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Deane EC, Wong A, Bloom JD. Fat Grafting the Male Face. Facial Plast Surg Clin North Am 2024; 32:391-398. [PMID: 38936996 DOI: 10.1016/j.fsc.2024.03.003] [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] [Indexed: 06/29/2024]
Abstract
There are many developmental sexual dimorphisms of the human face, and thereby differences in aging based on sex. Sensitivity regarding the nature of the changes that are unique to the male face as well as understanding men's unique aesthetic goals will allow the skilled practitioner to tailor rejuvenating treatments accordingly. Fat grafting of the male face has not been extensively described but is an excellent tool for facial rejuvenation either as an adjunct or a stand-alone procedure. Each treatment area demands different techniques and special attention to avoid unintentional feminization.
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Affiliation(s)
- Emily C Deane
- Facial Plastic & Reconstructive Surgery, Department of Otolaryngology Head & Neck Surgery, University of Pennsylvania, 3737 Market Street, Suite 302, Philadelphia, PA 19104, USA
| | - Anni Wong
- Facial Plastic & Reconstructive Surgery, Department of Otolaryngology Head & Neck Surgery, University of Pennsylvania, 3737 Market Street, Suite 302, Philadelphia, PA 19104, USA
| | - Jason D Bloom
- Facial Plastic & Reconstructive Surgery, Department of Otolaryngology Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA; Bloom Facial Plastic Surgery, Two Town Place, Suite 110, Bryn Mawr, PA 19010, USA.
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Delay A, Brochet L, Zrounba P, Delay E. Titanium plates salvage in irradiated facial areas with the lipomodeling technique. ANN CHIR PLAST ESTH 2024; 69:79-84. [PMID: 37423827 DOI: 10.1016/j.anplas.2023.06.004] [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: 05/28/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023]
Abstract
Major defects of the facial structures cause severe functional and aesthetic impairment. For composite defects with bone loss, the use of a titanium plate bridging the bony defect, associated or not to a soft tissue pedicled flap is to be considered in complex cases, or for patients with high comorbidities. The principal limit of this technique is the risk of plate exposure, especially for patients who had adjuvant radiation therapy. We present two clinical cases of patients who had a facial reconstruction using a titanium plate associated with a locoregional soft tissue flap, and who presented a near-exposed plate a few years after the first surgery and adjuvant radiation therapy. In order to prevent plate exposure, we performed several lipomodeling sessions between skin and plate. Our results are very encouraging, with no plate exposure and thickening of the soft tissues which cover the plate at 10-years follow-up. The knowledge of the possibility to use fat grafting transfer could therefore lead to a strong return to the use of titanium plates in facial reconstruction.
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Affiliation(s)
- A Delay
- Service de chirurgie ORL et cervico-faciale, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France; Unité de chirurgie plastique et reconstructrice, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France
| | - L Brochet
- Service de chirurgie ORL et cervico-faciale, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France
| | - P Zrounba
- Service de chirurgie ORL et cervico-faciale, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France
| | - E Delay
- Unité de chirurgie plastique et reconstructrice, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon cedex 08, France.
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Jiang X, Chen W, Chen N, Wang Y, Lin J, Tian X, Wu H, Zhang Q. Comprehensive management for complex complications after periumbilical fat implantation into the upper eyelid. BMC Ophthalmol 2023; 23:306. [PMID: 37430215 DOI: 10.1186/s12886-023-02989-z] [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: 12/31/2022] [Accepted: 05/23/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Recently, periumbilical fat (PF) mass, an autologous material with a high survival rate, has been transplanted to treat sunken or dissatisfactory double eyelids. However, the intricate complications of PF grafts and associated reconstructive strategies are infrequently discussed. METHODS During 3 years, 20 patients (33 eyes) with eyelid malformations caused by PF grafts into the orbital septum or on the surface of the levator aponeurosis underwent corrective blepharoplasty. We recorded patients' subjective feelings and identified deformities from crease abnormalities, bloated appearance, and problems with the eyelid's height. Then, we categorize them into three types based on their complexity: type I, swollen appearance; type II, obvious adhesion; type III, severe comprehensive damage. The relevant management included removing fat implants, releasing the adhesion, and rebuilding the physical structure according to the anatomic damage mechanism. The improvement effect was assessed with a satisfaction survey from patients and doctors at 6 months of follow-up. RESULTS The swollen appearance was observed in 26 eyes (78.8%), an unsmooth double-eyelid line was in 23 eyes (69.7%), and the incidence of adhesion was in 22 eyes (66.7%). Following a comprehensive evaluation, 15 eyes (45.5%) and 13 (39.4%) were classified as type I and type II respectively. After the 6-month follow-up, 22 eyes (66.7%) showed exceptional aesthetic results, whereas only 2 eyes as type III had a poor outcome. CONCLUSIONS The deformities emerging from periumbilical fat into the upper eyelid are associated with the shape of the fat and the adhesion in tissues. Graft removal, adhesion release, and restoration of the natural anatomic structure can have positive outcomes.
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Affiliation(s)
- Xuewei Jiang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Plastic Surgery, Mylike Medical Cosmetic Hospital, Shanghai, China
| | - Wei Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nan Chen
- The Affiliated Eye Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yu Wang
- Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jiayan Lin
- Department of Plastic and Reconstructive Surgery, The Frist Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xufeng Tian
- Department of Plastic and Reconstructive Surgery, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
| | - Hailong Wu
- Department of Plastic Surgery, NuoYa Stomatological Hospital, Siping, Jilin, China.
| | - Qun Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Sidhu N, Agrawal S, Pushker N, Bhari N, Meel R, Bajaj MS. Autologous fat transfer for orbital volume augmentation in sockets with small nonseeing eyes. J Plast Reconstr Aesthet Surg 2023; 82:170-175. [PMID: 37182248 DOI: 10.1016/j.bjps.2023.02.024] [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: 07/06/2022] [Revised: 01/15/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE End-stage ocular diseases usually end up with atrophic bulbi or phthisis bulbi leading to orbital volume loss which needs to be addressed. We studied the use of autologous fat for volume augmentation of the orbit because it is minimally invasive and allows early rehabilitation with the use of an artificial eye. DESIGN It was a prospective, interventional study. METHODS A total of 14 eyes of 14 patients with atrophic bulbi with shrinkage or phthisis bulbi with no perception of light (PL) and aged older than 18 years were included for the study purpose. Painful or inflamed eyes or suspected intraocular tumors were excluded. An autologous fat graft was obtained from the lower abdomen or buttocks and injected into the retrobulbar space using a 20-gauge cannula after adequate peribulbar anesthesia. Outcomes measures were patient satisfaction, change in Hertel's exophthalmometry, vertical and horizontal palpebral aperture, and socket volume. RESULTS Hertel exophthalmometry showed a significant improvement both with and without an artificial eye from 14.92 ± 2.3 mm to 16.71 ± 1.94 mm (p-value 0.003 without an artificial eye). The vertical palpebral aperture also showed a significant improvement from 5 ± 1.70 mm to 6.71 ± 1.58 mm (p-value < 0.001). There was a significant reduction in the socket volume from 1.22 ml to 0.39 ml (p-value < 0.001). No local or donor site complications were seen. CONCLUSIONS Autologous fat transfer is a minimally invasive, safe, and effective procedure for orbital volume augmentation in small, nonseeing eyes. The short-term outcome of our study was good in most patients and can be considered for such patients.
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Affiliation(s)
- Navneet Sidhu
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sahil Agrawal
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Neelam Pushker
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Dept. of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Meel
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mandeep S Bajaj
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Three Different Types of Fat Grafting for Facial Systemic Sclerosis: A Case Series. J Clin Med 2022; 11:jcm11185489. [PMID: 36143136 PMCID: PMC9505604 DOI: 10.3390/jcm11185489] [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: 08/02/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 12/04/2022] Open
Abstract
Systemic sclerosis (SSc) is a heterogeneous, chronic connective tissue disease, characterized by skin fibrosis as well as vascular and visceral lesions. It can involve the lungs, heart, kidneys, gastrointestinal tract, and bones. The orofacial manifestations of SSc can cause functional, aesthetic, and social distress, resulting in significant psychological implications for the patients. In recent decades, fat grafting improved the aesthetic outcomes in terms of volume deficiency, contour asymmetry, and skin elasticity of the face thanks to the regenerative action of the stem cells contained within it. We describe five cases of a patient with SSc treated with fat grafting used to correct volume loss and facial elasticity of the lips and perioral region on the middle and lower third of the face. All the patients received regular postoperative checks at weeks 1 and 2. A multiple choice questionnaire was administered to assess the degree of tolerability of the procedure. The reliability of the questionnaire was evaluated by calculating the Cronbach alpha using the MedCalc Statistical Software version 20.113. The aim of our study is to describe three different types of fat grafting used to correct volume loss and restore facial elasticity of the lips and perioral region on the middle and lower third of the face.
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An Y, Wang G, Li X, Zhen Y, Zhao J, Li D. Rhinoplasty with Simultaneous Autologous Full-Face Fat Transfer for Asian Facial Contouring Balance: A Retrospective Study. Aesthetic Plast Surg 2022; 47:746-756. [PMID: 36042025 DOI: 10.1007/s00266-022-03064-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aesthetic facial contouring procedures have gained an increasing popularity in the Asian population. Nevertheless, currently, there are few specific literature assessments and studies on the outcomes of rhinoplasty combined with full-face fat graft contouring. To conduct an objective evaluation of the efficacy of Asian rhinoplasty combined with autologous facial fat transfer in terms of 3-dimensional measurement and patient-reported outcomes. METHODS Patients who underwent rhinoplasty combined with full-face fat transfer for facial contouring between January 2016 and July 2019 were recruited in the study. The preoperative and postoperative clinical variables and 3-dimensional measurement of patients were also collected. The satisfaction outcome of surgeons and patients was assessed. RESULTS Twenty patients completed rhinoplasty with full-face fat transfer. The average postoperative follow-up was 10.2 months (range 6-24 months). The nasal length, and the nasal protrusion rate were significantly increased (p < 0.05) after surgery, and the median number of nasolabial angles decreased from 106° to 101°, which was closer to the aesthetic standard of 90°-100°. The topographical projection images of whole face indicated that the volume of frontal, temporal, inner cheek and chin regions were increased obviously. All cases received satisfaction outcome based on surgeons' satisfaction scale, ROE scale, FACE-Q overall facial satisfaction scale, and FACE-Q Rhinoplasty scale. Additionally, no patients had intraoperative or postoperative complications. CONCLUSIONS Rhinoplasty combined with full-face fat transfer is a reliable and effective method of augmenting and contouring the facial convexity in the Asian populations. 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)
- Yang An
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
| | - Guanhuier Wang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xiao Li
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Jianfang Zhao
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Dong Li
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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The Impact of N-Acetylcysteine on Autologous Fat Graft: First-in-Human Pilot Study. Aesthetic Plast Surg 2021; 45:2397-2405. [PMID: 32221675 PMCID: PMC8481185 DOI: 10.1007/s00266-020-01633-1] [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: 11/11/2019] [Accepted: 01/25/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Our goal was to determine whether N-acetylcysteine (NAC) administered to the tumescent solution can reduce oxidative stress and increase autologous fat graft (AFG) viability. METHODS The study included 15 women with a mean age of 31.8 years (range 23-39 years) who underwent breast asymmetry correction with AFG harvested from both thighs. One thigh was infiltrated with a standard tumescent fluid (control graft) and other with a NAC-enriched tumescent fluid (NAC-treated graft). Each participant had breast MRI imaging before and 6 months after the procedure. Also, adipose tissue samples from each graft were subjected to biochemical analysis, flow cytometric assay and qRT-PCR to determine the markers of oxidative stress, angiogenesis and adipogenesis. RESULTS Concentration and activity of superoxide dismutase in the NAC-treated grafts turned out to be significantly higher than in the control grafts, in both fresh (p = 0.041 and p = 0.023, respectively) and frozen samples (p = 0.004 and p = 0.003, respectively). The level of nitric oxide in frozen samples from the control grafts was significantly higher than in the NAC-treated grafts (p = 0.009). iNOS was the only qRT-PCR target showing significant intergroup differences, with higher transcription levels observed in the control grafts (p = 0.027). Breast volumetric analysis demonstrated that the NAC-treated group had a 12.19% lower resorption rate than the control group, although it was found to be statistically insignificant (p = 0.149). No postoperative complications were observed during a 6-month follow-up. CONCLUSIONS Some results of this study are promising. Further studies on larger groups are needed to determine NAC impact on AFG. 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 . TRIAL REGISTRY NAME The Impact of N-Acetylcysteine on Volumetric Retention of Autologous Fat Graft for Breast Asymmetry Correction. REGISTRATION IDENTIFICATION NUMBER NCT03197103. URL FOR THE REGISTRY: https://clinicaltrials.gov/ct2/show/NCT03197103?term=acetylcysteine&rank=6.
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Lee S, Chae DS, Song BW, Lim S, Kim SW, Kim IK, Hwang KC. ADSC-Based Cell Therapies for Musculoskeletal Disorders: A Review of Recent Clinical Trials. Int J Mol Sci 2021; 22:ijms221910586. [PMID: 34638927 PMCID: PMC8508846 DOI: 10.3390/ijms221910586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 01/04/2023] Open
Abstract
Recently published clinical trials involving the use of adipose-derived stem cells (ADSCs) indicated that approximately one-third of the studies were conducted on musculoskeletal disorders (MSD). MSD refers to a wide range of degenerative conditions of joints, bones, and muscles, and these conditions are the most common causes of chronic disability worldwide, being a major burden to the society. Conventional treatment modalities for MSD are not sufficient to correct the underlying structural abnormalities. Hence, ADSC-based cell therapies are being tested as a form of alternative, yet more effective, therapies in the management of MSDs. Therefore, in this review, MSDs subjected to the ADSC-based therapy were further categorized as arthritis, craniomaxillofacial defects, tendon/ligament related disorders, and spine disorders, and their brief characterization as well as the corresponding conventional therapeutic approaches with possible mechanisms with which ADSCs produce regenerative effects in disease-specific microenvironments were discussed to provide an overview of under which circumstances and on what bases the ADSC-based cell therapy was implemented. Providing an overview of the current status of ADSC-based cell therapy on MSDs can help to develop better and optimized strategies of ADSC-based therapeutics for MSDs as well as help to find novel clinical applications of ADSCs in the near future.
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Affiliation(s)
- Seahyoung Lee
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung 210-701, Korea; (S.L.); (B.-W.S.); (S.L.); (S.W.K.)
| | - Dong-Sik Chae
- Department of Orthopedic Surgery, International St. Mary’s Hospital, Catholic Kwandong University, Gangneung 210-701, Korea;
| | - Byeong-Wook Song
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung 210-701, Korea; (S.L.); (B.-W.S.); (S.L.); (S.W.K.)
| | - Soyeon Lim
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung 210-701, Korea; (S.L.); (B.-W.S.); (S.L.); (S.W.K.)
| | - Sang Woo Kim
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung 210-701, Korea; (S.L.); (B.-W.S.); (S.L.); (S.W.K.)
| | - Il-Kwon Kim
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung 210-701, Korea; (S.L.); (B.-W.S.); (S.L.); (S.W.K.)
- Correspondence: (I.-K.K.); (K.-C.H.); Fax: +82-32-290-2774 (K.-C.H.)
| | - Ki-Chul Hwang
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung 210-701, Korea; (S.L.); (B.-W.S.); (S.L.); (S.W.K.)
- Correspondence: (I.-K.K.); (K.-C.H.); Fax: +82-32-290-2774 (K.-C.H.)
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Non-Surgical Touch-Up with Hyaluronic Acid Fillers Following Facial Reconstructive Surgery. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11167507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The use of hyaluronic acid (HA) injectable fillers has become increasingly widespread in facial recontouring and rejuvenation. We report our experiences to emphasize the role of HA fillers as tools beyond aesthetic treatments in cases of post-surgical facial sequelae. HA fillers are generally used for aesthetic rejuvenation, but one potential new horizon could be their application in trauma, reconstructive, and craniofacial surgery. This study was conducted retrospectively, evaluating medical reports of patients treated at the Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, for lip incompetence, trauma, oncological, reconstructive, and craniosynostosis surgery sequelae. Visual analog scale (VAS) evaluation was performed to assess patient satisfaction. No major complications (i.e., impending necrosis or visual loss) were reported. Bruising and swelling was reported for 48 h after lip injection. At the immediate VAS evaluation, 67% of the patients were “extremely satisfied” and 33% “satisfied”. In those 33%, VAS scores changed to “extremely satisfied” at 6–9 weeks and 3–6 months of VAS evaluation (contextually to improvement in tissue flexibility, elasticity, and aesthetic appearance). Results indicate that this minimally invasive approach achieves a high level of aesthetic enhancement, improving patient satisfaction. The concept of HA filler applications could be a frontier that may be applicable to other areas of reconstructive facial plastic surgery.
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Changing the Paradigm of Craniofacial Reconstruction: A Prospective Clinical Trial of Autologous Fat Transfer for Craniofacial Deformities. Ann Surg 2021; 273:1004-1011. [PMID: 30985369 DOI: 10.1097/sla.0000000000003318] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to prospectively assess outcomes for surgical autologous fat transfer (AFT) applied for traumatic and postsurgical craniofacial deformities. The minimally invasive nature of AFT has potential for reduced risk and superior outcomes compared with current reconstructive options. BACKGROUND Craniofacial deformities have functional and psychosocial sequelae and can profoundly affect quality of life. Traditional reconstructive options are invasive, invasive, complex, and often lack precision in outcomes. Although AFT is safe, effective, and minimally invasive, only anecdotal evidence exists for reconstruction of craniofacial deformities. METHODS In this Institutional Review Board-approved prospective cohort study, 20 subjects underwent AFT (average volume: 23.9 ± 13.2 mL). Volume retention over time was determined using high-resolution computed tomography. Flow cytometry was used to assess cellular subpopulations and viability in the stromal vascular fraction. Quality of life assessments were performed. After the completion of 9-month follow-up, 5 subjects were enrolled for a second treatment. RESULTS No serious adverse events occurred. Volume retention averaged 63 ± 17% at 9 months. Three-month retention strongly predicted 9-month retention (r=0.996, P < 0.0001). There was no correlation between the total volume injected and retention. Patients undergoing a second procedure had similar volume retention as the first (P = 0.05). Age, sex, body mass index, and stromal vascular fraction cellular composition did not impact retention. Surprisingly, former smokers had greater volume retention at 9 months compared with nonsmokers (74.4% vs 56.2%, P = 0.009). Satisfaction with physical appearance (P = 0.002), social relationships (P = 0.02), and social functioning quality of life (P = 0.05) improved from baseline to 9 months. CONCLUSIONS For craniofacial defects, AFT is less invasive and safer than traditional reconstructive options. It is effective, predictable, and reaches volume stability at 3 months. Patient-reported outcomes demonstrate a positive life-changing impact.
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Custom-Made Zirconium Dioxide Implants for Craniofacial Bone Reconstruction. MATERIALS 2021; 14:ma14040840. [PMID: 33578685 PMCID: PMC7916391 DOI: 10.3390/ma14040840] [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] [Received: 12/28/2020] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 11/18/2022]
Abstract
Reconstruction of the facial skeleton is challenging for surgeons because of difficulties in proper shape restoration and maintenance of the proper long-term effect. ZrO2 implant application can be a solution with many advantages (e.g., osseointegration, stability, and radio-opaqueness) and lacks the disadvantages of other biomaterials (e.g., metalosis, radiotransparency, and no osseointegration) or autologous bone (e.g., morbidity, resorption, and low accuracy). We aimed to evaluate the possibility of using ZrO2 implants as a new application of this material for craniofacial bone defect reconstruction. First, osteoblast (skeleton-related cell) cytotoxicity and genotoxicity were determined in vitro by comparing ZrO2 implants and alumina particle air-abraded ZrO2 implants to the following: 1. a titanium alloy (standard material); 2. ultrahigh-molecular-weight polyethylene (a modern material used in orbital surgery); 3. a negative control (minimally cytotoxic or genotoxic agent action); 4. a positive control (maximally cytotoxic or genotoxic agent action). Next, 14 custom in vivo clinical ZrO2 implants were manufactured for post-traumatologic periorbital region reconstruction. The soft tissue position improvement in photogrammetry was recorded, and clinical follow-up was conducted at least 6 years postoperatively. All the investigated materials revealed no cytotoxicity. Alumina particle air-abraded ZrO2 implants showed genotoxicity compared to those without subjection to air abrasion ZrO2, which were not genotoxic. The 6-month and 6- to 8-year clinical results were aesthetic and stable. Skeleton reconstructions using osseointegrated, radio-opaque, personalized implants comprising ZrO2 material are the next option for craniofacial surgery.
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Efficacy of Autologous Fat Grafting in Restoring Facial Symmetry in Linear Morphea-Associated Lesions. Symmetry (Basel) 2020. [DOI: 10.3390/sym12122098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Morphea is a rare sclerotic autoimmune disorder primary affecting the skin and subcutaneous tissues. The linear head variants involve the facial area, with asymmetries and deformities. Eighteen patients with hemifacial deformity (age range 14–75 years) were assessed before surgery (T0), and after one (T1, 18 patients) or two (T2, six patients) surgical treatments of facial autologous fat grafting. A stereophotogrammetric reconstruction of the facial surface was obtained for each patient and a group of control subjects, and facial symmetry was quantified according to the root mean square distance between homologous areas of trigeminal innervation. Values obtained from the control subjects were used to calculate z-scores for patients. At T0, all facial thirds of the patients resulted significantly more asymmetrical than those of the control subjects (Mann–Whitney test, p < 0.05), while at T1, the symmetry of the middle facial third did not differ from that of control subjects (p = 0.263). At T2, the upper and the lower facial thirds also did not differ from the control values (p > 0.05). The faster result obtained in the facial middle third was in accord with clinical findings. In conclusion, autologous fat grafting significantly improved facial asymmetry after one (middle facial third) or two (lower and upper thirds) treatments; the outcomes were efficaciously quantified by stereophotogrammetry.
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Pietruski P, Paskal W, Paluch Ł, Paskal AM, Nitek Ż, Włodarski P, Walecki J, Noszczyk B. The Impact of N-Acetylcysteine on Autologous Fat Graft: First-in-Human Pilot Study. Aesthetic Plast Surg 2020:10.1007/s00266-020-01730-1. [PMID: 32424535 DOI: 10.1007/s00266-020-01730-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/25/2020] [Indexed: 09/29/2022]
Abstract
BACKGROUND Our goal was to determine whether N-acetylcysteine (NAC) administered to the tumescent solution can reduce oxidative stress and increase autologous fat graft (AFG) viability. METHODS The study included 15 women with a mean age of 31.8 years (range 23-39 years) who underwent breast asymmetry correction with AFG harvested from both thighs. One thigh was infiltrated with a standard tumescent fluid (control graft) and other with a NAC-enriched tumescent fluid (NAC-treated graft). Each participant had breast MRI imaging before and 6 months after the procedure. Also, adipose tissue samples from each graft were subjected to biochemical analysis, flow cytometric assay and qRT-PCR to determine the markers of oxidative stress, angiogenesis and adipogenesis. RESULTS Concentration and activity of superoxide dismutase in the NAC-treated grafts turned out to be significantly higher than in the control grafts, in both fresh (p = 0.041 and p = 0.023, respectively) and frozen samples (p = 0.004 and p = 0.003, respectively). The level of nitric oxide in frozen samples from the control grafts was significantly higher than in the NAC-treated grafts (p = 0.009). iNOS was the only qRT-PCR target showing significant intergroup differences, with higher transcription levels observed in the control grafts (p = 0.027). Breast volumetric analysis demonstrated that the NAC-treated group had a 12.19% lower resorption rate than the control group, although it was found to be statistically insignificant (p = 0.149). No postoperative complications were observed during a 6-month follow-up. CONCLUSIONS Some results of this study are promising. Further studies on larger groups are needed to determine NAC impact on AFG. TRIAL REGISTRY NAME The Impact of N-Acetylcysteine on Volumetric Retention of Autologous Fat Graft for Breast Asymmetry Correction. REGISTRATION IDENTIFICATION NUMBER NCT03197103. URL FOR THE REGISTRY: https://clinicaltrials.gov/ct2/show/NCT03197103?term=acetylcysteine&rank=6 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)
- Piotr Pietruski
- Department of Plastic and Reconstructive Surgery, Medical Centre of Postgraduate Education, Prof. W. Orlowski Memorial Hospital, Warsaw, Poland
| | - Wiktor Paskal
- Laboratory of Center for Preclinical Research, Department of Methodology, Medical University of Warsaw, Stefana Banacha 1B, 02-097, Warsaw, Mazowieckie, Poland
| | - Łukasz Paluch
- Department of Radiology, Medical Centre of Postgraduate Education, Gruca Orthopaedic and Trauma Teaching Hospital, Otwock, Poland
| | - Adriana M Paskal
- Laboratory of Center for Preclinical Research, Department of Methodology, Medical University of Warsaw, Stefana Banacha 1B, 02-097, Warsaw, Mazowieckie, Poland
| | - Żaneta Nitek
- Department of Radiology, Medical Centre of Postgraduate Education, Gruca Orthopaedic and Trauma Teaching Hospital, Otwock, Poland
| | - Paweł Włodarski
- Laboratory of Center for Preclinical Research, Department of Methodology, Medical University of Warsaw, Stefana Banacha 1B, 02-097, Warsaw, Mazowieckie, Poland.
| | - Jerzy Walecki
- Department of Radiology, Medical Centre of Postgraduate Education, Gruca Orthopaedic and Trauma Teaching Hospital, Otwock, Poland
| | - Bartłomiej Noszczyk
- Department of Plastic and Reconstructive Surgery, Medical Centre of Postgraduate Education, Prof. W. Orlowski Memorial Hospital, Warsaw, Poland
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Creadore A, Watchmaker J, Maymone MBC, Pappas L, Lam C, Vashi NA. Cosmetic treatment in patients with autoimmune connective tissue diseases: Best practices for patients with morphea/systemic sclerosis. J Am Acad Dermatol 2020; 83:315-341. [PMID: 32360721 DOI: 10.1016/j.jaad.2019.12.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/24/2019] [Accepted: 12/28/2019] [Indexed: 02/06/2023]
Abstract
Morphea and systemic sclerosis are inflammatory, sclerosing disorders. Morphea primarily affects the dermis and subcutaneous fat, while systemic sclerosis typically involves the skin and internal organs. Functional impairment and cosmetic disfigurement are common in both diseases. Treatment options to mitigate disease progression remain limited. Both functional impairment and cosmetic deficits negatively impact quality of life and psychological well-being in this patient population. While the number of cosmetic procedures performed in the United States continues to rise each year, limited data exist regarding best practices for correcting aesthetic deficits caused by autoimmune conditions. There is scarce information to guide safety decisions regarding laser parameters, soft tissue augmentation, treatment intervals, and the concurrent use of immune-modifying or immune-suppressing medications. Given the fears of disease reactivation and exacerbation from postprocedural inflammation along with limited data, it is difficult for clinicians to provide evidence-based cosmetic treatment with realistic expectations with regard to short- and long-term outcomes. In the first article in this continuing medical education series, we attempt to address this practice gap.
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Affiliation(s)
| | - Jacqueline Watchmaker
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Mayra B C Maymone
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Leontios Pappas
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Christina Lam
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Neelam A Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
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The Current Status of the Autologous Fat Grafting for Pediatric Craniofacial Patients. Ann Plast Surg 2020; 85:568-573. [DOI: 10.1097/sap.0000000000002286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A Potential Role of RUNX2- RUNT Domain in Modulating the Expression of Genes Involved in Bone Metastases: An In Vitro Study with Melanoma Cells. Cells 2020; 9:cells9030751. [PMID: 32204402 PMCID: PMC7140624 DOI: 10.3390/cells9030751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 01/07/2023] Open
Abstract
Ectopic expression of RUNX2 has been reported in several tumors. In melanoma cells, the RUNT domain of RUNX2 increases cell proliferation and migration. Due to the strong link between RUNX2 and skeletal development, we hypothesized that the RUNT domain may be involved in the modulation of mechanisms associated with melanoma bone metastasis. Therefore, we evaluated the expression of metastatic targets in wild type (WT) and RUNT KO melanoma cells by array and real-time PCR analyses. Western blot, ELISA, immunofluorescence, migration and invasion ability assays were also performed. Our findings showed that the expression levels of bone sialoprotein (BSP) and osteopontin (SPP1) genes, which are involved in malignancy-induced hypercalcemia, were reduced in RUNT KO cells. In addition, released PTHrP levels were lower in RUNT KO cells than in WT cells. The RUNT domain also contributes to increased osteotropism and bone invasion in melanoma cells. Importantly, we found that the ERK/p-ERK and AKT/p-AKT pathways are involved in RUNT-promoted bone metastases. On the basis of our findings, we concluded that the RUNX2 RUNT domain is involved in the mechanisms promoting bone metastasis of melanoma cells via complex interactions between multiple players involved in bone remodeling.
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Abstract
Craniofacial deformities represent a great challenge for the patient and the plastic surgeon. Fat grafting has allowed a shift in paradigm for craniofacial reconstruction by providing a less invasive and safer alternative than traditional reconstructive options. Increasing evidence supports its use with optimal results. This article examines the evidence and practical aspects involved in the decision making and technique of fat grafting to treat secondary craniofacial deformities.
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Affiliation(s)
- Francesco M Egro
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street, 6B Scaife Hall, Pittsburgh, PA 15261, USA
| | - Sydney R Coleman
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street, 6B Scaife Hall, Pittsburgh, PA 15261, USA
| | - J Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street, 6B Scaife Hall, Pittsburgh, PA 15261, USA.
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Abstract
BACKGROUND Aesthetic facial contouring procedures, particularly forehead augmentation, continue to increase in popularity in the Asian population. However, there are very few reports in the literature specifically examining the long-term outcomes of forehead fat grafting. In the present study, the authors aimed to objectively evaluate the efficacy of autologous forehead fat grafting through evaluation of facial proportions and patient-reported outcomes. METHODS Patients who underwent autologous fat grafting for forehead contouring procedures between July of 2011 and June of 2017 were recruited for participation in the study. Patient demographic and clinical variables were collected preoperatively and postoperatively. Facial proportion analysis was collected and compared from preoperative and postoperative photographs. Satisfaction with outcome was assessed by the patient, the surgeon, and a layperson postoperatively. A related-samples Wilcoxon signed rank test was used for statistical analysis. RESULTS Postoperative outcomes were evaluated in a total of 24 patients who underwent forehead autologous fat-grafting procedures. The average postoperative follow-up was 8.1 months. There were no intraoperative or postoperative complications. More than 50 percent of the postoperative results were evaluated as "satisfactory" by all three groups (i.e., patient, surgeon, and layperson) in terms of aesthetic contouring. Average forehead projection increased 0.24 U (ratio of horizontal distance from midforehead plane to cornea plane/cornea diameter) after one round of fat grafting (p = 0.01). Seven patients (29.2 percent) required more than a single round of fat grafting to achieve optimal results. CONCLUSIONS Autologous fat grafting remains a viable option for forehead contouring and augmentation. The findings of this study demonstrate that the operation is effective and offers stable satisfactory results after long-term follow-up. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Hyaluronic Acid Injections as Nonsurgical Alternative in case of Delayed Diagnosis of Malar Arch Fracture: Case Report and Literature Review. Case Rep Surg 2020; 2019:1360741. [PMID: 31976115 PMCID: PMC6955121 DOI: 10.1155/2019/1360741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 12/23/2019] [Indexed: 11/18/2022] Open
Abstract
Background In this article, we describe a nonsurgical approach based on hyaluronic acid filler injection to restore the facial features of a delayed diagnosis of malar fracture. We analyze the differences between surgical and nonsurgical solution: in case of early detection, the surgical approach is the gold standard of treatment. However, in cases of delayed facial fracture diagnosis without functional impairment, nonsurgical procedures could be considered an alternative tool as we show in the present case report. Aims The aim of this study is to underline the importance of a complete aesthetic restoration in patients treated for noncosmetic purposes. Patients/Methods We present a case of a 26-year-old male patient with a delayed diagnosis of malar fracture without functional impairment that was treated with hyaluronic acid (HA) filler injections. Results The patient was followed up for 1 year showing stable results for the first 8 months; at the 12-month follow-up, a touch-up was suggested due to partial resorption of the filler. Conclusion This is the first case describing a facial fracture treated with HA injections for only recontouring purposes. We assess that nonsurgical cosmetic procedures could be considered a "new" tool in the process of facial rehabilitation but only when functional problems are not associated with facial trauma.
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An Y, Panayi AC, Mi B, Fu S, Orgill DP. Comparative Analysis of Two Automated Fat-processing Systems. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2587. [PMID: 32095398 PMCID: PMC7015611 DOI: 10.1097/gox.0000000000002587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/22/2019] [Indexed: 12/19/2022]
Abstract
Plastic surgeons desire more efficient methods of processing lipoaspirate when performing fat grafting procedures. We compared, in a preclinical study, the quantity and quality of lipoaspirate processed by a novel Poloxamer Wash, Absorption, mesh filtration System (PWAS) to a frequently used Ringer's Lactate wash, Decant, and mesh filtration System (RLDS). Methods Lipoaspirate from 10 patients was processed with the RLDS and PWAS systems. The processed lipoaspirate from each device was centrifuged to quantify the amount of fat, free oil, and aqueous components remaining in the fat graft. A trypan blue dye exclusion test assessed cell viability. The processing time for the lipoaspirate was also measured. Results The 10-patient average fat volume processed and available for grafting was similar using both systems. The adipose volume fraction of PWAS was greater (89% ± 3%) than RLDS (76% ± 10%, P = 0.02). The trypan blue exclusion values and processing time were similar for both systems. Oil was efficiently removed from the lipoaspirate, and both systems processed fat efficiently. Conclusion The PWAS effectively cleans lipoaspirate with increased fat concentration.
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Affiliation(s)
- Yang An
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.,Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Adriana C Panayi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Bobin Mi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Siqi Fu
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Dennis P Orgill
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
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Kokai LE, Sivak WN, Schilling BK, Karunamurthy A, Egro FM, Schusterman MA, Minteer DM, Simon P, D’Amico RA, Rubin JP. Clinical Evaluation of an Off-the-Shelf Allogeneic Adipose Matrix for Soft Tissue Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2574. [PMID: 32095393 PMCID: PMC7015604 DOI: 10.1097/gox.0000000000002574] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/10/2019] [Indexed: 01/20/2023]
Abstract
Biomaterials derived from human adipose extracellular matrix have shown promise in vitro and in animal studies as an off-the-shelf adipogenic matrix for sustained volume replacement. Herein, we report the results of a randomized prospective study conducted with allograft adipose matrix (AAM) grafted into the pannus of presurgical abdominoplasty patients 3 or 6 months before scheduled surgery. This is the first report of a longitudinal histologic analysis of AAM in clinical use. METHODS Ten healthy patients undergoing elective abdominoplasty were recruited to receive AAM before surgery. Enrolled subjects were randomized into either a 3-month follow-up cohort or a 6-month follow-up cohort. Subjects were monitored for adverse events associated with AAM grafting in addition to undergoing serial biopsy. Following surgical excision of the pannus, representative samples from the AAM surgical sites were stained and evaluated with hematoxylin and eosin for tissue morphology, Masson's trichrome for collagen, and perilipin for adipocytes. RESULTS All subjects tolerated AAM with no severe adverse events reported. At 3 months following implantation, AAM remained visible within the confines of the subjects' native surrounding adipose tissue with sparse adipocytes apparent within the matrix. By 6 months, AAM had remodeled and was primarily composed of perilipin-positive adipocytes. Histologic analysis confirmed tissue remodeling (hematoxylin and eosin), adipogenesis (perilipin), and angiogenesis (Masson's trichrome) occurred with the presence of AAM. CONCLUSIONS AAM is a safe, allogeneic, off-the-shelf regenerative matrix that is adipogenic and noninflammatory and promotes angiogenesis.
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Affiliation(s)
- Lauren E. Kokai
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
- McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Wesley N. Sivak
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Benjamin K. Schilling
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pa
| | | | - Francesco M. Egro
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - M. Asher Schusterman
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Danielle M. Minteer
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
- McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Patsy Simon
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
- McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
| | - Richard A. D’Amico
- Department of Plastic Surgery, Mount Sinai School of Medicine, New York, N.Y
| | - J. Peter Rubin
- From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pa
- McGowan Institute for Regenerative Medicine, Pittsburgh, Pa
- Division of Molecular & Genomic Pathology, Pittsburgh, Pa
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Role of Autologous Fat Injection in Neglected Patients With Anterior Plagiocephaly. J Craniofac Surg 2019; 30:e637-e639. [DOI: 10.1097/scs.0000000000005662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cabrejo R, Sawh-Martinez R, Steinbacher DM. Effect of Fat Grafting on Postoperative Edema After Orthognathic Surgery. J Craniofac Surg 2019; 30:698-702. [DOI: 10.1097/scs.0000000000005287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Virtual Surgical Planning and Three-Dimensional Printed Guide for Soft Tissue Correction in Facial Asymmetry. J Craniofac Surg 2019; 30:846-850. [DOI: 10.1097/scs.0000000000005204] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Facial aesthetic fat graft retention rates after filtration, centrifugation, or sedimentation processing techniques measured using three-dimensional surface imaging devices. Chin Med J (Engl) 2019; 132:69-77. [PMID: 30628961 PMCID: PMC6629306 DOI: 10.1097/cm9.0000000000000016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE How to increase the long-term retention rate of autologous fat grafting has been widely discussed. This study aimed to evaluate long-term fat graft retention rates for the most widely used fat processing methods in the area of facial esthetic surgery, including centrifugation, filtration, and sedimentation, using three-dimensional (3D) imaging. DATA SOURCES PubMed, Embase, Wiley/Cochrane Library, and Web of Science databases were comprehensively searched from inception to July 2018 according to the guidelines of the American Society of Plastic Surgeons Fat Graft Task Force Assessment Methodology. STUDY SELECTION Articles were screened using predetermined inclusion and exclusion criteria. Data collected included patient characteristics, follow-up devices, fat grafting techniques, and clinical outcomes. Patient cohorts were pooled, and fat graft retention rates were calculated. Complications were summarized according to different clinical characteristics. RESULTS Of 77 articles, 10 clinical studies met the inclusion criteria and reported quantified measurement outcomes with 3D imaging which provide precise volumetric data with approximately 2% standard deviation compared to real volumes. Data of 515 patients were included. Fat grafting retention varied from 21% to 82%. We found filtration and centrifugation techniques could result in better retention outcomes. However, retention varied within each processing technique, with no significant difference among the 3 techniques. Twenty-two complications were reported among 515 patients, including donor-site hematoma (1 case), mild post-operative erythema (2 cases), mild volumetric asymmetries (2 cases), chronic edema (2 cases), overcorrection (2 cases), skin irregularity (6 cases), and headache or dysesthesia (7 cases). CONCLUSIONS Filtration and centrifugation techniques may result in better fat grafting retention outcomes than gravity sedimentation; however, more accurate statistical evidence is needed. Controversies continue to exist with respect to the performance of the different fat-processing techniques in fat graft retention.
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Adipogenic differentiation of murine bone marrow mesenchymal stem cells induced by visible light via photo- induced biomodulation. Photodiagnosis Photodyn Ther 2019; 25:119-127. [DOI: 10.1016/j.pdpdt.2018.11.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 11/13/2018] [Accepted: 11/16/2018] [Indexed: 12/13/2022]
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Objective and Subjective Evaluation of Lipoinjection for Correction of Temporal Depression. Dermatol Surg 2019; 45:1374-1380. [PMID: 30720496 DOI: 10.1097/dss.0000000000001792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Temporal depression is commonly found among people. OBJECTIVE Objective and subjective evaluation of lipoinjection for correction of temporal depression. METHODS From November 2012 to January 2018, 34 healthy female subjects underwent temporal augmentation by lipoinjection on both sides. Efficacy was assessed by objective and subjective parameters. The quantitative measurement of the temporal defect was obtained using molded plasticine preoperatively and 12 months after treatment. The subjective assessment consisted of excellent, good, fair, and poor results based on the patients' self-evaluations. The adverse events were recorded. RESULTS The follow-up period ranged from 12 to 36 months. It was found that a statistically significant difference existed between the preoperative and postoperative defect on both temples. Regarding the patients' self-evaluations, 17 patients (50.0%) reported feeling excellent, 15 patients (44.1%) as good, and 2 patients (5.9%) as fair, and no patient as poor. After the statistical analysis, it was found that the volumetric restoration rate of the grafted fat decreased as the temporal defect generally increased during the aging process. Injection-site swelling and bruising were commonly found complications; other complications were not found. CONCLUSION Autologous fat is inexpensive and readily available. Fat grafting is an alternative for correction of temporal depression.
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Jan SN, Bashir MM, Khan FA, Hidayat Z, Ansari HH, Sohail M, Bajwa AB, Shami HB, Hanif A, Aziz F, Choudhery MS. Unfiltered Nanofat Injections Rejuvenate Postburn Scars of Face. Ann Plast Surg 2019; 82:28-33. [PMID: 30285990 DOI: 10.1097/sap.0000000000001631] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of this study was to compare the quality of postburn facial scars before and after injection of unfiltered nanofat. The study was performed in the Plastic Surgery Department of Mayo Hospital, Lahore, Pakistan, from January 2015 to December 2016. Forty-eight patients with postburn facial scars were included; age range was 4 to 32 years with Fitzpatrick skin types between 3 and 4. Patients with hypertrophic scars, contractures, or keloids were excluded. Scars were assessed by a senior plastic surgeon and the patient on the POSAS (Patient Observer Scar Assessment Scale). Fat was harvested from the abdomen and/or thighs with a 3-mm multiport liposuction cannula (containing several sharp side holes of 1 mm) using Coleman technique. The harvested fat was emulsified and transferred into 1-mL Luer-Lock syringes for injection into the subdermal or intradermal plane. Final follow-up was scheduled at 6 months, and scar was rated by the patient and the same surgeon on the POSAS. Preoperative and postoperative scar scores were compared, and P values were calculated. Results indicated that after nanofat grafting, there was a statistically significant improvement in scar quality. The most significant improvements on the observer scale were seen in pigmentation and pliability (P < 0.0001). Thickness and relief were the least improved variables (P = of 0.785 and 0.99, respectively). ImageJ scanning also showed pigmentation change (P = 0.076). A statistically significant improvement was seen in all parameters of the patient section of the POSAS (P < 0.0001). In conclusion, unfiltered nanofat grafting seems to be a promising and effective therapeutic approach in postburn facial scars, showing significant improvement in scar quality. The trial was registered on www.clinicaltrials.gov with following ID NCT03352297.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Faiza Aziz
- Tissue Engineering and Regenerative Medicine Laboratory, King Edward Medical University, Lahore, Pakistan
| | - Mahmood S Choudhery
- Tissue Engineering and Regenerative Medicine Laboratory, King Edward Medical University, Lahore, Pakistan
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Baum SH, Rieger G, Pförtner R, Mohr C. Correction of whistle deformity using autologous free fat grafting: first results of a pilot study and review of the literature. Oral Maxillofac Surg 2017; 21:409-418. [PMID: 28920163 DOI: 10.1007/s10006-017-0648-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/30/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Whistle deformities are frequent sequelae after surgical correction of cleft lip, trauma, or tumor excision. The aim of this study was to examine the role of autologous free fat grafting in the reconstruction of whistle deformity. PATIENTS Fifteen patients with whistle deformity were enrolled in this pilot study. The mean follow-up period was 19 months. Liposuction was done followed by the replantation of an average of 2.2 ml autologous fat per patient (range 0.7-4 ml). An overcorrection was performed in all patients. RESULTS All the patients showed improvements in whistle deformity. The mean resorption rate was 53% (range 30-80%). Three patients (20%) were not satisfied with the postoperative result. Six complications were assessed (4× feeling of pressure [27%], one hematoma [7%], one recurrent pain [7%]), but a major complication did not occur. REVIEW We also present a review of the literature with different techniques that were described in the last 20 years. CONCLUSION Autologous free fat graftings for reconstruction of whistle deformity represent a reliable method with a low complication rate. However, the resorption rate is unpredictable. If necessary, several autologous fat transplantations should be conducted at an interval of at least 6 months.
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Affiliation(s)
- Sven Holger Baum
- Department of Oral and Maxillofacial Surgery, University Essen, Kliniken-Essen-Mitte, Henricistr. 92, 45136, Essen, Germany.
| | - Gunnar Rieger
- Department of Oral and Maxillofacial Surgery, University Essen, Kliniken-Essen-Mitte, Henricistr. 92, 45136, Essen, Germany
| | - Roman Pförtner
- Department of Oral and Maxillofacial Surgery, University Essen, Kliniken-Essen-Mitte, Henricistr. 92, 45136, Essen, Germany
| | - Christopher Mohr
- Department of Oral and Maxillofacial Surgery, University Essen, Kliniken-Essen-Mitte, Henricistr. 92, 45136, Essen, Germany
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Silva VZDA, Albacete A, Horácio GDES, Andrade GAMDE, Procópio LD, Coltro PS, Farina JA. Evidences of autologous fat grafting for the treatment of keloids and hypertrophic scars. Rev Assoc Med Bras (1992) 2017; 62:862-866. [PMID: 28001261 DOI: 10.1590/1806-9282.62.09.862] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 02/15/2016] [Indexed: 02/02/2023] Open
Abstract
Introduction Since the 1980s, the use of autologous fat grafting has been growing in plastic surgery. Recently, this procedure has come to be used as a treatment for keloids and hypertrophic scars mainly due to the lack of satisfactory results with other techniques. So far, however, it lacks more consistent scientific evidence to recommend its use. The aim of this study was to review the current state of autologous fat grafting for the treatment of keloids and hypertrophic scars, their benefits and scientific evidences in the literature. Method A review in the Pubmed database was performed using the keywords "fat grafting and scar", "fat grafting and keloid scar" and "fat grafting and hypertrophic scar." Inclusion criteria were articles written in English and published in the last 10 years, resulting in 15 studies. Results These articles indicate that autologous fat grafting carried out at sites with pathological scars leads to a reduction of the fibrosis and pain, an increased range of movement in areas of scar contraction, an increase in their flexibility, resulting in a better quality of scars. Conclusion So far, evidences suggest that autologous fat grafting for the treatment of keloids and hypertrophic scars is associated with a better quality of scars, leading to esthetic and functional benefits. However, this review has limitations and these findings should be treated with reservations, since they mostly came from studies with low levels of evidence.
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Affiliation(s)
- Vinícius Zolezi DA Silva
- Resident Plastic Surgeon, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Antonio Albacete
- Resident Plastic Surgeon, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Grazielle DE Souza Horácio
- Resident Plastic Surgeon, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Guilherme Augusto Magalhães DE Andrade
- Resident Plastic Surgeon, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Leandro Debs Procópio
- Plastic Surgeon, Full Member of the Sociedade Brasileira de Cirurgia Plástica (SBCP), Ribeirão Preto, SP, Brazil
| | - Pedro Soler Coltro
- PhD Professor, Division of Plastic Surgery, FMRP-USP, Ribeirão Preto, SP, Brazil
| | - Jayme Adriano Farina
- PhD Professor and Head of the Division of Plastic Surgery, FMRP-USP, Ribeirão Preto, SP, Brazil
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Hu X, Xue Z, Qi H, Chen B. Comparative study of autologous fat vs hyaluronic acid in correction of the nasolabial folds. J Cosmet Dermatol 2017; 16:e1-e8. [PMID: 28294535 DOI: 10.1111/jocd.12333] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVE In the article, comparison of the hyaluronic acid (HA) and autologous fat is conducted to evaluate the effectiveness and safety in correction of the nasolabial folds (NLFs). METHODS From November 2012 to December 2015, a single-blinded, randomized study was conducted. Sixty-two patients were included in the study, and 57 of them completed the whole procedure. The patients were randomly allocated to receive the treatments of HA or fat in both NLFs. The Wrinkle Severity Rating Scale (WSRS) and Global Aesthetic Improvement Scale (GAIS) were used for assessment. Efficacy was assessed using two parameters: evaluation of final improvement by blinded evaluator and patient-self using photographs. The effectiveness endpoint was improvement of scores at 1, 3, 6, 9, and 12 months from baseline. The adverse events (AEs) were recorded. RESULTS In the blinded evaluator scores for NLF in accordance with WSRS, there were no significant differences between the two methods within 9 months. A statistically significant difference between the lipoinjection and HA groups was found at 12-month follow-up period. Subjects' self-assessment was similar to the results seen for the evaluator scores. The difference of AEs between the HA and fat group was obvious in the early stage of recovery. In the later stage, the AEs of the HA and fat group were similar. CONCLUSIONS Both HA gel and autologous fat provide augmentation of NLFs. The magnitude and duration of NLF correction appear to be similarly effective and safe within a period.
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Affiliation(s)
- Xiaogen Hu
- Plastic Surgery Department, China Japan Friendship Hospital, Beijing, China
| | - Zhiqiang Xue
- Plastic Surgery Department, China Japan Friendship Hospital, Beijing, China
| | - Huijie Qi
- Plastic Surgery Department, China Japan Friendship Hospital, Beijing, China
| | - Bo Chen
- Plastic Surgery Department, China Japan Friendship Hospital, Beijing, China
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[Reconstruction of proximal nasal defect after deep carcinological resection. Interest to combine titane mesh with fat grafting]. ANN CHIR PLAST ESTH 2016; 62:181-186. [PMID: 27894610 DOI: 10.1016/j.anplas.2016.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/03/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The mucosal cylindroma or adenoid cystic carcinoma is the second sinonasal non-epithelial malignant tumor frequency argument. Due to the achievement of the nasal mucosa and a late diagnosis reconstructions are often complex. We report the case of a mucous cylindroma recurrence of nasal septum requiring a wide and deep excision of the root of the nose with nasal reconstruction. CASE REPORT A patient aged 66 years whose history resection two years ago with a mucous adenoid cystic carcinoma of the right side of the nasal septum, had a local recurrence T2NOM0 imposing a wide excision with amputation nasal septum own bones of nose, the anterior portion of the triangular cartilages. The reconstruction was carried out in three areas: a musculocutaneous forehead flap to the mucosal level, a titanium plate to the bone plane, nasal native skin to skin level. Histological examination confirmed the existence of a recurrence cylindroma infiltrating the bone. The surgical margins were however in sano. Adjuvant radiotherapy to 60Gy dose of the surgical area was indicated after surgery. The consequences of surgery and radiotherapy were simple. However local changes to show a progressive refinement of the nasal skin due to irradiation leading to a small titanium plate exposure revision surgery with coverage by a glabellar flap associated with a time of lipomodeling unexposed areas have improved and trophism of soft tissue. Two further lipomodeling sessions have yielded a good quality and stable skin. From an oncological point of view, no recurrence was detected with a decline of 10 years. Aesthetic and functional point of view the results were highly satisfactory. DISCUSSION Oncologic resections subtotal nasal pyramid are complex, we will see the benefits and disadvantages of the different techniques used in the different stages. CONCLUSION This case report illustrates the difficulties of reconstruction after wide excision of mucosal lesions root of the nose carrying the mucous plan and nasal bones. It stresses the importance of bone reconstruction titanium plate and innovative element, the efficiency of fat transfer to restore the quality and trophicity soft tissue. Fat transfer in addition to reconstructions by titanium plates and splints may thus expand the indications of these types of techniques in complex facial and cranial reconstructions.
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Zollino I, Zuolo M, Gianesini S, Pedriali M, Sibilla MG, Tessari M, Carinci F, Occhionorelli S, Zamboni P. Autologous adipose-derived stem cells: Basic science, technique, and rationale for application in ulcer and wound healing. Phlebology 2016; 32:160-171. [PMID: 27056621 DOI: 10.1177/0268355516641546] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives The present review represents a translational boundary between basic research and surgery, particularly focusing on the promising application of adipose-derived stem cells harvested intra-operatively during debridement of venous leg ulcers. Methods We reviewed 830 out of 5578 articles on MEDLINE starting from 1997 and sorted by the relevance option. Results The technique currently used for adipose-derived stem cells intra-operative harvesting is presented, including a safety evaluation on a cohort of 5089 revised patients who underwent plastic surgery and maxillo-facial surgical procedures. Complications were reported in 169 cases (3.3%). One hundred and forty-one (2.77%) patients were classified as having minor complications, specifically: nodularity/induration 93 (1.83%), dysesthesia 14 (0.26%), hematoma 12 (0.23%), superficial infection 11 (0.21%), pain 7 (0.13%), poor cosmesis 3 (0.06%), and abnormal breast secretion 1 (0.02%), while 28 patients (0.55%) were classified as having major complications, specifically: deep infection 22 (0.43%), sepsis 3 (0.06%), abdominal hematoma 2 (0.04%), and pneumothorax 1 (0.02%). Application of cell therapy in venous leg ulcer is currently used only for patients not responding to the standard treatment. The review shows the lack of randomized clinical trials for application of adipose-derived stem cells among treatments for venous leg ulcer. Finally, adipose-derived stem cells implantation at the wound site promotes a new tissue formation rich in vascular structures and remodeling collagen. Conclusion Adipose-derived stem cells strategy represents a great opportunity for the treatment of chronic wounds, due to the simplicity of the technique and the application of cell treatment in the operating room immediately following debridement. However, clinical studies and data from randomized trials are currently lacking.
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Affiliation(s)
- Ilaria Zollino
- 1 Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and Surgery, University of Ferrara, Italy
| | - Michele Zuolo
- 2 Unit of Translational Surgery and Vascular Diseases Center, Sant'Anna University Hospital, Ferrara, Italy
| | - Sergio Gianesini
- 1 Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and Surgery, University of Ferrara, Italy.,2 Unit of Translational Surgery and Vascular Diseases Center, Sant'Anna University Hospital, Ferrara, Italy
| | - Massimo Pedriali
- 3 Department of Experimental and Diagnostic Medicine, Sant'Anna University Hospital, Ferrara, Italy
| | - Maria Grazia Sibilla
- 2 Unit of Translational Surgery and Vascular Diseases Center, Sant'Anna University Hospital, Ferrara, Italy
| | - Mirko Tessari
- 1 Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and Surgery, University of Ferrara, Italy.,2 Unit of Translational Surgery and Vascular Diseases Center, Sant'Anna University Hospital, Ferrara, Italy
| | - Francesco Carinci
- 1 Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and Surgery, University of Ferrara, Italy
| | - Savino Occhionorelli
- 1 Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and Surgery, University of Ferrara, Italy.,2 Unit of Translational Surgery and Vascular Diseases Center, Sant'Anna University Hospital, Ferrara, Italy
| | - Paolo Zamboni
- 1 Department of Morphology, Surgery and Experimental Medicine, Section of Translational of Medicine and Surgery, University of Ferrara, Italy.,2 Unit of Translational Surgery and Vascular Diseases Center, Sant'Anna University Hospital, Ferrara, Italy
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Kao WP, Lin YN, Lin TY, Huang YH, Chou CK, Takahashi H, Shieh TY, Chang KP, Lee SS, Lai CS, Lin SD, Lin TM. Microautologous Fat Transplantation for Primary Augmentation Rhinoplasty: Long-Term Monitoring of 198 Asian Patients. Aesthet Surg J 2016; 36:648-56. [PMID: 26764261 PMCID: PMC5127412 DOI: 10.1093/asj/sjv253] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 12/11/2022] Open
Abstract
Background Numerous techniques and materials are available for increasing the dorsal height and length of the nose. Microautologous fat transplantation (MAFT) may be an appropriate strategy for augmentation rhinoplasty. Objectives The authors sought to determine the long-term results of MAFT with the so-called one-third maneuver in Asian patients who underwent augmentation rhinoplasty. Methods A total of 198 patients who underwent primary augmentation rhinoplasty with MAFT were evaluated in a retrospective study. Fat was harvested by liposuction and was processed and refined by centrifugation. Minute parcels of purified fat were transplanted to the nasal dorsum with a MAFT-Gun. Patient satisfaction was scored with a 5-point Likert scale, and aesthetic outcomes were validated with pre- and postoperative photographs. Results The mean age of the patients was 45.5 years. The mean operating time for MAFT was 25 minutes, and patients underwent 1-3 MAFT sessions. The mean volume of fat delivered per session was 3.4 mL (range, 2.0-5.5 mL). Patients received follow-up for an average of 19 months (range, 6-42 months). Overall, 125 of 198 patients (63.1%) indicated that they were satisfied with the results of 1-3 sessions of MAFT. There were no major complications. Conclusions The results of this study support MAFT as an appropriate fat-transfer strategy for Asian patients undergoing primary augmentation rhinoplasty. Level of Evidence: 4
Therapeutic
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Affiliation(s)
- Wen-Pin Kao
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Yun-Nan Lin
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Tsung-Ying Lin
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Yu-Hao Huang
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Chih-Kang Chou
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Hidenobu Takahashi
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Tung-Ying Shieh
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Kao-Ping Chang
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Su-Shin Lee
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Chung-Sheng Lai
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Sin-Daw Lin
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
| | - Tsai-Ming Lin
- Dr Kao is a Plastic Surgeon, Division of Plastic Surgery, Changhua Christian Hospital, Chang-Hua, Taiwan. Drs Y-N Lin, Shieh, and Huang are Plastic Surgeons; Drs Chang, Lai, and S-D Lin are Professors; Dr Lee is an Associate Professor; and Dr T-M Lin is a Clinical Professor, Department of Plastic Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan. Dr T-Y Lin is a Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Division of Plastic Surgery, Kaohsiung Medical University. Dr Chou is a Plastic Surgeon, Yuan's General Hospital, Kaohsiung, Taiwan. Mr Takahashi is a medical student, Department of Post Baccalaureate Medicine, Kaohsiung Medical University
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Huang SH, Wu SH, Chang KP, Lin CH, Chang CH, Wu YC, Lee SS, Lin SD, Lai CS. Alleviation of neuropathic scar pain using autologous fat grafting. Ann Plast Surg 2016; 74 Suppl 2:S99-104. [PMID: 25695456 DOI: 10.1097/sap.0000000000000462] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Traumatic wounds inflict small- and large-fiber sensory nerve damage, causing neuropathic pain in scar tissue, thus impairing patients' quality of life and leading to the development of psychological disorders. Autologous fat grafting has been clinically shown to improve scar quality, but few studies have explored the effects of this technique on pain. The purpose of this study was to assess the effect of fat grafting on treating neuropathic scar pain. From February 2008 to January 2013, 13 patients who were identified using the Douleur Neuropathique 4 Questions (scores>4/10) were enrolled in this study. The Visual Analog Scale (VAS) and Neuropathic Pain Symptom Inventory (NPSI) were used to evaluate pain preoperatively and 1 week, 4 weeks, and 24 weeks postoperatively. The mechanism of trauma, scar location and size, duration of allodynia, fat graft volume, pharmacologic therapy duration, and total follow-up time were recorded. Thirteen patients experiencing neuropathic pain were enrolled in this study. The mean±SD age was 33.08±16.35 years. The mean duration of pain was 4.29±2.85 months. The mean VAS score before treatment was 7.54±1.05. The mean VAS scores decreased by 4.38±1.66 after 1 week of treatment (P=0.009), 5.38±2.06 after 4 weeks of treatment, and 5.62±2.18 after 24 weeks of treatment. The mean NPSI scores were 49.38±13.25 before treatment, 25±14.4 after 1 week of treatment (P=0.004), 21±17.78 after 4 weeks of treatment, and 14.62±16.88 after 24 weeks of treatment. The 13 patients followed a mean of 24 weeks; 10 (77%) of the patients had improvement of 5 or greater on the VAS score. The mean follow-up period was 19.3±12.26 months (range, 6-38 months). No surgical complications were noted in this series. In our study, both VAS and NPSI scores decreased significantly, revealing that the autologous fat grafting can alleviate neuropathic scar pain 1 week after operation and in the long term.
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Affiliation(s)
- Shu-Hung Huang
- From the *Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, †Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ‡Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, §Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan, and ∥Department of Anesthesia, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Boureaux E, Chaput B, Bannani S, Herlin C, De Runz A, Carloni R, Mortemousque B, Mouriaux F, Watier E, Bertheuil N. Eyelid fat grafting: Indications, operative technique and complications; a systematic review. J Craniomaxillofac Surg 2016; 44:374-80. [PMID: 26880013 DOI: 10.1016/j.jcms.2015.12.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/24/2015] [Accepted: 12/23/2015] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Many recent studies concerning autologous fat grafting in the eyelids have been published, mostly consisting of case reports and retrospective case series. However, no study on the overall complication or satisfaction rate associated with the various grafting techniques exists. We performed a comprehensive literature review to determine the outcomes and complications of eyelid fat grafting, as well as patient satisfaction. METHODS A systematic review of the literature using the PRISMA criteria was conducted. This protocol was registered at the Prospective Register of Systematic Reviews at the National Institute for Health Research. RESULTS Sixteen studies, representing 1,159 patients and published between June 2004 and December 2014, were included. Satisfactory results, judged by clinical examination, were observed in all studies. Few postoperative complications were reported. CONCLUSIONS We demonstrated that the procedures were easy to perform, and achieved satisfactory and sustainable results with few complications in both reconstructive and cosmetic surgery. However, a wide disparity exists in the various fat harvesting, fat purification, and reinjection techniques. Further studies are required to assess the long-term outcomes. Our conclusions should be accepted cautiously due to the small number of articles and the lack of evidence in published studies.
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Affiliation(s)
- Elodie Boureaux
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France; Department of Ophthalmology, Pontchaillou Hospital, University of Rennes 1, Rennes, France
| | - Benoit Chaput
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rangueil Hospital, Toulouse, France
| | - Sahar Bannani
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - Christian Herlin
- Department of Plastic and Reconstructive Surgery, Lapeyronie Burn Center, CHU of Montpellier, Montpellier, France
| | - Antoine De Runz
- Department of Maxillofacial, Plastic, Reconstructive and Cosmetic Surgery, CHU of Nancy, Nancy, France
| | - Raphael Carloni
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France
| | - Bruno Mortemousque
- Department of Ophthalmology, Pontchaillou Hospital, University of Rennes 1, Rennes, France
| | - Frederic Mouriaux
- Department of Ophthalmology, Pontchaillou Hospital, University of Rennes 1, Rennes, France
| | - Eric Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France; INSERM U917, University of Rennes 1, Rennes, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France; INSERM U917, University of Rennes 1, Rennes, France; SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, Rennes, France; Stromalab Laboratory, UMR5273 CNRS/UPS/EFS - INSERM U1031, Rangueil Hospital, Toulouse, France.
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The Current State of Fat Grafting: A Review of Harvesting, Processing, and Injection Techniques. Plast Reconstr Surg 2016; 136:897-912. [PMID: 26086386 DOI: 10.1097/prs.0000000000001590] [Citation(s) in RCA: 266] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Interest in and acceptance of autologous fat grafting for use in contour abnormalities, breast reconstruction, and cosmetic procedures have increased. However, there are many procedural variations that alter the effectiveness of the procedure and may account for the unpredictable resorption rates observed. METHODS The authors highlighted studies investigating the effects of harvesting procedures, processing techniques, and reinjection methods on the survival of fat grafts. This review focused on the impact different techniques have on outcomes observed in the following: in vitro analyses, in vivo animal experiments, and human studies. RESULTS This systemic review revealed the current state of the literature. There was no significant difference in the outcomes of grafted fat obtained from different donor sites, different donor-site preparations, harvest technique, fat harvesting cannula size, or centrifugation speed, when tumescent solution was used. Gauze rolling was found to enhance the volume of grafted fat, and no significant difference in retention was observed following centrifugation, filtration, or sedimentation in animal experiments. In contrast, clinical studies in patients found more favorable outcomes with fat processed by centrifugation compared with sedimentation. In addition, higher retention was observed with slower reinjection speed and when introduced into less mobile areas. CONCLUSIONS There has been a substantial increase in research interest to identify methodologies for optimizing fat graft survival. Despite some differences in harvest and implantation technique in the laboratory, these findings have not translated into a universal protocol for fat grafting. Therefore, additional human studies are necessary to aid in the development of a universal protocol for clinical practice.
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Abstract
OBJECTIVE This study aimed to compare the graft survival rates of various ratios of fat particles to stromal vascular fraction (SVF) in rabbits. METHODS Fifteen purebred white rabbits of the same brood were used. In the study, the grafts of equal weight (0.8 g) were mixtures of fat particles with various proportions of SVF (1/3, 1/4, 1/5, and 1/6) to form 4 treated groups (I, II, III, and IV), whereas merely fat particles formed 1 control group. They were randomly autoimplanted into subcutaneous pockets on both sides of the dorsal midlines of the rabbits. Animals were killed 3 months after surgery. The grafts were harvested and weighed. Comparisons were performed between the groups for survival rates. RESULTS The treated group II (fat particle-to-SVF ratio was 3:1) revealed the greatest weight maintenance in all of the groups, showing the greatest survival rate [87.94% (1.30%), P < 0.01 or P < 0.05]. CONCLUSIONS It was suggested that the optimal fat particle-to-SVF ratio might be 3:1, with a low resorption rate.
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Abstract
The authors reported their surgical experience about structural fat grafting in
the management of facial volumetric deficit. The purpose of this study was to
assess the real indications, cosmetic results, complications, and global patient
satisfaction of the Coleman technique in redefining facial contours in
congenital and postoperative deformities. A retrospective analysis of 32
patients grafted according to Coleman's technique was performed, and the
long-term outcomes and patient satisfaction were evaluated. The mean
postoperative clinical follow-up was 14 months. The morphological changes were
analyzed by comparing the photographic presurgical facial contour and the
postoperative correction of soft tissue defects. All consecutive cases reported
showed a progressive fat resorption for 3 months after surgery and its stable
integration only after this period. Best results were performed in the treatment
of genetically determined syndromes, such as the Franceschetti and Romberg
syndromes. The authors suggest this surgical technique also for the treatment of
unaesthetic cutaneous abscess cavity after incision and drainage. Unsatisfactory
outcomes were obtained in the treatment of the posttraumatic facial scar, which
needed more surgical procedures.
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Clauser L, Elia G, Candotto V, Gafà R, Galié M. Recidiva di ameloblastoma della mandibola: descrizione di un caso clinico. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)30106-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The versatility of autologous fat transplantation in correction of facial deformities: a single-center experience. PLASTIC SURGERY INTERNATIONAL 2015; 2015:703535. [PMID: 25821598 PMCID: PMC4363609 DOI: 10.1155/2015/703535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 02/19/2015] [Accepted: 02/19/2015] [Indexed: 11/18/2022]
Abstract
Deformities in the craniofacial region are of great social and functional importance. Several surgical techniques have been used to treat such pathologies often with high morbidity and lacking the ability to address smaller contour defects. The minimally invasive technique of fat transplantation has evolved rapidly within the last few decades. The objective of this paper is to present the versatility and applicability of fat transplantation in a wide range of contour deformities in the craniofacial region. We share our experiences in treating 13 patients with autoimmune disorders, congenital malformations, and acquired defects. Future perspectives of fat transplantation in the field of craniofacial reconstruction are discussed.
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Fat Graft Viability in the Subcutaneous Plane versus the Local Fat Pad. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 2:e260. [PMID: 25587494 PMCID: PMC4292242 DOI: 10.1097/gox.0000000000000228] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 10/08/2014] [Indexed: 01/22/2023]
Abstract
Background: Fat grafting has been increasingly utilized in both aesthetic and reconstructive surgical procedures, yet the basic scientific understanding of fat grafting has lagged behind the pace of clinical innovation and utilization. This lack of basic scientific understanding has perhaps manifested itself in the wide range of graft viability reported across the literature. This study attempts to further the underlying mechanisms of fat graft take and viability through the comparison of the subcutaneous plane and the local fat pad in athymic rats. Methods: Lipoaspirate from a consenting patient was grafted into 2 locations in the subcutaneous plane and into the 2 inguinal fat pads in each of 4 athymic rats. Specimens were then collected after 47 days, and immunohistochemistry was utilized to determine angiogenesis in the fat grafts as a measure of fat graft take. Data were analyzed using the Student’s t test and analysis of variance followed by multiple comparisons. Results: There was no statistically significant difference (P = 0.2913) between the inguinal fat pad and the subcutaneous plane when measuring neovascularization. Analysis of variance comparing the graft locations also indicated no statistically significant difference when comparing each of the rats. Conclusions: Investigation into fat graft injection location indicates that there is no statistically significant difference in angiogenesis signals between the subcutaneous plane and the local fat pad in the athymic rat model. Further research should aim to continue to close the gap between clinical practice and basic scientific understanding of fat grafting.
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Clauser L, Ferroni L, Gardin C, Tieghi R, Galiè M, Elia G, Piattelli A, Pinton P, Bressan E, Zavan B. Selective augmentation of stem cell populations in structural fat grafts for maxillofacial surgery. PLoS One 2014; 9:e110796. [PMID: 25375632 PMCID: PMC4222876 DOI: 10.1371/journal.pone.0110796] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 09/01/2014] [Indexed: 11/18/2022] Open
Abstract
Structural fat grafting utilizes the centrifugation of liposuction aspirates to create a graded density of adipose tissue. This study was performed to qualitatively investigate the effects of centrifugation on stem cells present in adipose tissue. Liposuction aspirates were obtained from healthy donors and either not centrifuged or centrifuged at 1,800 rpm for 3 minutes. The obtained fat volumes were divided into three layers and then analyzed. The results demonstrate that centrifugation induces a different distribution of stem cells in the three layers. The high-density layer displays the highest expression of mesenchymal stem cell and endothelial markers. The low-density layer exhibits an enrichment of multipotent stem cells. We conclude that appropriate centrifugation concentrates stem cells. This finding may influence the clinical practice of liposuction aspirate centrifugation and enhance graft uptake.
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Affiliation(s)
- Luigi Clauser
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery – Reference Center for Rare Disease, Sant'Anna Hospital and University, Cona, Ferrara, Italy
| | - Letizia Ferroni
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Chiara Gardin
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Riccardo Tieghi
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery – Reference Center for Rare Disease, Sant'Anna Hospital and University, Cona, Ferrara, Italy
| | - Manlio Galiè
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery – Reference Center for Rare Disease, Sant'Anna Hospital and University, Cona, Ferrara, Italy
| | - Giovanni Elia
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery – Reference Center for Rare Disease, Sant'Anna Hospital and University, Cona, Ferrara, Italy
| | - Adriano Piattelli
- Department of Medical, Oral, and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Paolo Pinton
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Eriberto Bressan
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Barbara Zavan
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- * E-mail:
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Clauser LC, Consorti G, Elia G, Galié M, Tieghi R. Three-dimensional volumetric restoration by structural fat grafting. Craniomaxillofac Trauma Reconstr 2014; 7:63-70. [PMID: 24624259 DOI: 10.1055/s-0033-1356757] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 01/10/2013] [Indexed: 10/25/2022] Open
Abstract
The use of adipose tissue transfer for correction of maxillofacial defects was reported for the first time at the end of the 19th century. Structural fat grafting (SFG) was introduced as a way to improve facial esthetics and in recent years has evolved into applications in craniomaxillofacial reconstructive surgery. Several techniques have been proposed for harvesting and grafting the fat. However, owing to the damage of many adipocytes during these maneuvers, the results have not been satisfactory and have required several fat injection procedures for small corrections. The author's (L.C.) overview the application of SFG in the management of volumetric deficit in the craniomaxillofacial in patients treated with a long-term follow-up.
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Affiliation(s)
- Luigi C Clauser
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery, Ferrara, Italy
| | - Giuseppe Consorti
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery, Ferrara, Italy
| | - Giovanni Elia
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery, Ferrara, Italy
| | - Manlio Galié
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery, Ferrara, Italy
| | - Riccardo Tieghi
- Unit of Cranio Maxillo Facial Surgery, Center for Craniofacial Deformities and Orbital Surgery, Ferrara, Italy
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Rieck KL, Fillmore WJ, Ettinger KS. Late revision or correction of facial trauma-related soft-tissue deformities. Oral Maxillofac Surg Clin North Am 2013; 25:697-713. [PMID: 24183375 DOI: 10.1016/j.coms.2013.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Surgical approaches used in accessing the facial skeleton for fracture repair are often the same as or similar to those used for cosmetic enhancement of the face. Rarely does facial trauma result in injuries that do not in some way affect the facial soft-tissue envelope either directly or as sequelae of the surgical repair. Knowledge of both skeletal and facial soft-tissue anatomy is paramount to successful clinical outcomes. Facial soft-tissue deformities can arise that require specific evaluation and management for correction. This article focuses on revision and correction of these soft-tissue-related injuries secondary to facial trauma.
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Affiliation(s)
- Kevin L Rieck
- Division of Oral & Maxillofacial Surgery, Department of Surgery, Mayo College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA.
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Cugno S, Farhadieh RD, Bulstrode NW. Autologous microtia reconstruction combined with ancillary procedures: a comprehensive reconstructive approach. J Plast Reconstr Aesthet Surg 2013; 66:1487-93. [PMID: 23938195 DOI: 10.1016/j.bjps.2013.06.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 04/14/2013] [Accepted: 06/18/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Autologous microtia reconstruction is generally performed in two stages. The second stage presents a unique opportunity to carry out other complementary procedures. The present study describes our approach to microtia reconstruction, wherein the second stage of reconstruction is combined with final refinements to the ear construct and/or additional procedures to enhance facial contour and symmetry. METHODS Retrospective analysis of patients who underwent two-stage microtia reconstruction by a single surgeon (NWB) was conducted in order to ascertain those that had ancillary procedures at the time of the second stage. Patient and operative details were collected. RESULTS Thirty-four patients (male, 15, median age and age range at second stage, 11 and 10-18 years, respectively) who had complementary procedures executed during the second stage of auricular reconstruction were identified. Collectively, these included centralizing genioplasty (n = 1), fat transfer (n = 22), ear piercing (n = 7), and contralateral prominauris correction (n = 7). Six patients had correction for unilateral isolated microtia and in the remaining 28 patients, auricular reconstruction for microtia associated with a named syndrome. All patients reported a high rate of satisfaction with the result achieved and the majority (85%) reported no perceived need for additional surgical refinements to the ear or procedure(s) to achieve further facial symmetry. No peri- or post-operative complications were noted. CONCLUSION Combining the final stage of autologous microtia reconstruction with other ancillary procedures affords a superior aesthetic outcome and decreased patient morbidity.
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Affiliation(s)
- S Cugno
- Department of Plastic Surgery, Great Ormond Street Hospital for Children NHS Trust, Level 7, Paul O'Gorman Building, Great Ormond Street, London WC1N 3JH, United Kingdom.
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