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Jia X, Chai Y, Zhu J, Zhang X, Jiang C, Yin N, Li F. Enhancing Fat Graft Survival via Upregulating Autophagy of Adipocytes. Aesthetic Plast Surg 2024; 48:1807-1816. [PMID: 38347131 DOI: 10.1007/s00266-023-03797-y] [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] [Received: 08/23/2023] [Accepted: 12/04/2023] [Indexed: 05/16/2024]
Abstract
BACKGROUND Autophagy is a cellular self-protection mechanism. The upregulation of adipose-derived stem cells' (ADSCs) autophagy can promote fat graft survival. However, the effect of interfering with adipocyte autophagy on graft survival is still unknown. In addition, autophagy is involved in adipocyte dedifferentiation. We investigated the effect of autophagy on adipocyte dedifferentiation and fat graft survival. METHODS The classic autophagy regulatory drugs rapamycin (100 nM) and 3-methyladenine (3-MA; 10 mM) were used to treat adipocytes, adipocyte dedifferentiation was observed, and their effects on ADSCs were detected. In our experiments, 100 nM rapamycin, 10 mM 3-MA and saline were mixed with human adipose tissue and transplanted into nude mice. At 2, 4, 8 and 12 weeks postoperatively, the grafts were harvested for histological and immunohistochemical analysis. RESULTS Rapamycin and 3-MA can promote and inhibit adipocyte dedifferentiation by regulating autophagy. Both drugs can inhibit ADSC proliferation, and 10 mM 3-MA can inhibit ADSC adipogenesis. At weeks 8 and 12, the volume retention rate of the rapamycin group (8 weeks, 64.77% ± 6.36%; 12 weeks, 56.13% ± 4.73%) was higher than the control group (8 weeks, 52.62% ± 4.04%; P < 0.05; 12 weeks, 43.17% ± 6.02%; P < 0.05) and the rapamycin group had more viable adipocytes and better vascularization. Compared with the control group, the volume retention rate, viable adipocytes and vascularization of the 3-MA group decreased. CONCLUSIONS Rapamycin can promote adipocyte dedifferentiation by upregulating autophagy to promote fat graft survival. 3-MA can inhibit graft survival, but its mechanism includes the inhibition of adipocyte dedifferentiation and ADSC proliferation and adipogenesis. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xinyu Jia
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Yimeng Chai
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Jinglin Zhu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Xinyu Zhang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Chanyuan Jiang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Ningbei Yin
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Facheng Li
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
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Araya S, Chang AH, Moss C, Gubara SM, Gebreyesus MT, Jordan K, Ruth KJ, Baltodano P, Patel SA. Contemporary Prophylactic Antibiotic Practices and Adjunct Therapies in Autologous Fat Grafting Procedures: A Survey of The Aesthetic Society Members. Aesthet Surg J Open Forum 2024; 6:ojae001. [PMID: 38333667 PMCID: PMC10852999 DOI: 10.1093/asjof/ojae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background Autologous fat grafting (AFG) is a widely used surgical technique that involves extracting a patient's own adipose tissue and transferring it to different areas of the body. This practice is still evolving. Guidelines for antibiotic prophylaxis and use of adjuncts in plastic surgery are currently limited, with a notable absence of standardized guidelines for AFG. Objectives In this survey, we assess contemporary antibiotic practices and adjuncts in AFG procedures. Methods A 52-question survey was emailed to 3106 active members of The Aesthetic Society. Two hundred and ninety-three responses were recorded, representing a 9% response rate. Results We analyzed 288 responses. The most common AFG procedures were facial (38%), gluteal (34%), and breast (27%) augmentation. Preoperative antibiotics were used by 84.0% overall, with rates of 74.3%, 88.0%, and 92.7% in face, breast, and gluteal AFG, respectively. Lipoaspirate-antibiotic mixing was reported by 19.8%, mainly during gluteal AFG (46.9%), and less so in face (2.8%) and breast (8%) AFG. Notably, 46.9% of surgeons administered prolonged prophylaxis for 72 h or more. Tranexamic acid was utilized by 39.9% of the surveyed surgeons. Platelet-rich plasma was used by 5.6%. Doppler ultrasound was incorporated by 16.7% in AFG, with 21.5% in gluteal AFG, 14% in the face, and 19% in breast procedures. Conclusions In this survey, we offer insights into antibiotic practices and adjunct therapies in AFG, especially intraoperative antibiotic mixing. Practices among members of The Aesthetic Society vary from guidelines. It is crucial to standardize practices and conduct further research to pave the way for evidence-based guidelines in AFG. Level of Evidence 5
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sameer A Patel
- Corresponding Author: Dr Sameer A. Patel, Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Temple University Health System, 333 Cottman Avenue, Philadelphia, PA 19111, USA. E-mail:
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Brucato D, Ülgür II, Alberti A, Weinzierl A, Harder Y. Complications Associated with Facial Autologous Fat Grafting for Aesthetic Purposes: A Systematic Review of the Literature. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5538. [PMID: 38260755 PMCID: PMC10803033 DOI: 10.1097/gox.0000000000005538] [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: 07/29/2023] [Accepted: 11/17/2023] [Indexed: 01/24/2024]
Abstract
Background With the increasing demand for aesthetic procedures, autologous fat grafting (AFG) seems to be an attractive option for facial volumization and rejuvenation. The aim of this study was to assess the type and severity of associated complications after facial AFG for aesthetic purposes. Methods The entire PubMed/Medline and Cochrane databases were screened to identify studies describing complications that occurred after the injection of autologous fat into the face. These complications have been reviewed and analyzed according to their occurrence and severity in the different anatomical regions of the face. Results Twenty-two articles including 38 patients reported on a total of 58 complications. Thirty-two complications have been classified as severe or permanent, including hemiplegia (n = 11), loss of vision (n = 7), or skin necrosis (n = 3). The other 26 complications were classified as mild or transient, such as lipogranuloma (n = 12) or mycobacterial abscess (n = 2). The majority of complications were reported after injection to the forehead (n = 26) and the temporal region (n = 21). Interestingly, this location seems to be the area at risk because 53% of all severe complications occurred in this anatomical region. Conclusions AFG to the face is associated with a low incidence of complications, but if they occur, they can be dramatic, particularly in the forehead and temporal region. Nevertheless, AFG can be used to correct age-related changes of the face and volume loss and may represent an alternative to synthetic fillers. Therefore, AFG to the face should be performed by qualified doctors under careful consideration of risks and facial anatomy.
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Affiliation(s)
- Davide Brucato
- From the Department of Plastic, Reconstructive and Aesthetic Surgery EOC, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Ismail I. Ülgür
- From the Department of Plastic, Reconstructive and Aesthetic Surgery EOC, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
- Cfc Hirslanden- Cranio Facial Center, Aarau, Switzerland
| | - Andrea Alberti
- From the Department of Plastic, Reconstructive and Aesthetic Surgery EOC, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Andrea Weinzierl
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Yves Harder
- From the Department of Plastic, Reconstructive and Aesthetic Surgery EOC, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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de Sousa AMS, Duarte AC, Decnop M, Guimarães DDF, Coelho Neto CAF, Sarpi MDO, Duarte LGP, Souza SA, Segato LF, Zavariz JD, Mukherji SK, Garcia MRT. Imaging Features and Complications of Facial Cosmetic Procedures. Radiographics 2023; 43:e230060. [PMID: 37943699 DOI: 10.1148/rg.230060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Facial aesthetic procedures have become increasingly popular and complex, making knowledge of facial anatomy crucial for achieving desired outcomes without complications. Some of the most common procedures include blepharoplasty, bichectomy, face-lifts, facial implants, thread lifting, and fillers. Blepharoplasty and bichectomy are surgical procedures that respectively aim to restore youthful contours to the periorbita and create a slimmer lower face by removing Bichat fat from the maxillofacial region. Facial implants are used for aesthetic augmentation of the skeletal structure and restoration of facial contour by using biomaterials or autogenous bone grafts. Face-lift surgeries involve incisions and removal of excess skin, and thread lifts involve less invasive procedures performed by inserting threads beneath the skin, with the aim to lift the skin and thus reduce wrinkles and sagging. Fillers improve wrinkles and loss of facial volume, with biologic types made from animal, human, or bacterial sources (such as hyaluronic acid), while synthetic fillers include substances such as paraffin, silicone, calcium hydroxyapatite, polymethylmethacrylate microspheres, polyacrylamide hydrogel, hydroxyethyl-ethyl methacrylate, and poly-l-lactic acid. Synthetic fillers can be classified as rapidly resorbable (<12 months), slowly resorbable (<24 months), or permanent. Imaging modalities such as US, CT, and MRI can help identify and analyze each type of facial aesthetic procedure or filler, as well as their possible complications such as foreign-body granuloma, noninflammatory nodule, late intermittent persistent edema, filler migration, infection, or complications after removal of the buccal fat pad. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center The online slide presentation from the RSNA Annual Meeting is available for this article.
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Affiliation(s)
- Andrea Meneses Soares de Sousa
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Angelo Chelotti Duarte
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Marcos Decnop
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Daniel de Faria Guimarães
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Carlos Alberto Ferreira Coelho Neto
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Maíra de Oliveira Sarpi
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Luis Gustavo Palhiari Duarte
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Soraia Ale Souza
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Larissa Freire Segato
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Julia Diva Zavariz
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Suresh K Mukherji
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Márcio Ricardo Taveira Garcia
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
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Beiu C, Popa LG, Bălăceanu-Gurău B, Iliescu CA, Racoviță A, Popescu MN, Mihai MM. Personalization of Minimally-Invasive Aesthetic Procedures with the Use of Ultrasound Compared to Alternative Imaging Modalities. Diagnostics (Basel) 2023; 13:3512. [PMID: 38066753 PMCID: PMC10705986 DOI: 10.3390/diagnostics13233512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 04/12/2024] Open
Abstract
Ultrasonography is a well-tolerated procedure that aids in the targeted esthetic therapies of special cutaneous regions, as well as in the prevention (vascular mapping, identification of previous filler, and others) and management of potential complications (vascular occlusion, external vascular compression, product misplacement or migration, inflammatory reactions, and others). It has lately been promoted as the first-line imaging tool to address injectables. In this article, we aim to review the evolving role of ultrasonography in cosmetic filler procedures, from the fundamental ultrasound characterization of cosmetic fillers to the ultrasound-enhanced detection and management of cosmetic filler complications, including ultrasound's role in hyaluronidase-guided injections for cosmetic filler dissolution. Furthermore, the paper explores the integral role played by ultrasound in enhancing the precision, efficacy, and safety of additional minimally invasive aesthetic techniques such as mesotherapy, radiofrequency, cryolipolysis, and polydioxanone procedures.
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Affiliation(s)
- Cristina Beiu
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.B.); (L.G.P.); (M.M.M.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | - Liliana Gabriela Popa
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.B.); (L.G.P.); (M.M.M.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | | | - Carmen Andrada Iliescu
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | - Andreea Racoviță
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | - Marius Nicolae Popescu
- Department of Physical and Rehabilitation Medicine, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Clinic of Physical and Rehabilitation Medicine, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Mara Mădălina Mihai
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.B.); (L.G.P.); (M.M.M.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
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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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Anderson L, Nguyen CDT, Trinh K, Dorfman R, Tandon V, Do N, Lambros V, Grotting J, Song D, Delong M. Facial Hypertrophy as a Complication of Weight Gain in Autologous Fat Graft Patients: Considerations and Recommendations. Aesthet Surg J 2023; 43:NP738-NP747. [PMID: 37350541 DOI: 10.1093/asj/sjad196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
Fat grafting can restore facial volume for reconstructive and cosmetic indications. Common practice often involves extracting lipoaspirate from the most abundant anatomic location. However, grafted fat retains the phenotypic characteristics of its original location and can undergo exaggerated hypertrophy with patient weight fluctuations. The aim of this study was to systematically assess the literature to summarize the reported effects of postoperative weight gain on facial hypertrophy in patients after facial fat grafting and to determine potentially avoidable factors. A search through PubMed/MEDLINE was conducted on October 4, 2022, to identify relevant articles with appropriate search terms. No lower date limit was applied and all eligible nonanimal clinical articles in English were included for review. Reports were summarized and presented as descriptive statistics. The search generated 714 articles. After abstract and full-text review of the initial set of articles, 6 were included in our analysis. All articles described poor cosmetic outcomes resulting from nonanatomic hypertrophy of the grafted fat. None of the articles reported a thorough methodology for selecting the donor site to minimize fat hypertrophy with potential future weight fluctuations. Grafted facial fat is susceptible to exaggerated hypertrophy as a result of changes in patient weight. Specifically, harvesting lipoaspirate from maximally abundant areas of the body may increase this risk. Individualizing the area of fat donation may attenuate unwanted fat growth and further contribute to increased patient quality of life. LEVEL OF EVIDENCE: 4
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Wanitphakdeedecha R, Ng JNC, Phumariyapong P, Nokdhes YN, Patthamalai P, Tantrapornpong P, Suphatsathienkul P, Apinuntham C, Yan C, Nanchaipruek Y, Thongjaroensirikul P, Maneeprasopchoke P, Techapichetvanich T, Eimpunth S, Manuskiatti W, Thanachaipiwat S, Panich U. A pilot study comparing the efficacy of autologous cultured fibroblast injections with hyaluronic acid fillers for treating nasolabial folds. Sci Rep 2023; 13:6616. [PMID: 37095274 PMCID: PMC10126053 DOI: 10.1038/s41598-023-33786-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 04/19/2023] [Indexed: 04/26/2023] Open
Abstract
Autologous cultured fibroblast injections for soft tissue augmentation are a potential alternative to other filler materials. No studies have compared autologous fibroblast injections and hyaluronic acid (HA) fillers for treating nasolabial folds (NLFs). To compare the efficacies and safeties of autologous cultured fibroblast injections and HA fillers for treating NLFs. This prospective, evaluator-blinded, pilot study enrolled 60 Thai female adult patients diagnosed with moderate to severe NLFs. They were randomized to receive either 3 treatments of autologous fibroblasts at 2-week intervals or 1 treatment with HA fillers. The primary outcome was the clinical improvement of the NLFs graded by 2 blinded dermatologists immediately after injection and at 1-, 3-, 6-, and 12-month follow-ups. Objective measurement of the NLF volume was evaluated. Patient self-assessment scores, pain scores, and adverse reactions were recorded. Of the 60 patients, 55 (91.7%) completed the study protocol. The NLF volumes improved significantly in the autologous fibroblast group at all follow-ups relative to baseline (P = 0.000, 0.004, 0.000, 0.000, and 0.003). The patients in the autologous fibroblast group rated more noticeable NLF improvements than those in the HA filler group (3-month follow-up, 58.41% vs. 54.67%; 6-month follow-up, 52.50% vs. 46%; 12-month follow-up, 44.55% vs. 31.33%). No serious adverse reactions were recorded. Autologous fibroblast injections are safe and effective for treating NLFs. These injections also promise sustained growth of living cells, possibly leading to a greater persistence than shown by other fillers.
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Affiliation(s)
- Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand.
| | - Janice Natasha C Ng
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Phumithep Phumariyapong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Ya-Nin Nokdhes
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Poramin Patthamalai
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Ploypailin Tantrapornpong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Panittra Suphatsathienkul
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Chalermkwan Apinuntham
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Yanisorn Nanchaipruek
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Panwadee Thongjaroensirikul
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Pitchaya Maneeprasopchoke
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Thanya Techapichetvanich
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Sasima Eimpunth
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok Noi 10700, Bangkok, Thailand
| | - Saowalak Thanachaipiwat
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Uraiwan Panich
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Ophthalmic Complications Following Facial Autologous Fat Graft Injection: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg 2022; 46:3013-3035. [PMID: 35650299 DOI: 10.1007/s00266-022-02924-5] [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: 03/08/2022] [Accepted: 05/01/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION With the recent increase in interest in using autologous fat (AF) filler injections to enhance aesthetic facial appearance, there is a noticeable increase in the complications such as vascular compromise and blindness. This systematic review and meta-analysis aimed to understand the symptomatology of ophthalmic complications related to AF facial injections for cosmetic purposes, their underlying causes, management options, and the final clinical outcomes. METHODS This review was conducted according to the International Prospective Register of Systematic Reviews (PROSPERO) guidelines. In November 2021, we performed a systematic review of available literature using the following electronic databases: Cochrane, MEDLINE, and EMBASE. Our search was limited to the published studies between 2000 and 2021. RESULTS A total of 1052 publications and 34 articles published were included. Twenty case reports, two case series, one prospective cohort study, and eleven retrospective studies were evaluated. The forehead was the most common single injection site (n = 196, 55.36%). The most common initial symptom was periorbital swelling (92.7%). The pooled prevalence of ophthalmic artery occlusion was 50.4% out of all AF injection-related complications. Regarding the management, most patients were managed conservatively (n = 278, 51.38%). Complete improvement was observed among 423 patients (80.57%). CONCLUSION Autologous facial fat injection is a minimally invasive procedure with a favorable safety profile in cosmetic applications. However, the common use of these injections in aesthetic surgery has resulted in a concomitant increase in devastating consequences, such as blindness. Therefore, a firm understanding of the potential complications of such interventions is essential. 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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10
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Monnet P, Bagot M, Rivet J, Roux J, Petit A, Al-Hage J. Epidermal cyst formation of the lip following autologous fat transplant. JAAD Case Rep 2022; 26:101-103. [PMID: 35937544 PMCID: PMC9350862 DOI: 10.1016/j.jdcr.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Patricia Monnet
- Department of Dermatology, Saint-Louis Hospital, Assistances Publiques des Hôpitaux de Paris, Paris, France.,Université Paris Cité, Paris, France
| | - Martine Bagot
- Department of Dermatology, Saint-Louis Hospital, Assistances Publiques des Hôpitaux de Paris, Paris, France.,Université Paris Cité, Paris, France
| | - Jacqueline Rivet
- Department of Pathology, Saint-Louis Hospital, Assistances Publiques des Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Jennifer Roux
- Department of Dermatology, Saint-Louis Hospital, Assistances Publiques des Hôpitaux de Paris, Paris, France
| | - Antoine Petit
- Department of Dermatology, Saint-Louis Hospital, Assistances Publiques des Hôpitaux de Paris, Paris, France.,Université Paris Cité, Paris, France
| | - Jana Al-Hage
- Department of Dermatology, Saint-Louis Hospital, Assistances Publiques des Hôpitaux de Paris, Paris, France.,Université Paris Cité, Paris, France
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11
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Dayal A, Bhatia A, Hsu JTS. Fat grafting in aesthetics. Clin Dermatol 2022; 40:35-44. [DOI: 10.1016/j.clindermatol.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Understand age-related changes to the face and neck and pertinent anatomy and discuss important aspects of fat graft harvesting, processing, and infiltration. 2. Recognize key differences between common techniques for fat processing and infiltration and develop a plan for patients based on site-specific facial anatomical zones. 3. Appreciate the utility of fat grafting as an adjunct to other facial rejuvenating procedures such as face lift and blepharoplasty procedures and list the potential complications from fat grafting to the face and neck. SUMMARY Fat grafting to the face and neck aids in volume restoration, thereby addressing soft-tissue atrophy associated with the aging face, acquired conditions, or congenital malformations. Often, fat grafting may sufficiently restore facial volume alone or in conjunction with other facial rejuvenation procedures. Facial/neck fat grafting requires a systematic and thoughtful approach, with special care to atraumatic technique. This CME article covers the principles and techniques for modern facial fat grafting to the face and neck. Increasing data support the ability of autologous fat to produce significant and sustainable appearance-related changes. The authors follow the general principles of the Coleman technique for facial fat grafting and have observed tremendous success over the years. Other techniques for facial fat grafting are also discussed including microfat and nanofat processing. As the understanding of facial fat compartments continues to evolve, the authors may better predict fat grafting outcomes following augmentation. Finally, the technique described as "lipotumescence" has been successfully used in the breast and other regions of the body that have radiation damage and is discussed in this article specifically for the face and neck.
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13
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Fiedler LS, Saleh DB, Mukrowsky A. Autologous fat grafting in the face and neck: Multinational trends and knowledge of the safety, applications, and indications considering oncologic risk potential. Laryngoscope Investig Otolaryngol 2021; 6:1024-1030. [PMID: 34667845 PMCID: PMC8513435 DOI: 10.1002/lio2.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/29/2021] [Accepted: 08/23/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Autologous fat grafting (AFG) is evolving in both aesthetic and reconstructive applications, since the body of evidence for its use has expanded. The earliest controversies were evident in lipofilling for oncological breast reconstruction, and to this day, some countries do not allow it for fear of inducing tumourigenesis in an oncologically ablated field. METHODS We sought to review contemporary harvesting and processing techniques for AFG in the craniofacial region, therefore distributed a survey to evaluate the clinical impact of oncological risk across four European countries. RESULTS We found no significant geographical differences between the German-speaking and the English groups concerning their harvesting and processing technique. Half of our respondents discuss the possibility of pro-oncologic behavior of AFG. CONCLUSION AFG harvesting and processing techniques do not considerably vary by geography. Further studies should evaluate oncologic risk potential of AFG in head and neck tumor sites, especially because there is no excellent article regarding this phenomenon.Level of Evidence: V.
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Affiliation(s)
- Lukas S Fiedler
- Otorhinolaryngology and Head and Neck SurgeryKlinikum Mutterhaus der Borromäerinnen MitteTrierGermany
| | - Daniel B Saleh
- Plastic and Reconstructive Surgery, Royal Victoria InfirmaryNewcastle upon TyneUK
| | - Alicia Mukrowsky
- General and Thoracic SurgeryKlinikum Mutterhaus der Borromäerinnen MitteGermany
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14
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Moak TN, Ebersole TG, Tandon D, Tenenbaum M. Assessing Clinical Outcomes in Autologous Fat Grafting: A Current Literature Review. Aesthet Surg J 2021; 41:S50-S60. [PMID: 34002770 DOI: 10.1093/asj/sjab148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Autologous fat grafting, first described in the 1890s, has since undergone many modifications to optimize safety and efficacy. These changes have resulted in the technique that we now consider standard of care, one that is applied to reconstruction and cosmetic enhancement of the breast and the face both independently and in conjunction with surgical treatment. There is a growing body of evidence that this application has positive outcomes for patient satisfaction, surgeon satisfaction, and overall aesthetic appearance. This article summarizes the body of literature regarding these outcomes, reviews complications of fat grafting in the face and breast, and discusses controversies including radiologic imaging changes and longevity of grafting. Level of Evidence: 4.
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Affiliation(s)
- Teri N Moak
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Barnes Jewish Hospital, Washington University, St. Louis, MO, USA
| | - Trina G Ebersole
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Barnes Jewish Hospital, Washington University, St. Louis, MO, USA
| | - Damini Tandon
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Barnes Jewish Hospital, Washington University, St. Louis, MO, USA
| | - Marissa Tenenbaum
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Barnes Jewish Hospital, Washington University, St. Louis, MO, USA
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15
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Kadouch J, Schelke LW, Swift A. Ultrasound to Improve the Safety and Efficacy of Lipofilling of the Temples. Aesthet Surg J 2021; 41:603-612. [PMID: 32162653 DOI: 10.1093/asj/sjaa066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Autologous fat is known for a reliable and natural safety profile, but complications do occur-even serious vascular adverse events. OBJECTIVES The authors sought to examine doppler-ultrasound (DUS) imaging for the harvesting and subsequent facial implantation of autologous fat tissue. METHODS All patients underwent lipofilling treatment of the temporal fosse of the face. DUS examination was performed for preprocedural vascular mapping and imaging of previously injected (permanent) fillers. In addition, the injection of autologous fat was performed DUS-guided. RESULTS Twenty patients (all female; mean age, 57.9 years; range, 35-64 years). DUS examination showed that 16 of the 20 patients (80%) had been injected with resorbable or nonresorbable fillers elsewhere in the past. The temporal artery could be visualized and avoided in all cases. An average of 1.1 cc of autologous fat was injected in the temporal fossa per side. One case of edema and nodules was described, but no other adverse events were reported. CONCLUSIONS The utilization of DUS can add valuable information to a lipofilling procedure and should be considered an integral part of a safe lipofilling treatment. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Jonathan Kadouch
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Leonie W Schelke
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Arthur Swift
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
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Molina-Burbano F, Smith JM, Ingargiola MJ, Motakef S, Sanati P, Lu J, Taub PJ, Hill ME. Fat Grafting to Improve Results of Facelift: Systematic Review of Safety and Effectiveness of Current Treatment Paradigms. Aesthet Surg J 2021; 41:1-12. [PMID: 31907534 DOI: 10.1093/asj/sjaa002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Autologous fat grafting is a helpful supplement to facelift surgery that helps to combat age-related volume loss of facial structures. Despite the widespread prevalence of combined facelift and fat-grafting, significant procedural variation exists between providers. OBJECTIVES The primary purpose of this systematic review was to study the efficacy and complication rates of facelift with lipofilling compared with facelift alone. METHODS A systematic review of the Cochrane Library and MEDLINE databases as completed was undertaken to identify all clinical reports of fat grafting combined with facelift surgery based on the following key terms: ("fat grafting" OR "lipotransfer" OR "lipofilling" OR "fat transfer") AND ("facelift" OR "rhytidectomy" OR "SMASectomy" OR "facial rejuvenation"). Data on techniques, outcomes, complications, and patient satisfaction were collected. RESULTS The systematic review was performed in April 2017. In total, 248 articles were identified for review. After application of exclusion criteria, 15 primary studies were included in this review. Various facelift techniques were reported, including deep-plane or sub-superficial musculoaponeurotic system (SMAS) facelift, SMAS facelift, modified minimal access cranial suspension lift, component facelift, midface lift, SMAS plication, SMAS-stacking/SMASectomy, and SMASectomy. The most common locations of fat graft injection included the nasolabial folds, tear troughs, temporal regions, midface/cheek/malar eminence, marionette groove, lips, and ear lobes. The addition of fat grafting to facelift surgery resulted in significant improvements in facial volume and aesthetic assessments. CONCLUSIONS Combined facelift and fat grafting is a safe and efficacious means to simultaneously address age-related ptosis and volume loss. Further research is required to validate and improve existing treatment modalities. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Felipe Molina-Burbano
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Michael Smith
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Texas Medical Branch, Galveston, TX
| | - Michael J Ingargiola
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Saba Motakef
- Department of Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, CA
| | - Paymon Sanati
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jocelyn Lu
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter J Taub
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael E Hill
- Department of Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, CA
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17
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Rao AYN, Reddy SN, Chandrappa AB, Vasudevan S, Batth R. A Study of Aesthetic and Functional Outcome Following Structural Fat Grafting for Facial Scars and Contour Deformity. Craniomaxillofac Trauma Reconstr 2020; 13:305-312. [PMID: 33456702 DOI: 10.1177/1943387520948709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Study Design This is a prospective observational study of 60 consecutive cases with facial scars and contour deformity who underwent structural fat grafting. Objectives The aim of the present article is to highlight how fat grafting helps to improve aesthetic and functional outcome in facial scars and contour deformities. It also highlights the factors that need to be considered while planning autologous fat grafting to get better aesthetic results. Methods This is a prospective observational study of 60 consecutive cases with facial scars and contour deformity. The study was conducted from May 2014 to April 2019 in a tertiary care hospital. All the patients were followed up for a minimum period of 1 year from the date of surgery. Assessment of post-operative aesthetic outcome, in terms of satisfaction, was done using the Visual Analogue Scale (VAS), which ranges from 1 to 10 by the patient and operative surgeon. Results The mean age was 30.8 9.8 years. Out of 60 patients, 20 patients underwent additional procedure like dermabrasion and collagen dressing to improve aesthetic outcome. Among 60 patients, 24 patients had transient edema and 10 patients had bruising at the recipient site. There were no major donor site complications except pain which was managed conservatively. Mean patient satisfaction score is 7 and mean surgeon satisfaction score is 7.25. Conclusion Despite the ongoing concerns about survival and longevity of fat grafts and also unpredictability of long-term outcomes, fat grafting has become a very useful surgical tool to improve the quality of facial scars and correct contour deformity. Our series shows excellent outcome both clinically as well as from the patient satisfaction. Future research is warranted in the fields of the adipocyte derived stem cells and to expand the clinical application of fat grafting.
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Affiliation(s)
- Anantheswar Y N Rao
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Sudarshan Nagireddy Reddy
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Ashok Basroor Chandrappa
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Srikanth Vasudevan
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Rittu Batth
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
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18
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Zhao P, Zhao W, Zhang K, Lin H, Zhang X. Polymeric injectable fillers for cosmetology: Current status, future trends, and regulatory perspectives. J Appl Polym Sci 2020. [DOI: 10.1002/app.48515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Peng Zhao
- Center for Medical Device EvaluationNational Medical Products Administration Beijing 100081 People's Republic of China
| | - Wanlu Zhao
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
| | - Kai Zhang
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
- Institute of Regulatory Science for Medical DeviceSichuan University Chengdu Sichuan 610065 People's Republic of China
| | - Hai Lin
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
| | - Xingdong Zhang
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
- Institute of Regulatory Science for Medical DeviceSichuan University Chengdu Sichuan 610065 People's Republic of China
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19
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Ramot Y, Silyuk T, Murad S, Zlotogorski A. Hirsutism Induced by Facial Autologous Fat Grafting. Skin Appendage Disord 2019; 6:41-43. [PMID: 32021861 DOI: 10.1159/000502444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022] Open
Abstract
Autologous fat grafting (AFG) is a common procedure, which gains popularity for a large number of indications, mainly for reshaping and filling of contour defects. It is considered a safe procedure, with only uncommon and mild complications. Here we report on a 60-year-old female patient who developed excess hair growth on both cheeks 1 month following facial AFG done in conjunction with a facelift. Complete endocrine evaluation was within normal levels. Previous reports have suggested that adipocyte mesenchymal stem cells can secrete a number of growth factors, which in turn can lead to activation of stem cells in the hair follicle, affecting their growth. However, to the best of our knowledge, this is the first report on hirsutism as a side effect of AFG.
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Affiliation(s)
- Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Tatiana Silyuk
- The Hair Treatment and Transplantation Center, Saint Petersburg, Russian Federation
| | - Sari Murad
- Department of Dermatology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
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20
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Abu-Ghname A, Perdanasari AT, Reece EM. Principles and Applications of Fat Grafting in Plastic Surgery. Semin Plast Surg 2019; 33:147-154. [PMID: 31384229 DOI: 10.1055/s-0039-1693438] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Autologous fat transplantation has become increasingly popular in recent years. Its biocompatable properties and availability made it a widely used treatment modality for soft tissue augmentation and volume replacement in both reconstructive and aesthetic plastic surgery. Multiple protocols and clinical applications have been described in the literature, with wide variations in the harvesting, processing, and injection techniques. In this review, the authors will discuss the basic principles and clinical applications of fat grafting in plastic and reconstructive surgery. The article will then conclude with a discussion of fat grafting limitations as well as potential future applications, giving the reader a well-rounded understanding of autologous fat transfer.
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Affiliation(s)
- Amjed Abu-Ghname
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | | | - Edward M Reece
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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Abstract
Potential complications related to dermal fillers depend on the type of the fillers and the site of their application. The classification of dermal filler complications can be divided into early and late, and into minor and major events. According to their mechanism, they can be divided into non-ischaemic and ischaemic complications. The aim of this study is to present possible complications related to dermal fillers, to explain their aetiology and to propose preventive management and treatment. Non-ischaemic complications can be technique-dependent and include the reactions at the site of the injection, contour irregularities, and inflammatory and infectious reactions. They are usually resolved as a matter of course after 2-7 days. Arterial or venous occlusion leads to ischemia, with subsequent necrosis of the skin and/or vision loss.
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22
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Review: Proposed Methods to Improve the Survival of Adipose Tissue in Autologous Fat Grafting. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1870. [PMID: 30324057 PMCID: PMC6181489 DOI: 10.1097/gox.0000000000001870] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/01/2018] [Indexed: 01/13/2023]
Abstract
In 2009, the American Society of Plastic Surgeons Task Force on Autologous Fat Grafting (AFG) determined that autologous fat grafting was a safe procedure with a relatively low rate of complications. This consensus opinion unleashed a wave of popularity as plastic surgeons discovered the procedures' efficacy in a wide variety of cosmetic and reconstructive indications. Frequently reported cosmetic applications include soft-tissue augmentation of breast, buttocks, hips, face, and hands, whereas reconstructive applications include adjunct for breast reconstruction contour problems, plantar fat pad improvement, and correction of various posttraumatic and surgical contour deformities. Recognition of other regenerative effects of fat grafting expanded the use AFG for improvement of hypertrophic scar tissue, postradiation sequelae, lipodystrophy, hyperpigmentation, senile skin changes, and actinic damage. The popularity of AFG is supported by a remarkably low risk of complications, minimal scars, and readily available donor sites. Despite recognition of the advantages of AFG, there still is no consensus regarding optimal techniques of harvest, graft preparation, and injection. Further, the yield of permanent volume falls within a very wide range. In this article, we review the basic science of fat grafting, proposed methods offered to improve engraftment, and reported outcomes of AFG procedures.
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