Regenerative and stem cell-based techniques for facial rejuvenation

"SAVE"-Shock-Assisted Viable Extraction: A Minimally Manipulative Method of Processing Regenerative Cells for Clinical Use

Background

Extraction of adipose-derived stem cells (ASCs) from the stromal vascular fraction (SVF) has gained significant attention lately in the realm of regenerative medicine. However, finding highly efficient methods of extraction that also comply with the US regulations has prevented widespread clinical use.

Objectives

The objective of this study was to evaluate a novel ASC extraction device to quantify viable ASC extraction and processing efficiency.

Methods

SVF extracted from abdominal fat samples and processed using a novel shock-assisted viable extraction (SAVE) device was tested for stem-cell count and viability. Additionally, time required for processing was recorded.

Results

Twelve adipose samples were utilized for this study. After a mean time of 3 min, cell count yield ranged of 47,400 to 189,400 of viable regenerative cells per cc, with an average of 122,464 viable regenerative cells per cc.

Conclusions

SAVE is a novel fat-processing technique with high stem-cell extraction that shows promise from a regulatory, yield, time efficiency, and cost perspective.

Level of Evidence 5 Therapeutic

Role of mesenchymal cells in enhancing cosmetic outcomes for autologous augmented fat transfers for facial rejuvenation and reconstructive surgery

In recent years, autologous fat transfer (AFT) has gained popularity for reconstructive and cosmetic procedures due to its minimally invasive nature and natural-looking results. However, limitations such as unpredictable fat resorption and safety concerns persist. To address these issues, researchers have explored incorporating adipose-derived stromal cells (ADSCs) into fat grafts. Enriching fat grafts with ADSCs, often through stromal vascular fraction (SVF), shows promise in regenerative medicine, though their effectiveness remains debated. Some studies suggest no significant difference in outcomes, while others indicate that ADSCs are more effective in larger-volume grafts. This implies that ADSC-enriched grafts might achieve similar results to traditional methods, with volume retention being a crucial success indicator. Given that these cosmetic procedures impact body image and self-confidence, innovative techniques like ADSC-enriched grafts are crucial for improving clinical outcomes. ADSCs are favoured for their abundance in adipose tissue and wound healing properties, which enhance cosmetic results. Patients receiving ADSC-enriched grafts show increased collagen, elastin, and CD31 levels, and better graft survival compared to those with traditional fat grafting, reducing the need for repeat procedures. Recent applications in patients with fibrotic facial deformities have demonstrated positive outcomes both cosmetically and psychologically. This mini-review evaluates the efficacy and benefits of ADSC-enriched AFT for facial rejuvenation and reconstruction, focusing on graft retention and overall procedural outcomes.

Toward facial rejuvenation; A clinical trial to assess the efficacy of nano fat grafting on wrinkles

INTRODUCTION

With increasing age, patients' facial volume decrease. For this reason, nano fat grafting has recently gained popularity as adjunctive treatment to facial rejuvenation procedures. However, few quantitative studies have been conducted to investigate the impact of nano fat on facial wrinkles.

AIMS

In the present study, authors aim to investigate the therapeutic effect of intradermal injection of nano fat on fine facial wrinkles and assess their changes over 7 months of follow-up.

METHODS

In this randomized trial, 15 patients with fine facial wrinkles were enrolled. The fat was harvested from the abdomen and processed into nano fat. Nano fat was injected into the facial wrinkles intradermally with a needle of 27 gauge. The patients were evaluated before and 7 months postinjection utilizing Visio face 1000D (CK electronic, manufactured in Germany); and four parameters of wrinkles (area, volume, depth, and percent area) were evaluated before and after the nano fat injection.

RESULTS

Our evaluation with Visio face showed that nano fat injection was significantly reduced the volume, area, depth, and percent area of wrinkles after 7 months of follow-up without serious long-lasting adverse effects. Moreover, wrinkles with higher percent area, depth and volume loss show greater improvement after the treatment. Our results also indicate that males and females equally benefit from this treatment except for the percent area parameter that was improved more significantly in male patients.

CONCLUSION

Our study showed that intradermal injection of nano fat significantly decreases the volume, area, depth, and percent area of fine facial wrinkles. Further quantitative studies with control groups and larger sample sizes are required.

Complications Associated with Facial Autologous Fat Grafting for Aesthetic Purposes: A Systematic Review of the Literature

Background

With the increasing demand for aesthetic procedures, autologous fat grafting (AFG) seems to be an attractive option for facial volumization and rejuvenation. The aim of this study was to assess the type and severity of associated complications after facial AFG for aesthetic purposes.

Methods

The entire PubMed/Medline and Cochrane databases were screened to identify studies describing complications that occurred after the injection of autologous fat into the face. These complications have been reviewed and analyzed according to their occurrence and severity in the different anatomical regions of the face.

Results

Twenty-two articles including 38 patients reported on a total of 58 complications. Thirty-two complications have been classified as severe or permanent, including hemiplegia (n = 11), loss of vision (n = 7), or skin necrosis (n = 3). The other 26 complications were classified as mild or transient, such as lipogranuloma (n = 12) or mycobacterial abscess (n = 2). The majority of complications were reported after injection to the forehead (n = 26) and the temporal region (n = 21). Interestingly, this location seems to be the area at risk because 53% of all severe complications occurred in this anatomical region.

Conclusions

AFG to the face is associated with a low incidence of complications, but if they occur, they can be dramatic, particularly in the forehead and temporal region. Nevertheless, AFG can be used to correct age-related changes of the face and volume loss and may represent an alternative to synthetic fillers. Therefore, AFG to the face should be performed by qualified doctors under careful consideration of risks and facial anatomy.