrated by therapeutic physician‘s evaluation, was statistically significant for dark circle (P value 0.008) and nasolabial folds (P value 0.025). Moderate to good improvement in periorbital dark circles (34.8%, 52.2%), periorbital wrinkles (26.1%, 34.8%) and nasolabial folds (4.4%, 13%) by second dermatologist, was statistically significant for dark circle (P value 0.025). Conclusion: Face rejuvenation with PRP is a promising and noninvasive technique with best results observed in improving periorbital dark circles and wrinkles. (www.actabiomedica.it)
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Affiliation(s)
| | - Naghmeh Zabolinejad
- a:1:{s:5:"en_US";s:95:"Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.";}.
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43
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Liu W, Shi K, Zhu X, Zhao H, Zhang H, Jones A, Liu L, Li G. Adipose Tissue-derived Stem cells in Plastic and Reconstructive Surgery: A Bibliometric Study. Aesthetic Plast Surg 2021; 45:679-689. [PMID: 31980863 DOI: 10.1007/s00266-020-01615-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/02/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Due to the evolving nature of the applications of adipose tissue-derived stem cells (ADSCs) and the rapidly growing body of scientific literature, it is difficult to generate a manual compilation and systematic review of ADSCs in plastic and reconstructive surgery. METHODS Bibliographic records were retrieved from the Web of Science Core Collection and analyzed with CiteSpace. RESULTS We retrieved 691 publications and their references. We identified 52 research categories. Interdisciplinary studies were common. The journals clustered into 13 subnetworks. The top institutions were Stanford University; University of Pittsburgh; University of Tokyo; University of California, Los Angeles; University of California, Davis; New York University; Tulane University; and University of Michigan. National Institutes of Health and National Natural Science Foundation of China provided the most generous financial support. Studies clustered into 22 topics. Emerging trends may include improvement of fat grafting, and application of ADSCs in wound healing, scleroderma, and facial rejuvenation. CONCLUSION The present study provides a panoramic view of ADSCs in plastic and reconstructive surgery. Analysis of journals, institutions, and grants could help researchers in different ways. Researchers may consider the emerging trends when deciding the direction of their study. LEVEL OF EVIDENCE III 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)
- Wenhui Liu
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Ke Shi
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Xuran Zhu
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Hongyan Zhao
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Hui Zhang
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Andrew Jones
- Center for Regenerative Medicine, Oregon Health and Science University, Portland, 97239, USA
| | - Linbo Liu
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Guangshuai Li
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
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Markov A, Thangavelu L, Aravindhan S, Zekiy AO, Jarahian M, Chartrand MS, Pathak Y, Marofi F, Shamlou S, Hassanzadeh A. Mesenchymal stem/stromal cells as a valuable source for the treatment of immune-mediated disorders. Stem Cell Res Ther 2021; 12:192. [PMID: 33736695 PMCID: PMC7971361 DOI: 10.1186/s13287-021-02265-1] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
Over recent years, mesenchymal stem/stromal cells (MSCs) and their potential biomedical applications have received much attention from the global scientific community in an increasing manner. Firstly, MSCs were successfully isolated from human bone marrow (BM), but in the next steps, they were also extracted from other sources, mostly from the umbilical cord (UC) and adipose tissue (AT). The International Society for Cellular Therapy (ISCT) has suggested minimum criteria to identify and characterize MSCs as follows: plastic adherence, surface expression of CD73, D90, CD105 in the lack of expression of CD14, CD34, CD45, and human leucocyte antigen-DR (HLA-DR), and also the capability to differentiate to multiple cell types including adipocyte, chondrocyte, or osteoblast in vitro depends on culture conditions. However, these distinct properties, including self-renewability, multipotency, and easy accessibility are just one side of the coin; another side is their huge secretome which is comprised of hundreds of mediators, cytokines, and signaling molecules and can effectively modulate the inflammatory responses and control the infiltration process that finally leads to a regulated tissue repair/healing or regeneration process. MSC-mediated immunomodulation is a direct result of a harmonic synergy of MSC-released signaling molecules (i.e., mediators, cytokines, and chemokines), the reaction of immune cells and other target cells to those molecules, and also feedback in the MSC-molecule-target cell axis. These features make MSCs a respectable and eligible therapeutic candidate to be evaluated in immune-mediated disorders, such as graft versus host diseases (GVHD), multiple sclerosis (MS), Crohn's disease (CD), and osteoarthritis (OA), and even in immune-dysregulating infectious diseases such as the novel coronavirus disease 2019 (COVID-19). This paper discussed the therapeutic applications of MSC secretome and its biomedical aspects related to immune-mediated conditions. Sources for MSC extraction, their migration and homing properties, therapeutic molecules released by MSCs, and the pathways and molecular mechanisms possibly involved in the exceptional immunoregulatory competence of MSCs were discussed. Besides, the novel discoveries and recent findings on immunomodulatory plasticity of MSCs, clinical applications, and the methods required for their use as an effective therapeutic option in patients with immune-mediated/immune-dysregulating diseases were highlighted.
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Affiliation(s)
| | - Lakshmi Thangavelu
- Department of Pharmacology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Surendar Aravindhan
- Department of Pharmacology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Angelina Olegovna Zekiy
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mostafa Jarahian
- German Cancer Research Center, Toxicology and Chemotherapy Unit (G401), 69120 Heidelberg, Germany
| | | | - Yashwant Pathak
- Professor and Associate Dean for Faculty Affairs, Taneja College of Pharmacy, University of South Florida, Tampa, FL USA
| | - Faroogh Marofi
- Department of Hematology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Shamlou
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hassanzadeh
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Cell Therapy and Regenerative Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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45
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Giuggioli D, Spinella A, Cocchiara E, de Pinto M, Pinelli M, Parenti L, Salvarani C, De Santis G. Autologous fat grafting in the treatment of a scleroderma stump-skin ulcer: a case report. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2021; 8:18-22. [PMID: 33628864 PMCID: PMC7889081 DOI: 10.1080/23320885.2021.1881521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Here we describe the case of a 60‐year‐old-woman with systemic sclerosis sent to our Scleroderma Unit to treat digital stumps. The stumps were successfully treated with autologous fat grafting (crown-shape infiltration). Our technique of autologous lipotransfer improved wound healing in a scleroderma patient with stump-digital ulcers where all other options failed.
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Affiliation(s)
- Dilia Giuggioli
- Scleroderma Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy.,Rheumatology Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Amelia Spinella
- Scleroderma Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy.,Rheumatology Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | | | - Marco de Pinto
- Scleroderma Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy.,Rheumatology Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Massimo Pinelli
- Plastic Surgery Unit, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Luca Parenti
- Scleroderma Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy.,Rheumatology Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Carlo Salvarani
- Rheumatology Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Giorgio De Santis
- Plastic Surgery Unit, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy.,Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
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46
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Liang Z, Huang D, Nong W, Mo J, Zhu D, Wang M, Chen M, Wei C, Li H. Advanced-platelet-rich fibrin extract promotes adipogenic and osteogenic differentiation of human adipose-derived stem cells in a dose-dependent manner in vitro. Tissue Cell 2021; 71:101506. [PMID: 33607525 DOI: 10.1016/j.tice.2021.101506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 01/01/2023]
Abstract
Advanced platelet-rich fibrin (A-PRF) is an autogenous biological material obtained from peripheral blood. A-PRF extract (A-PRFe) contains a high concentration of various cytokines that are increasingly appreciated for their roles in improving stem cell repairing function during tissue regeneration. However, the optimal A-PRFe concentration to stimulate stem cells is unknown. This study aimed to identify the optimal concentrations of A-PRFe to promote adipogenic and osteogenic differentiation of human adipose-derived stem cells (ASCs). We produced A-PRFe from A-PRF clots by centrifuging fresh peripheral blood samples and isolated and identified ASCs using surface CD markers and multilineage differentiation potential. Enzyme-linked immunosorbent assay (ELISA) showed the concentrations of several cytokines, including b-FGF, PDGF-BB, and others, increased gradually, peaked on day 7 and then decreased. Cell proliferation assays showed A-PRFe significantly stimulated ASC proliferation, and proliferation significantly increased at higher A-PRFe doses. The degree of adipogenic and osteogenic differentiation increased at higher A-PRFe concentrations in the culture medium, as determined by oil red O and alizarin red staining. Reverse transcription polymerase chain reaction (RT-PCR) showed that expression levels of genes related to adipogenic/osteogenic differentiation (PPARγ2, C/EBPα, FABP4, Adiponectin, and ALP, OPN, OCN, RUNX2), paracrine (HIF-1α, VEGF, IGF-2) and immunoregulation (HSP70, IL-8) function were higher in groups with a higher concentration of A-PRFe than in lower concentration groups. This study demonstrates that A-PRFe is ideal for use in ASC applications in regenerative medicine because it improves biological functions, including proliferation, adipogenic/osteogenic differentiation, and paracrine function in a dose-dependent manner.
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Affiliation(s)
- Zhijie Liang
- Department of Wound Repair Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China; Department of Breast Surgery, Guangxi Medical University Cancer Hospital, 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
| | - Wenhai Nong
- Department of Orthopaedics, the People's Hospital of Binyang County, Binyang, Guangxi, China
| | - Jinping Mo
- Department of Orthopaedics, the People's Hospital of Binyang County, Binyang, Guangxi, China
| | - Dandan Zhu
- Department of Wound Repair Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China
| | - Mengxin Wang
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Maojian Chen
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Changyuan Wei
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Hongmian Li
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China.
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47
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Mazini L, Ezzoubi M, Malka G. Overview of current adipose-derived stem cell (ADSCs) processing involved in therapeutic advancements: flow chart and regulation updates before and after COVID-19. Stem Cell Res Ther 2021; 12:1. [PMID: 33397467 PMCID: PMC7781178 DOI: 10.1186/s13287-020-02006-w] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/01/2020] [Indexed: 12/11/2022] Open
Abstract
Adipose-derived stem cells (ADSCs) have raised big interest in therapeutic applications in regenerative medicine and appear to fulfill the criteria for a successful cell therapy. Their low immunogenicity and their ability to self-renew, to differentiate into different tissue-specific progenitors, to migrate into damaged sites, and to act through autocrine and paracrine pathways have been altogether testified as the main mechanisms whereby cell repair and regeneration occur. The absence of standardization protocols in cell management within laboratories or facilities added to the new technologies improved at patient's bedside and the discrepancies in cell outcomes and engraftment increase the limitations on their widespread use by balancing their real benefit versus the patient safety and security. Also, comparisons across pooled patients are particularly difficult in the fact that multiple medical devices are used and there is absence of harmonized assessment assays despite meeting regulations agencies and efficient GMP protocols. Moreover, the emergence of the COVID-19 breakdown added to the complexity of implementing standardization. Cell- and tissue-based therapies are completely dependent on the biological manifestations and parameters associated to and induced by this virus where the scope is still unknown. The initial flow chart identified for stem cell therapies should be reformulated and updated to overcome patient infection and avoid significant variability, thus enabling more patient safety and therapeutic efficiency. The aim of this work is to highlight the major guidelines and differences in ADSC processing meeting the current good manufacturing practices (cGMP) and the cellular therapy-related policies. Specific insights on standardization of ADSCs proceeding at different check points are also presented as a setup for the cord blood and bone marrow.
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Affiliation(s)
- Loubna Mazini
- Laboratoire Cellules Souches et Régénération Cellulaire et Tissulaire, Center of Biological and Medical Sciences CIAM, Mohammed VI Polytechnic University (UM6P), Lot 660, Hay Moulay Rachid, 43150 Ben Guerir, Morocco
| | - Mohamed Ezzoubi
- Centre des Brûlés et chirurgie réparatrice, Centre Hospitalier Universitaire Ibn Rochd Casablanca, Faculté de Médecine et de Pharmacie Casablanca, Casablanca, Morocco
| | - Gabriel Malka
- Laboratoire Cellules Souches et Régénération Cellulaire et Tissulaire, Center of Biological and Medical Sciences CIAM, Mohammed VI Polytechnic University (UM6P), Lot 660, Hay Moulay Rachid, 43150 Ben Guerir, Morocco
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48
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Cohen SR, Hewett S. Commentary on: Fat Grafting to Improve Results of Facelift: Systematic Review of Safety and Effectiveness of Current Treatment Paradigms. Aesthet Surg J 2021; 41:13-15. [PMID: 32556099 DOI: 10.1093/asj/sjaa043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Steven R Cohen
- Dr Cohen is a Clinical Professor of Plastic Surgery, University of California, San Diego, CA
| | - Sierra Hewett
- Ms Hewett is a research assistant at a private plastic surgery practice in La Jolla, CA
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49
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The Crosstalk of Adipose-Derived Stem Cells (ADSC), Oxidative Stress, and Inflammation in Protective and Adaptive Responses. Int J Mol Sci 2020; 21:ijms21239262. [PMID: 33291664 PMCID: PMC7730805 DOI: 10.3390/ijms21239262] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 02/08/2023] Open
Abstract
The potential use of stem cell-based therapies for the repair and regeneration of various tissues and organs is a major goal in repair medicine. Stem cells are classified by their potential to differentiate into functional cells. Compared with other sources, adipose-derived stem cells (ADSCs) have the advantage of being abundant and easy to obtain. ADSCs are considered to be tools for replacing, repairing, and regenerating dead or damaged cells. The capacity of ADSCs to maintain their properties depends on the balance of complex signals in their microenvironment. Their properties and the associated outcomes are in part regulated by reactive oxygen species, which mediate the oxidation-reduction state of cells as a secondary messenger. ADSC therapy has demonstrated beneficial effects, suggesting that secreted factors may provide protection. There is evidence that ADSCs secrete a number of cytokines, growth factors, and antioxidant factors into their microenvironment, thus regulating intracellular signaling pathways in neighboring cells. In this review, we introduce the roles of ADSCs in the protection of cells by modulating inflammation and immunity, and we develop their potential therapeutic properties.
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50
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Affiliation(s)
- Diane I. Duncan
- Department of Plastic Surgery Plastic Surgical Associates of Fort Collins, P. C. Fort Collins Colorado USA
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