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Denadai R, Tangco I, Valentine M, Wallace CG, Hsiao YC, Huang JJ, Chang FCS, Lo LJ, Chen JP, Chen YR. Enhancing Philtrum Morphology Using Fat Grafting Combined with Percutaneous Rigottomy in Repaired Unilateral Cleft Lip. Plast Reconstr Surg 2024; 153:605e-611e. [PMID: 37053450 DOI: 10.1097/prs.0000000000010548] [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: 04/15/2023]
Abstract
BACKGROUND Improving the philtrum morphology of patients with a secondary cleft lip deformity has been a challenge in cleft care. Combining fat grafting with percutaneous rigottomy has been advocated for treatment of volumetric deficiency associated with a scarred recipient site. This study assessed the outcome of synchronous fat grafting and rigottomy for improvement of cleft philtrum morphology. METHODS Consecutive young adult patients ( n = 13) with a repaired unilateral cleft lip who underwent fat grafting combined with rigottomy expansion technique for enhancement of philtrum morphology were included. Preoperative and postoperative three-dimensional facial models were used for three-dimensional morphometric analyses including philtrum height, projection, and volume parameters. Lip scar was qualitatively judged by a panel composed by two blinded external plastic surgeons using a 10-point visual analogue scale. RESULTS Three-dimensional morphometric analysis revealed a significant (all P < 0.05) postoperative increase of the lip height-related measurements for cleft philtrum height, noncleft philtrum height, and central lip length parameters, with no difference ( P > 0.05) between cleft and noncleft sides. The postoperative three-dimensional projection of the philtral ridges was significantly ( P < 0.001) larger in cleft (1.01 ± 0.43 mm) than in noncleft sides (0.51 ± 0.42 mm). The average philtrum volume change was 1.01 ± 0.68 cm 3 , with an average percentage fat graft retention of 43.36% ± 11.35%. The panel assessment revealed significant ( P < 0.001) postoperative scar enhancement for the qualitative rating scale, with mean preoperative and postoperative scores of 6.69 ± 0.93 and 7.88 ± 1.14, respectively. CONCLUSION Synchronous fat grafting and rigottomy improved philtrum length, projection, and volume and lip scar in patients with repaired unilateral cleft lip. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Rafael Denadai
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
- Plastic and Cleft-Craniofacial Surgery, A&D DermePlastique
| | - Ivy Tangco
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
| | - Maria Valentine
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
| | - Christopher Glenn Wallace
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
- Department of Plastic Surgery, Royal Devon & Exeter Hospital
| | - Yen-Chang Hsiao
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
- Graduate Institute of Clinical Medical Sciences, School of Medicine
| | - Jung-Ju Huang
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
- Department of Plastic Surgery, Taipei Medical University Hospital
| | - Frank Chun-Shin Chang
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
- Graduate Institute of Clinical Medical Sciences, School of Medicine
- Department of Chemical and Materials Engineering, College of Engineering, Chang Gung University
- Department of Plastic Surgery, Taipei Medical University Hospital
- Elysée Aesthetics Medical Center
| | - Lun-Jou Lo
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
| | - Jyh-Ping Chen
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
- Department of Chemical and Materials Engineering, College of Engineering, Chang Gung University
- Research Center for Food and Cosmetic Safety, Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology
- Department of Materials Engineering, Ming Chi University of Technology
| | - Yu-Ray Chen
- From the Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital
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Andreoletti S, Klinger F, Vinci V. Comment on "Oncological Safety of Autologous Fat Grafting in Breast Reconstruction: A Meta-analysis Based on Matched Cohort Studies". Aesthetic Plast Surg 2023; 47:2207-2208. [PMID: 37217604 DOI: 10.1007/s00266-023-03373-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Stefania Andreoletti
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, IRCCS Humanitas Research Hospital, University of Milan, Rozzano, Milan, Italy.
| | - Francesco Klinger
- Department of Health Sciences, Ospedale San Paolo University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, IRCCS Humanitas University, Pieve Emanuele, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Alhindi N, Attar A, Alhamed L, Hassan O, Alyamani S, Hassan Alsquor A, Alnoman H. Autologous fat graft in cleft lip patients: a comprehensive systematic review of technique, outcomes, and complications. Br J Oral Maxillofac Surg 2023; 61:482-490. [PMID: 37479532 DOI: 10.1016/j.bjoms.2023.06.005] [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: 10/27/2022] [Revised: 04/13/2023] [Accepted: 06/12/2023] [Indexed: 07/23/2023]
Abstract
Cleft lip is a common craniofacial anomaly and aesthetic obstacle. Different procedures, techniques, and steps are required for repair. These procedures may result in secondary abnormalities or volume deficiencies that can be managed by different methods such as autologous fat grafting. We aim through this study to identify the technique of autologous fat graft in cleft lip deformity and the patient characteristics for selecting this particular technique. This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The study systematically reviewed MEDLINE, Cochrane, and EMBASE databases without time-limitation. A total of 14 articles published in the period between 2004 and 2022 were included, then patients in each study who did not meet the inclusion criteria were excluded. A total of 519 patients who underwent autologous adipose tissue augmentation of cleft lip deformity were included and analyed. Autologous fat graft is found to be safe, effective in improving lip appearance as well as contour, and associated with high satisfaction rate among cleft lip patients. A selected patients with vermilion deficiency, whistle deformity, or overall lip volume deficiency is found to have a higher satisfaction rate. The most frequently reported complications were excess fullness, nodule formation, graft resorption, and nostril deformity.
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Affiliation(s)
- Nawaf Alhindi
- Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia.
| | - Abdullah Attar
- Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia.
| | - Latifah Alhamed
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Omar Hassan
- College of Medicine, King Saud bin Abdulaziz university for health sciences, Jeddah, Saudi Arabia.
| | - Sarah Alyamani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | | | - Hatem Alnoman
- Division of Plastic and Reconstruction Surgery, Department of Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia; King Saud bin Abdulaziz University, Jeddah, Saudi Arabia.
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Klinger F, Bozzo G, Vinci V, Klinger M, Battistini A. Comment on "Reverse Expansion Following Nipple Sparing Mastectomy: A Natural, Safe and Effective Autologous Technique for Breast Reconstruction". Aesthetic Plast Surg 2023; 47:49-50. [PMID: 35543725 DOI: 10.1007/s00266-022-02898-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 12/13/2022]
Abstract
Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Francesco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy
| | - Giulia Bozzo
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele- Milan, Italy
| | - Marco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy
| | - Andrea Battistini
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy.
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Lorenzano V, Vaccari S, Vinci V, Klinger FM. Letter to the Editor on Density-Based High-Quality Fat: Characterization and Correlation with Different Body Fat Ratio. Aesthetic Plast Surg 2023; 47:109-110. [PMID: 35920863 DOI: 10.1007/s00266-022-03040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Valerio Lorenzano
- Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, Milan, Italy.
| | - Stefano Vaccari
- Humanitas Clinical and Research Center - IRCCS - Plastic Surgery Unit, Rozzano, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Francesco Maria Klinger
- Department of Health Sciences, Ospedale San Paolo, University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy
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Autologous Fat Grafting as Treatment of Postmastectomy Pain Syndrome: A Randomized Controlled Trial. Plast Reconstr Surg 2023; 151:520e-521e. [PMID: 36730330 DOI: 10.1097/prs.0000000000009940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Costanzo D, Romeo A, Marena F. Autologous Fat Grafting in Plastic and Reconstructive Surgery: An Historical Perspective. EPLASTY 2022; 22:e4. [PMID: 35958738 PMCID: PMC9350545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Autologous fat grafting (AFG or lipofilling) is a common technique used in plastic and reconstructive surgery that involves the transfer of autologous fat tissue from one region of the body to another. The indications and techniques of AFG have changed dramatically over the years. We recount the historic milestones to the current state.
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Battistini A, Romeo MA, Bandi V, Caviggioli F, Vinci V. Comment on: "Oral and Maxillofacial Autologous Fat Transplantation: History, Clinical Application Status and Research Progress". Aesthetic Plast Surg 2021; 45:3071-3072. [PMID: 33903931 DOI: 10.1007/s00266-021-02311-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
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Comment on "Nanofat Injection for the Treatment of Depressed Facial Scars". Aesthetic Plast Surg 2021; 45:2546-2547. [PMID: 33890121 DOI: 10.1007/s00266-021-02264-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
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Comment on: "Breast Reconstruction Does Not Increase the Incidence of Postmastectomy Pain Syndrome". Ann Plast Surg 2021; 89:338-339. [PMID: 34510084 DOI: 10.1097/sap.0000000000002999] [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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Francesco K, Benedetta A, Valeria B, Andrea B, Stefano V, Giulia B, Valeriano V. Comment to "Early Intervention with Autologous Fat Grafting to Reduce Hypertrophic Scar Formation: A Preliminary Study". Aesthetic Plast Surg 2021; 46:223-224. [PMID: 34378074 DOI: 10.1007/s00266-021-02510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Klinger Francesco
- Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, MultiMedica Holding S.p.A., University of Milan, Milan, Sesto San Giovanni, Italy
| | - Agnelli Benedetta
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.
| | - Bandi Valeria
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Battistini Andrea
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vaccari Stefano
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Bozzo Giulia
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vinci Valeriano
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
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Caviggioli F, Agnelli B, Murolo M, Siliprandi M, Vinci V. Comment to "Treating Anisomastia and Tuberous Breast with Fat Grafting: Technique and Evaluation of Outcomes Using BREAST-Q Surveys". Aesthetic Plast Surg 2021; 46:16-17. [PMID: 34255154 DOI: 10.1007/s00266-021-02450-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
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13
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Battistini A, Lisa A, Maione L, Klinger M, Klinger F. Comment on: "Autologous Fat Grafting with Percutaneous Fasciotomy and Reduction of the Nipple-Areolar Complex for the Correction of Tuberous Breast Deformity in Teenagers". Aesthetic Plast Surg 2021; 45:806-807. [PMID: 33543345 DOI: 10.1007/s00266-021-02143-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Andrea Battistini
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, 20090, Rozzano, Milan, Italy.
| | - Andrea Lisa
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, 20090, Rozzano, Milan, Italy
| | - Luca Maione
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, 20090, Rozzano, Milan, Italy
| | - Marco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, 20090, Rozzano, Milan, Italy
| | - Francesco Klinger
- Plastic Surgery Unit, MultiMedica Holding S.p.A., Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Sesto San Giovanni, Milan, Italy
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