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Abu Alqam R, Alkhwildi LA, Almaghrabi MT, Alali FK, Khashab RM, Bamatraf MS, Altamimi LA, Alshammari AJ, Alsuhaim A, Fadel ZT. Hand Rejuvenation Using Autologous Fat Grafting: A Systematic Review of Recommended Doses, Complications, and Patient Satisfaction. Aesthetic Plast Surg 2025; 49:1734-1749. [PMID: 39806138 DOI: 10.1007/s00266-024-04641-7] [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: 10/14/2024] [Accepted: 12/12/2024] [Indexed: 01/16/2025]
Abstract
INTRODUCTION Hand rejuvenation addresses aging-related changes such as subcutaneous fat loss, skin degradation, and photodamage. Autologous fat transfer (AFT) has emerged as a promising treatment, offering durable volume augmentation and regenerative effects. This study aims to systematically review the evidence on the techniques, outcomes, and complications of AFT for hand rejuvenation. METHODS A systematic review was conducted following the PRISMA guidelines, searching databases such as MEDLINE, SCOPUS, DOAJ, and PUBMED from inception to April 2024. Inclusion criteria were studies reporting on hand rejuvenation using fat grafting, including randomized clinical trials, observational studies, case reports, and case series. Data extraction and risk of bias assessment were performed independently by multiple reviewers blindly. RESULTS Eleven studies published between 2001 and 2019 were included, comprising 303 patients with a strong female predominance. Study designs varied, with three randomized clinical trials, seven case series, and one prospective study. High satisfaction rates were consistently reported, with complications being generally infrequent and minor. Various fat grafting techniques were employed, with manual aspiration being the predominant fat harvesting method. Follow-up periods ranged from 5 to 38 months, facilitating thorough evaluation of treatment outcomes. CONCLUSION AFT for hand rejuvenation is effective and safe, offering high patient satisfaction and minimal complications. Long-term fat retention and regenerative effects of adipose-derived stem cells contribute to success. However, fat graft resorption may require multiple treatments. Future research should standardize assessment tools, volumetrically measure graft resorption, and conduct high-quality trials to optimize protocols. LEVEL OF EVIDENCE II 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)
- Rakan Abu Alqam
- College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Lama A Alkhwildi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Maan T Almaghrabi
- Division of Plastic Surgery, Department of Surgery, King Abdulaziz Medical City, National Guard Hospital Affairs, Riyadh, Saudi Arabia
| | - Feryal K Alali
- College of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Ranad Mohammed Khashab
- College of Medicine and Surgery, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Maha Salem Bamatraf
- College of Medicine and Surgery, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Lamees A Altamimi
- College of Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | | | | | - Zahir T Fadel
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Yamani VR, Gurindagunta SV, Raju RL, Kumar S, Valluri MK, Sharma M. Hand Rejuvenation by Autologous Fat Grafting in Post-Hansen's Hand Atrophy: Aesthetic and Psychological Implications. Indian J Plast Surg 2024; 57:461-468. [PMID: 39734368 PMCID: PMC11679190 DOI: 10.1055/s-0044-1791943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2024] Open
Abstract
Introduction Contemporary medical science has been using fat grafting in aesthetic and reconstructive procedures, consistently achieving successful outcomes. Hansen's disease, caused by Mycobacterium leprae , leads to hand deformities due to peripheral neuropathy, resulting in soft-tissue atrophy, volume loss, and compromised hand function. Tendon transfer surgery is a common remedy for functionality, but it often does not address aesthetic concerns and the patient's psychological impact of living with an atrophic hand. Autologous fat grafting can effectively address these concerns. Materials and Methods This prospective study evaluates the efficacy of fat grafting for hand rejuvenation in patients with Hansen's disease posttendon transfer surgery, focusing on aesthetic and psychological outcomes. We recorded data from 12 patients who underwent the procedure between 2015 and 2024. Using the Coleman technique, fat was harvested from the paraumbilical region of the abdomen and injected into various hand regions. Results Autologous fat grafting showed high patient satisfaction with significant improvements in hand contour, skin texture, and psychological health. The benefits of the procedure included improved self-esteem, enhanced quality of life, reduced social stigma, and psychological well-being. Conclusion Autologous fat grafting is a safe and effective technique for hand rejuvenation in patients with Hansen's disease, after functional treatment addressing both physical deformities and their psychological impacts. It could be considered one of the components in the comprehensive management of Hansen's disease-related hand deformities, significantly enhancing patients' overall quality of life.
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Affiliation(s)
- Venkata Ramana Yamani
- Department of Plastic Surgery, Contours Plastic and Aesthetic Clinic, Hyderabad, Telangana, India
| | - Swamy Vivek Gurindagunta
- Department of Plastic Surgery, Contours Plastic and Aesthetic Clinic, Hyderabad, Telangana, India
| | - Rama Linga Raju
- Department of Anaesthesia, Consultant, Contours Plastic and Aesthetic Clinic, Hyderabad, Telangana, India
| | - Shree Kumar
- Department of Plastic Surgery, Contours Plastic and Aesthetic Clinic, Hyderabad, Telangana, India
| | - Mukesh Krishna Valluri
- Department of Plastic Surgery, Contours Plastic and Aesthetic Clinic, Hyderabad, Telangana, India
| | - Mrigya Sharma
- Department of Plastic Surgery, Contours Plastic and Aesthetic Clinic, Medical College, Gotri, Gujarat, India
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Xiao Y, Nie M, Xu W, Zhang J, Lei S, Wu D. The efficiency of human fat products in wound healing: A systematic review and meta-analysis. Int Wound J 2024; 21:e70016. [PMID: 39216014 PMCID: PMC11365526 DOI: 10.1111/iwj.70016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/14/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024] Open
Abstract
Wound development and healing involve intricate genetic and molecular processes, posing significant clinical management challenges. The objective of this study was to assess commonly used fat extracts' efficacy and safety (autologous fat, stromal vascular fraction and adipose-derived stem cells) in wound healing, particularly for refractory wounds, with the goal of providing evidence in clinical use. After a systematic review, 21 randomised controlled trials were included in our study. Based on the classification of human fat products, our meta-analysis revealed that the use of human fat products could speed healing rate, shorten healing time and achieve more complete healing, with statistically significant differences in outcome indicators when compared to conventional treatments. The analysis of histological findings across various studies indicated that fat extracts can promote epithelialization, collagen deposition and vascularization, thereby facilitating tissue regeneration and reducing inflammatory reactions. There were potential benefits to reducing patient pain levels after using adipose extracts. Furthermore, we analysed and summarised adverse events indicating the safe and effective clinical use of human fat products in wound treatment. Our research findings supported the efficiency of human fat products and demonstrated a high degree of safety in the clinical practice of wound management.
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Affiliation(s)
- Yutian Xiao
- Department of Plastic and Cosmetic Surgery, Xiangya HospitalCentral South UniversityChangshaPR China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalChangshaPR China
| | - Mengqi Nie
- Department of Plastic and Cosmetic Surgery, Xiangya HospitalCentral South UniversityChangshaPR China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalChangshaPR China
| | - Wenqing Xu
- Department of Plastic and Cosmetic Surgery, Xiangya HospitalCentral South UniversityChangshaPR China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalChangshaPR China
| | - Jinglve Zhang
- Department of Plastic and Cosmetic Surgery, Xiangya HospitalCentral South UniversityChangshaPR China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalChangshaPR China
| | - Shaorong Lei
- Department of Plastic and Cosmetic Surgery, Xiangya HospitalCentral South UniversityChangshaPR China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalChangshaPR China
| | - Dingyu Wu
- Department of Plastic and Cosmetic Surgery, Xiangya HospitalCentral South UniversityChangshaPR China
- National Clinical Research Center for Geriatric DisordersXiangya HospitalChangshaPR China
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Tejero García P, Mota Antigua S, Ortega Zamorano M, de Lima Monteiro Saraiva RM, Pinto H. Photothermal Biostimulation of Platelet-Rich Plasma Improves Hand Rejuvenation Clinical Outcome: A Pilot Study. Photobiomodul Photomed Laser Surg 2024; 42:473-479. [PMID: 38836757 DOI: 10.1089/pho.2023.0192] [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: 06/06/2024] Open
Abstract
Objective: This study aimed to evaluate physical skin changes and patients' subjective perception of treatment with photothermal bioactivated platelet-rich plasma (MCT Plasma) for hand rejuvenation. Background: Age-related changes in the dorsum of the hand include volume loss, dyschromia, and soft-tissue atrophy, which result in wrinkles and prominent deep structures. Methods: We conducted a prospective, single-center, randomized pilot study on 10 healthy female volunteers from 30 to 65 years with hand aging signs. Patients received two sessions of MCT Plasma on the treated hand and two sessions of standard platelet-rich plasma (PRP) on the control hand. Results were assessed through high-frequency ultrasonography, photographs, a patient satisfaction survey, patient perception of skin aspect, and patient perception of amelioration survey. Results: Ten women with a mean age of 57.5 years (standard deviation 10.5, range 31 - 67) were included, and seven (70%) completed the study. The treated hands' skin subepidermal low-echogenic band (SLEB) decreased from 20% to 60%, and 57.1% (n = 4) had better results than control. Twenty percent of patients were very satisfied with the results, 40% were satisfied, 40% were neutral, and none were unsatisfied or very unsatisfied. Patients perceived the skin of the treated hand (MCT Plasma) as "much better" (20%), "better" (60%), and "no changes" (20%) compared with the skin of the control hand (standard PRP). No treatment-related adverse events were reported during the study. Conclusions: Hands treated with MCT Plasma tended to have better outcomes in reducing SLEB compared with those treated with standard PRP. Patients were satisfied and the treatment was safe with no technical complications. However, further randomized controlled trials with larger sample sizes are mandatory to validate the extent of improvement provided by this device based on photothermal biomodulation.
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Affiliation(s)
| | | | | | | | - Hernán Pinto
- i2e3 Biomedical Research Institute, Barcelona, Spain
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Hajimortezayi Z, Daei N, Gholizadeh N, Zakeri M, Alhili F, Hasanzadeh S, Hormozi A, Ebrahimi F, Zamani M. Fat transplant: Amazing growth and regeneration of cells and rebirth with the miracle of fat cells. J Cosmet Dermatol 2023. [PMID: 38010992 DOI: 10.1111/jocd.16103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUNDS AND OBJECTIVE During fat transplantation, adipose tissue is removed from the body and injected into different areas under the skin. The goal of this review article is to look into the efficacy and applicability of fat transplantation in regenerative medicine and rejuvenation, including Nanofat, Microfat, and Millifat. METHODS As a search strategy and study selection, we searched the PubMed and Medline databases until 2023 using related keywords (e.g., Nanofat, Microfat and Millifat, Regenerative Medicine, and Rejuvenation). RESULTS Autologous fat transplantation has no risk of an allergic reaction or rejection of the transplant by the individual. Autologous adipose tissue is considered an ideal filler for facial rejuvenation and is suggested as the most biocompatible and non-immunogenic skin filler. Adipose tissue transplant may have semi-permanent to permanent effects. According to recent reports, adipose tissues possess a high percentage of mature stem cells. The effect of regenerating adipose tissue and its intrinsic cells can be described as an obvious process. Variations in the sizes of adipose tissues can result in different results depending on the surgical site. Based on topographic assessment, graft fats are assigned depending on the anatomical locations and the size such as Millifat (2-2.5 mm), Microfat (1 mm), and Nanofat (500 μm or less). CONCLUSION Some characteristics of fat tissue increase its effectiveness, such as increasing stem cells, growth factors, cytokines, and compounds effective in repair, regeneration, and rejuvenation.
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Affiliation(s)
- Zahra Hajimortezayi
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Narges Daei
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Nasim Gholizadeh
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mana Zakeri
- Department of Biology, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Farah Alhili
- Medical Technical College, Al-Farahidi University, Baghdad, Iraq
| | - Sajedeh Hasanzadeh
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Arezoo Hormozi
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Faezeh Ebrahimi
- Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Majid Zamani
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Har-Shai L, Ofek SE, Lagziel T, Pikkel YY, Duek OS, Ad-El DD, Shay T. Revitalizing Hands: A Comprehensive Review of Anatomy and Treatment Options for Hand Rejuvenation. Cureus 2023; 15:e35573. [PMID: 37007409 PMCID: PMC10063163 DOI: 10.7759/cureus.35573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
Dorsal hand rejuvenation is gaining popularity as a solitary procedure and adjunct to face and neck rejuvenation treatments. As the hands age, the skin loses elasticity and becomes more translucent, the veins, joints, and tendons appear more prominent, and the bones become more noticeable. These changes are due to intrinsic and extrinsic factors. Current treatment methods include the injection of dermal fillers and autologous fat grafting. Anatomic studies to ensure the successful implementation of rejuvenation procedures identified three separate fascial layers in the dorsum, from superficial to deep. More recent re-evaluations revealed a less distinct, inseparable, sponge-like fascial layer. All authors agree that the superficial dermal layer is probably the optimal location for the injection of volumizing materials because it is free of anatomical structures. Many methods for harvesting, preparing, and injecting fat grafts to the dorsum of the hand have been described in the past three decades. Both filler and fat-graft procedures are performed on an ambulatory basis under local anesthesia. Good results with low postoperative and long-term complication rates and high patient satisfaction have been reported.
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Vermeersch N, De Fré M, Verhoeven V, Hunter JE, Tondu T, Thiessen FE. Autologous fat transfer for hand rejuvenation: systematic review on technique and outcome. JPRAS Open 2022; 32:182-194. [PMID: 35449731 PMCID: PMC9018121 DOI: 10.1016/j.jpra.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background Age-related changes to the dorsum of the hand present as dyschromia, soft-tissue atrophy, and volume loss, resulting in wrinkles and prominent deep structures. Volume augmentation by means of autologous fat transfer (AFT) is one of the options to rejuvenate the hand; theoretically, autologous fat is the ideal filler because of durability and biocompatibility. Objective This systematic review aims to summarize and describe the current evidence on the technique, effectiveness, and safety of AFT in hand rejuvenation. Methods Three major databases, PubMed, Embase, and Web of Science, were systematically searched up to November 2020 for studies reporting on AFT and hand rejuvenation. Results A total of 10 articles were included, reporting on a total of 320 patients treated by AFT to improve the aesthetic appearance of the dorsum of the hand. Some degree of postoperative oedema was present in nearly all patients. Other complications were infection (0.67%), cysts/irregularities (1.3%), temporary dysesthesia (5.3%), and ecchymosis (7%). There were no major complications. Of all patients, 97.6% self-reported to be satisfied with the result. Conclusions Overall, by combining the current evidence, AFT is considered a promising and safe technique to rejuvenate the aging hand with very high patient satisfaction. Future research, using validated patient questionnaires, objective volumetric measurements, and longer follow-up, is needed to confirm these results. Level of Evidence 3
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Affiliation(s)
- Nicolas Vermeersch
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
- Corresponding author: Dr. Nicolas Vermeersch.
| | - Maxime De Fré
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
| | - Veronique Verhoeven
- Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium
| | - Judith E. Hunter
- Department of Plastic and Reconstructive Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Thierry Tondu
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
| | - Filip E.F. Thiessen
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
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Hung YT, Cheng CY, Chen CB, Huang YL. Ultrasound Analyses of the Dorsal Hands for Volumetric Rejuvenation. Aesthet Surg J 2022; 42:1119-1126. [PMID: 35170732 DOI: 10.1093/asj/sjac035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Volumetric hand rejuvenation of the dorsal hands is increasingly applied for aged, skeletonized dorsal hand skin, with prominent veins, tendons, and joints due to volumetric loss of subcutaneous fat. However, the aging process of the fatty laminae remains unexplored. OBJECTIVES We aim to investigate the impact of aging and potential determinants on the fatty laminae to improve the therapeutic effect of volumetric injection. METHODS This cross-sectional study enrolled 105 Taiwanese participants aged ≥20 years, divided into five age groups per decade. Thicknesses of the dorsal superficial lamina (DSL), dorsal intermediate lamina (DIL), and dorsal deep lamina (DDL) were measured via ultrasonography by a single-blinded practitioner. The potential determining factors of the laminae thickness (age, sex, body mass index, and hand dominance) were analyzed. RESULTS The thicknesses of the three laminae decreased with aging, with the mean decrease in thickness from the 20s to >60 years in DSL, DIL, and DDL being 0.21 mm (30.0%), 1.38 mm (63.89%), and 0.31 mm (20.95%), respectively. DIL thickness decrease was the greatest and most significant since the 30s. Multiple linear regression analysis showed age as the only determinant for thicknesses of the 3 laminae (all P<0.001), whereas DIL was significantly thicker in men (P<0.001). CONCLUSIONS Volumetric fat loss was noted in the three fatty laminae of dorsal hands during aging; DIL has the greatest progressive fat loss since the 30s. Volumetric rejuvenation of the 3 laminae may result in the most esthetic appearance, especially in women.
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Affiliation(s)
- Yi-Teng Hung
- Department of Dermatology and Department of Aesthetic Medicine, Chang Gung Memorial Hospital, Linkou, Taipei, Taoyuan, Taiwan
| | - Chun-Yu Cheng
- Department of Dermatology and Department of Aesthetic Medicine, Chang Gung Memorial Hospital, Linkou, Taipei, Taoyuan, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology and Department of Aesthetic Medicine, Chang Gung Memorial Hospital, Linkou, Taipei, Taoyuan, Taiwan
| | - Yau-Li Huang
- Department of Dermatology and Department of Aesthetic Medicine, Chang Gung Memorial Hospital, Linkou, Taipei, Taoyuan, Taiwan
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Papaconstantinou A, Koletsa T, Demiri E, Tzorakoleftheraki SE, Gasteratos K, Pavlidis L, Dionyssiou D, Spyropoulou GA. Investigation of Autologous Fat Transfer in Capsule Formation around Silicone Implants in a Rat Model. Plast Reconstr Surg 2022; 149:881-887. [PMID: 35139050 DOI: 10.1097/prs.0000000000008923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In this experimental study, the authors investigated whether fat placement in the pocket during implant insertion affects capsule formation. METHODS Twenty albino Wistar rats, 400 g each, were used. The rats were divided into two groups, A and B, of 10 rats each. At the dorsum of each rat, four pockets (2 × 2 cm each) were dissected, two left and two right of the midline. In each pocket, a 1 × 1 × 1.5-cm silicone implant was inserted. In the two left pockets, only silicone implants were placed (control). In the two right pockets, 0.4 ml of fat was injected around the implant. Animals in group A were killed 2 months postoperatively, and those in group B were killed 4 months postoperatively. The implants were dissected with the capsule and sent for histopathologic examination. RESULTS The data of the fat transfer group was compared with control in groups A and B. Capsule thickness, neovascularization, myofibroblast layer thickness, and mast cell population demonstrated no statistically significant difference in either group A (p = 0.385, p = 0.862, p = 0.874, and p = 0.210, respectively) or group B (p = 0.338, p = 1.000, p = 0.288, and p = 0.344, respectively). Inflammation was statistically significantly less (p = 0.07) at 4 months (group B) in the fat transfer group compared to the control group. Likewise, cellularity was statistically significantly less (p = 0.019) at 4 months for the fat transfer group compared with the control group. CONCLUSION Fat injection in the pocket during implant placement may reduce inflammation and cellularity of capsules and predispose to faster capsule maturation. CLINICAL RELEVANCE STATEMENT PLEASE PROVIDE 1- TO 2-SENTENCE STATEMENT.
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Affiliation(s)
- Anthony Papaconstantinou
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Triantafyllia Koletsa
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Efterpi Demiri
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Sofia-Eleni Tzorakoleftheraki
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Kostantinos Gasteratos
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Leonidas Pavlidis
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Dimitrios Dionyssiou
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
| | - Georgia-Alexandra Spyropoulou
- From the Departments of Plastic Surgery and Pathology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki
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McGuire C, Boudreau C, Tang D. Hand Rejuvenation: A Systematic Review of Techniques, Outcomes, and Complications. Aesthetic Plast Surg 2022; 46:437-449. [PMID: 34382097 DOI: 10.1007/s00266-021-02519-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hand rejuvenation is an increasingly popular cosmetic procedure for hand atrophy and aging. The objective of this study is to systematically evaluate the techniques, outcomes, and complications of surgical hand rejuvenation. METHODS A systematic review was undertaken using a computerized search. Publication descriptors, methodological details, techniques, outcomes, and complications were extracted. Articles were assessed using the MINORS and Cochrane instruments. RESULTS Thirty-one studies were included. Most studies were published in the last five years (51.6 percent) and were prospective case series (35.5 percent). The mean age of patients was 56 (range 21-82), while the mean sample size was 47 (range 10-220). The most commonly examined interventions were Radiesse (32.2 percent) and fat grafting (32.2 percent). Major complications were not observed in any study, while minor complications such as edema and pain were temporary. Injection techniques varied, however, the proximal to distal fanning technique and using a cannula was associated with a lower risk of complications. Both Radiesse and fat grafting had robust long-term esthetic outcomes. CONCLUSIONS Hand rejuvenation is a safe and efficacious surgical intervention to reduce dorsal hand atrophy. Further studies are needed to compare the long-term outcomes of common interventions. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Wong J, Murphy M, Wu YF, Murphy R, Frueh FS, Farnebo S. Basic science approaches to common hand surgery problems. J Hand Surg Eur Vol 2022; 47:117-126. [PMID: 34472390 DOI: 10.1177/17531934211042697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The field of hand surgery is constantly evolving to meet challenges of populations with increasing age and higher demands for active living. While our surgical care has improved over the last decades, it seems that future major improvement in outcomes of clinical treatment will come through advances in biologics and the translation of major discoveries in basic science. This article aims to provide an update on where basic science solutions may answer some of the most critical issues in hand surgery, with a focus on augmentation of tissue repair.
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Affiliation(s)
- Jason Wong
- Blond McIndoe Laboratories, Manchester, UK.,Department of Plastic Surgery, University of Manchester and Manchester University Foundation Trust, Manchester, UK
| | - Matthew Murphy
- Blond McIndoe Laboratories, Manchester, UK.,Department of Plastic Surgery, University of Manchester and Manchester University Foundation Trust, Manchester, UK
| | - Ya Fang Wu
- Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Ralph Murphy
- Blond McIndoe Laboratories, Manchester, UK.,Department of Plastic Surgery, University of Manchester and Manchester University Foundation Trust, Manchester, UK
| | - Florian S Frueh
- Department of Plastic Surgery and Hand Surgery, University of Zurich, Zurich, Switzerland
| | - Simon Farnebo
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Plastic Surgery, Hand Surgery, and Burns, Linköping University, Linköping, Sweden
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