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Pruksapong C, Buarabporn N, Junkajorn S. Efficacy of Cold Tumescent for Prevention of Intraoperative Bleeding in Patients Undergoing Liposuction: A Double-Blind Randomized Controlled Trial-Half-Side Comparison. Aesthet Surg J 2023; 43:NP258-NP267. [PMID: 36495216 DOI: 10.1093/asj/sjac331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bleeding, a common intraoperative complication of liposuction, often causes pain and discomfort during recovery. Because of the vasoconstrictive effect of adrenaline in the tumescent solution, bleeding can be reduced; however, reports of postoperative bleeding persist. Cold temperatures also have a vasoconstrictive effect. OBJECTIVES This study aimed to determine the efficacy of cold tumescent solution in preventing and reducing intraoperative bleeding. METHODS This prospective randomized controlled trial was conducted between June 2018 and June 2019. The liposuction areas in each participant were divided into left and right sides; one side received operative room temperature tumescent solution (25 °C), and the other side received low-temperature tumescent solution (4 °C). The areas of ecchymosis, pain scores, and patient and surgeon satisfaction scores were compared and analyzed. RESULTS Ten patients with 36 pairs of liposuction areas were enrolled in the study. Cold tumescent liposuction resulted in a significantly lower lipocrit than was obtained on the standard tumescent side (1.56 ± 0.69 vs 2.92 ± 0.94; P < .001). The ecchymosis area and pain score were significantly lower in the cold tumescent group on days 2, 4, 7, and 14. The satisfaction evaluation scores did not differ between patients and surgeons at 12 months postoperatively. CONCLUSIONS The use of cold tumescent anesthesia significantly improved liposuction outcomes by reducing the intraoperative blood loss and the postoperative ecchymosis and pain, with no immediate or short-term complications in low-volume liposuction (<1000 mL) procedures. Furthermore, it generated a standard outcome and good patient satisfaction scores. LEVEL OF EVIDENCE: 2
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2
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Beyond the abdominal and pelvic cavity: abdominal wall and spinal "Aunt Minnies". Abdom Radiol (NY) 2023; 48:1479-1504. [PMID: 36790455 PMCID: PMC9930021 DOI: 10.1007/s00261-023-03830-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/16/2023]
Abstract
Abdominal wall and spinal soft tissue findings are frequently encountered on CT or MR imaging of the abdomen and pelvis. Many of these entities have specific imaging findings, for which a definitive diagnosis can be made without the need for further work up. These abdominal wall and spinal findings may be diagnostically challenging for sub-specialized abdominal radiologists who are unfamiliar with their appearance and appropriate management. This review article describes and illustrates pathognomonic or characteristic abdominal wall and spinal pathologies, which reside outside the abdominopelvic cavity. The cases selected all have findings that allow a confident diagnosis without further imaging or intervention. The cases presented include myonecrosis, intramuscular abscess, myositis, iliopsoas bursitis, Morel-Lavallée lesion, hydrocele of canal of Nuck, Klippel Trenaunay Weber syndrome, neurofibroma with target sign, perineural cysts, filum terminale lipoma, calvarial bone flap, transverse rectus abdominis muscle (TRAM) flap, liposuction, and hidradenitis suppurativa, among others. Although not all-encompassing, this paper will help abdominal radiologists to accurately diagnose a variety of abdominal and pelvic extra-cavitary soft tissue pathologies by identifying key radiologic findings.
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3
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Moradi A, Fabi S, Rapaport D, Shridharani S, Goldman MP, Tsai Fu F. Electromagnetic muscle stimulation: A retrospective study of patient experience. J Cosmet Dermatol 2021; 21:271-278. [PMID: 34560820 PMCID: PMC9292684 DOI: 10.1111/jocd.14401] [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: 07/06/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022]
Abstract
Background Electromagnetic muscle stimulation (EMMS) is a non‐invasive body contouring technology for strengthening, firming, and toning the abdomen, buttocks, and thighs that is associated with high patient satisfaction. Aims To gain a greater understanding of factors contributing to patient satisfaction with EMMS. Methods This was a retrospective, non‐comparative study of patient information and questionnaires regarding EMMS treatments to abdomen and/or buttocks collected July 1 to December 1, 2019 from clinical practices in the United States. Questionnaires collected and included for study analysis were the Subject Experience Questionnaire (SEQ), the Body Satisfaction Questionnaire (BSQ), and the Subject‐rated Global Aesthetic Improvement Scale (SGAIS). Results Responses from 146 treated patients were analyzed (abdomen only: n = 94; buttocks only, n = 30; abdomen and buttocks: n = 22). Patients were 79% female with mean age of 41.3 years (range: 19–73). Frequently cited reasons for seeking EMMS treatment were a desire to appear more toned (89%) or slimmer (42%), and to feel stronger (38%). BSQ and SGAIS scores were improved 4 weeks after treatment. On post‐treatment SEQ, most patients reported being “satisfied” or “very satisfied” with abdomen (83.2%; n = 89/107) or buttocks (57.4%; n = 27/47) treatment. Most patients reported feeling stronger after abdomen treatment, and across both body areas, patients were more confident, happier with their overall appearance, and motivated to work out and maintain treatment results. Conclusion This retrospective study of patient questionnaires provides important information on aesthetic and functional factors that can contribute to high patient satisfaction following EMMS treatment of the abdomen and/or buttocks.
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Affiliation(s)
| | - Sabrina Fabi
- Cosmetic Laser Dermatology: A West Dermatology Company, San Diego, CA, USA
| | | | | | - Mitchel P Goldman
- Cosmetic Laser Dermatology: A West Dermatology Company, San Diego, CA, USA.,Department of Dermatology, University of California, San Diego, San Diego, CA, USA
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4
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Piccotti F, Rybinska I, Scoccia E, Morasso C, Ricciardi A, Signati L, Triulzi T, Corsi F, Truffi M. Lipofilling in Breast Oncological Surgery: A Safe Opportunity or Risk for Cancer Recurrence? Int J Mol Sci 2021; 22:ijms22073737. [PMID: 33916703 PMCID: PMC8038405 DOI: 10.3390/ijms22073737] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 02/08/2023] Open
Abstract
Lipofilling (LF) is a largely employed technique in reconstructive and esthetic breast surgery. Over the years, it has demonstrated to be extremely useful for treatment of soft tissue defects after demolitive or conservative breast cancer surgery and different procedures have been developed to improve the survival of transplanted fat graft. The regenerative potential of LF is attributed to the multipotent stem cells found in large quantity in adipose tissue. However, a growing body of pre-clinical evidence shows that adipocytes and adipose-derived stromal cells may have pro-tumorigenic potential. Despite no clear indication from clinical studies has demonstrated an increased risk of cancer recurrence upon LF, these observations challenge the oncologic safety of the procedure. This review aims to provide an updated overview of both the clinical and the pre-clinical indications to the suitability and safety of LF in breast oncological surgery. Cellular and molecular players in the crosstalk between adipose tissue and cancer are described, and heterogeneous contradictory results are discussed, highlighting that important issues still remain to be solved to get a clear understanding of LF safety in breast cancer patients.
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Affiliation(s)
- Francesca Piccotti
- Laboratorio di Nanomedicina ed Imaging Molecolare, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (F.P.); (C.M.); (A.R.)
| | - Ilona Rybinska
- Molecular Targeting Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (I.R.); (T.T.)
| | - Elisabetta Scoccia
- Breast Unit, Surgery Department, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (E.S.); (F.C.)
| | - Carlo Morasso
- Laboratorio di Nanomedicina ed Imaging Molecolare, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (F.P.); (C.M.); (A.R.)
| | - Alessandra Ricciardi
- Laboratorio di Nanomedicina ed Imaging Molecolare, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (F.P.); (C.M.); (A.R.)
| | - Lorena Signati
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università Degli Studi di Milano, 20157 Milano, Italy;
| | - Tiziana Triulzi
- Molecular Targeting Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (I.R.); (T.T.)
| | - Fabio Corsi
- Breast Unit, Surgery Department, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (E.S.); (F.C.)
- Dipartimento di Scienze Biomediche e Cliniche “L. Sacco”, Università Degli Studi di Milano, 20157 Milano, Italy;
| | - Marta Truffi
- Laboratorio di Nanomedicina ed Imaging Molecolare, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (F.P.); (C.M.); (A.R.)
- Correspondence: ; Tel.: +39-0382-592219
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5
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Ruff PG. Thermal effects of percutaneous application of plasma/radiofrequency energy on porcine dermis and fibroseptal network. J Cosmet Dermatol 2020; 20:2125-2131. [PMID: 33197275 PMCID: PMC8359425 DOI: 10.1111/jocd.13845] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022]
Abstract
Background Skin laxity is one of the defining characteristics of aging and can be the result of various factors including intrinsic aging, genetics, diet, stress, lifestyle, sun exposure, weight fluctuations, and smoking. Recent reports suggest the ability of subdermal energy application to reduce skin laxity. Thermal energy can be delivered using different devices including lasers, radiofrequency (RF) monopolar and bipolar devices, and plasma/RF devices. Plasma‐based energy platforms generate a plasma gas, allowing heat to be applied to the tissue. This study focused on the evaluation of thermal effect of plasma/RF compared to a monopolar RF device applied percutaneously to the subdermis and connective fibroseptal network in a porcine model. Methods The subdermal application of energy was conducted using a plasma/RF system and a monopolar RF system. Both low and high energy/temperature settings were evaluated in dynamic and stationary modes. Histomorphometry was used to determine the depth of thermal effect associated with each treatment setting. Results Both dermis and fibroseptal network tissue exhibited the presence of microscopically thermally treated zones. There were no significant differences in average and maximum depths of thermal effect between the different handpieces and electrosurgical systems used for all treatment settings. Conclusions No significant differences in the thermal effect between plasma/RF and monopolar RF systems were observed, suggesting that plasma/RF systems can be safely used for the percutaneous application of energy in the subcutaneous space.
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Affiliation(s)
- Paul G Ruff
- West End Plastic Surgery and MedStar Georgetown University, Washington, DC, USA
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6
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Liposuction-Gadgets and Widgets: Save Your Money. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2759. [PMID: 32440427 PMCID: PMC7209887 DOI: 10.1097/gox.0000000000002759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 02/10/2020] [Indexed: 11/27/2022]
Abstract
In the past few decades, numerous adjunctives and devices have been introduced to body contouring surgeries, especially liposuction. Most of these devices require special maintenance and accessories for their proper functionality, which might be expensive in many parts of the world or for young surgeons starting their own practice. In this article, we suggest some tools that could be used during liposuction to save money, minimize complications rates, and enhance the results without endangering the patient's overall safety.
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7
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Taha S, Saller MM, Haas E, Farkas Z, Aszodi A, Giunta R, Volkmer E. Adipose-derived stem/progenitor cells from lipoaspirates: A comparison between the Lipivage200-5 liposuction system and the Body-Jet liposuction system. J Plast Reconstr Aesthet Surg 2020; 73:166-175. [DOI: 10.1016/j.bjps.2019.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/28/2019] [Accepted: 06/09/2019] [Indexed: 12/13/2022]
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8
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Fontes T, Brandão I, Negrão R, Martins MJ, Monteiro R. Autologous fat grafting: Harvesting techniques. Ann Med Surg (Lond) 2018; 36:212-218. [PMID: 30505441 PMCID: PMC6251330 DOI: 10.1016/j.amsu.2018.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/31/2018] [Accepted: 11/06/2018] [Indexed: 02/08/2023] Open
Abstract
Autologous fat grafting is widely used for soft-tissue augmentation and replacement in reconstructive and aesthetic surgery providing a biocompatible, natural and inexpensive method. Multiple approaches have been developed in the past years, varying in the location of adipose tissue donor-sites, use of wetting solutions, harvesting, processing and placing techniques. Despite many advances in this subject, the lack of standardization in the protocols and the unpredictability of the resorption of the grafted tissue pose a significant limitation for graft retention and subsequent filling. In this review, we discuss several approaches and methods described over the last years concerning the harvesting of autologous fat grafts. We focus on contents such as the best donor-site, differences between existing harvesting techniques (namely tissue resection, hand aspiration or liposuction techniques), recommended harvesting cannula diameters, pressure application and volume of wetting solution injected prior aspiration. Results and comparisons between methods tend to vary according to the outcome measured, thus posing a limitation to pinpoint the most efficient methods to apply in fat grafting. Additionally, the lack of a standard assay to determine viability or volume augmentation of fat grafting remains another limitation to obtain universally accepted grafting procedures and protocols. Distinct harvesting procedures associate with different outcomes of fat graft take. Flank, abdomen, thigh and knee are the more consistently used donor-sites for fat. Higher vacuum pressures in liposuction are more traumatic for the tissue. The tumescent technique is a safer procedure with improved aesthetic results. Comparing harvesting techniques is a big challenge given the multiple variables.
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Affiliation(s)
- Tomás Fontes
- Departamento de Biomedicina - Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Inês Brandão
- Departamento de Biomedicina - Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal
| | - Rita Negrão
- Departamento de Biomedicina - Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal
| | - Maria João Martins
- Departamento de Biomedicina - Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal
| | - Rosário Monteiro
- Departamento de Biomedicina - Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal.,Unidade de Saúde Familiar Pedras Rubras, Agrupamento de Centros de Saúde Maia-Valongo, Maia, Portugal
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9
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Mesenchymal Stem Cells from Adipose Tissue in Clinical Applications for Dermatological Indications and Skin Aging. Int J Mol Sci 2017; 18:ijms18010208. [PMID: 28117680 PMCID: PMC5297838 DOI: 10.3390/ijms18010208] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/05/2017] [Accepted: 01/05/2017] [Indexed: 12/13/2022] Open
Abstract
Operating at multiple levels of control, mesenchymal stem cells from adipose tissue (ADSCs) communicate with organ systems to adjust immune response, provide signals for differentiation, migration, enzymatic reactions, and to equilibrate the regenerative demands of balanced tissue homeostasis. The identification of the mechanisms by which ADSCs accomplish these functions for dermatological rejuvenation and wound healing has great potential to identify novel targets for the treatment of disorders and combat aging. Herein, we review new insights into the role of adipose-derived stem cells in the maintenance of dermal and epidermal homeostasis, and recent advances in clinical applications of ADSCs related to dermatology.
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10
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Simonacci F, Bertozzi N, Grieco MP, Grignaffini E, Raposio E. Autologous fat transplantation for breast reconstruction: A literature review. Ann Med Surg (Lond) 2016; 12:94-100. [PMID: 27942383 PMCID: PMC5137333 DOI: 10.1016/j.amsu.2016.11.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/21/2016] [Accepted: 11/21/2016] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The use of autologous fat transplantation to correct volume and contour defects, scars, and asymmetry after breast cancer surgery has increased over the past 20 years. Many developments and refinements in this technique have taken place in recent years, and several studies of the safety of lipofilling in the breast have been published. PRESENTATION OF CASE We performed a literature review of this technique, highlighting the crucial role of lipofilling in breast cancer reconstruction. DISCUSSION The efficacy of the fat graft transplantation depends on the experience and the technique used by the surgeon. The ASCs (adipose-derived stem cells) contained in the fat graft has proven to be crucial for breast reconstruction by mean the regeneration of tissue, through the chemotactic, paracrine, and immunomodulatory activities and their in situ differentiation. CONCLUSION The role of lipofilling for breast reconstruction could be more significant with the application of the findings of experimental research on tissue engineering and ASCs.
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Affiliation(s)
- Francesco Simonacci
- Department of Surgical Sciences, Plastic Surgery Division, University of Parma, Parma, Italy
- The Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Nicolò Bertozzi
- Department of Surgical Sciences, Plastic Surgery Division, University of Parma, Parma, Italy
- The Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Michele Pio Grieco
- Department of Surgical Sciences, Plastic Surgery Division, University of Parma, Parma, Italy
- The Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Eugenio Grignaffini
- Department of Surgical Sciences, Plastic Surgery Division, University of Parma, Parma, Italy
- The Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Edoardo Raposio
- Department of Surgical Sciences, Plastic Surgery Division, University of Parma, Parma, Italy
- The Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
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11
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Kim EJ, Kwon HI, Yeo UC, Ko JY. Lower face lifting and contouring with a novel internal real-time thermosensing monopolar radiofrequency. Lasers Med Sci 2016; 31:1379-89. [PMID: 27389364 DOI: 10.1007/s10103-016-1989-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 06/07/2016] [Indexed: 11/29/2022]
Abstract
As demand for a youthful appearance has increased, various techniques for face lifting and contouring have been used to reduce excess fat deposition and improve skin laxity. Recently, radiofrequency (RF)-assisted lipolysis and liposuction (RFAL) has been introduced for body and face contouring. This study aimed to evaluate the clinical improvement and safety of a new RFAL device for face lifting and contouring. A prospective study was conducted in 20 Korean patients who underwent an internal real-time thermosensing monopolar RFAL procedure. Prior to treatment and 12 and 24 weeks after treatment, digital photographs were taken, and the degree of improvement as measured by investigators and patients was recorded. Skin elasticity was measured using a Cutometer (CT575, Courage and Khazaka®, Cologne, Germany). Safety profiles were also evaluated at each visit. Results showed favorable improvement in skin laxity and fat deposition. Both investigators' evaluations and patients' evaluation showed significant improvement between 12 and 24 weeks. Although the changes in skin elasticity measured by the Cutometer were not statistically significant, all three treated regions showed a trend toward improvement. No major side effects such as infection or burn were observed. The internal, real-time thermosensing monopolar RFAL device showed clinical efficacy and safety. After further studies with more patients and longer follow-up periods, internal real-time thermosensing monopolar RF devices might become one of the popular treatment options for face lifting and contouring.
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Affiliation(s)
- Eun Jin Kim
- Department of Dermatology, Hanyang University College of Medicine, 221-1 Wangsimri-ro, Seoul, Korea
| | - Hyoung Il Kwon
- Department of Dermatology, Hanyang University College of Medicine, 221-1 Wangsimri-ro, Seoul, Korea
| | - Un Cheol Yeo
- Department of Dermatology, S&U Clinic, Seoul, Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, 221-1 Wangsimri-ro, Seoul, Korea.
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12
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Duscher D, Luan A, Rennert RC, Atashroo D, Maan ZN, Brett EA, Whittam AJ, Ho N, Lin M, Hu MS, Walmsley GG, Wenny R, Schmidt M, Schilling AF, Machens HG, Huemer GM, Wan DC, Longaker MT, Gurtner GC. Suction assisted liposuction does not impair the regenerative potential of adipose derived stem cells. J Transl Med 2016; 14:126. [PMID: 27153799 PMCID: PMC4859988 DOI: 10.1186/s12967-016-0881-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/27/2016] [Indexed: 01/22/2023] Open
Abstract
Background Adipose-derived stem cells (ASCs) have been identified as a population of multipotent cells with promising applications in tissue engineering and regenerative medicine. ASCs are abundant in fat tissue, which can be safely harvested through the minimally invasive procedure of liposuction. However, there exist a variety of different harvesting methods, with unclear impact on ASC regenerative potential. The aim of this study was thus to compare the functionality of ASCs derived from the common technique of suction-assisted lipoaspiration (SAL) versus resection. Methods Human adipose tissue was obtained from paired abdominoplasty and SAL samples from three female donors, and was processed to isolate the stromal vascular fraction. Fluorescence-activated cell sorting was used to determine ASC yield, and cell viability was assayed. Adipogenic and osteogenic differentiation capacity were assessed in vitro using phenotypic staining and quantification of gene expression. Finally, ASCs were applied in an in vivo model of tissue repair to evaluate their regenerative potential. Results SAL specimens provided significantly fewer ASCs when compared to excised fat tissue, however, with equivalent viability. SAL-derived ASCs demonstrated greater expression of the adipogenic markers FABP-4 and LPL, although this did not result in a difference in adipogenic differentiation. There were no differences detected in osteogenic differentiation capacity as measured by alkaline phosphatase, mineralization or osteogenic gene expression. Both SAL- and resection-derived ASCs enhanced significantly cutaneous healing and vascularization in vivo, with no significant difference between the two groups. Conclusion SAL provides viable ASCs with full capacity for multi-lineage differentiation and tissue regeneration, and is an effective method of obtaining ASCs for cell-based therapies.
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Affiliation(s)
- Dominik Duscher
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA. .,Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria. .,Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany.
| | - Anna Luan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Robert C Rennert
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - David Atashroo
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Zeshaan N Maan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Elizabeth A Brett
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Alexander J Whittam
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Natalie Ho
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Michelle Lin
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael S Hu
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Graham G Walmsley
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.,Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Raphael Wenny
- Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria
| | - Manfred Schmidt
- Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria
| | - Arndt F Schilling
- Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany
| | - Hans-Günther Machens
- Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany
| | - Georg M Huemer
- Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria
| | - Derrick C Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael T Longaker
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.,Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Geoffrey C Gurtner
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
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13
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Bertheuil N, Chaput B, Berger-Müller S, Ménard C, Mourcin F, Watier E, Grolleau JL, Garrido I, Tarte K, Sensébé L, Varin A. Liposuction Preserves the Morphological Integrity of the Microvascular Network: Flow Cytometry and Confocal Microscopy Evidence in a Controlled Study. Aesthet Surg J 2016; 36:609-18. [PMID: 26530477 DOI: 10.1093/asj/sjv209] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Liposuction is a very popular technique in plastic surgery that allows for the taking adipose tissue (AT) on large surfaces with little risk of morbidity. Although liposuction was previously shown to preserve large perforator vessels, little is known about the effects of liposuction on the microvasculature network. OBJECTIVES The aim of this study was to analyze the effect of liposuction on the preservation of microvessels at tissue and cellular levels by flow cytometry and confocal microscopy following abdominoplasty procedure. METHODS Percentage of endothelial cells in AT from liposuction and en bloc AT was determined by multicolor flow cytometry. Moreover, vessel density and adipocyte content were analyzed in situ in 3 different types of AT (en bloc, from liposuction, and residual AT after liposuction) by confocal microscopy. RESULTS Flow cytometric analysis showed that en bloc AT contained 30.6% ± 12.9% and AT from liposuction 21.6% ± 9.9% of endothelial cells (CD31(pos)/CD45(neg)/CD235a(neg)/CD11b(neg)) (P = .009). Moreover, analysis of paired AT from the same patients (n = 5) confirmed a lower percentage of endothelial cells in AT from liposuction compared to en bloc AT (17.7% ± 4.5% vs 21.9% ± 3.3%, P = .031). Likewise, confocal microscopy showed that en bloc AT contained 8.2% ± 6.3%, AT from liposuction only 1.6% ± 1.0% (P < .0001), and AT after liposuction 8.9% ± 4.1% (P = .111) of CD31(pos) vessels. Conversely, adipocyte content was 39.5% ± 14.5% in the en bloc AT, 45% ± 18.4% in AT from liposuction (P = .390), and 18.8 ± 14.8% in AT after liposuction (P = .011). CONCLUSIONS For the first time, we demonstrate that liposuction preserves the microvascular network. Indeed, a low percentage of endothelial cells was found in AT from liposuction and we confirm the persistence of microvessels in the tissue after liposuction.
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Affiliation(s)
- Nicolas Bertheuil
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Benoit Chaput
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Sandra Berger-Müller
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Cédric Ménard
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Frédéric Mourcin
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Eric Watier
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Jean-Louis Grolleau
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Ignacio Garrido
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Karin Tarte
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Luc Sensébé
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
| | - Audrey Varin
- Dr Bertheuil is a Staff Surgeon and Dr Waiter is a Professor, Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes, Rennes, France. Dr Chaput is a Staff Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Toulouse, France. Dr Berger-Müller has a Post-doctorate Position, Dr Sensébé is a Head Director of Team 2, and Dr Varin is a Staff Researcher, STROMALab Laboratory, Rangueil Hospital, Toulouse, France. Drs Ménard and Mourcin are Staff Researchers and Dr Tarte is a Professor and Head Director, SITI Laboratory, Rennes University Hospital, Rennes, France; and INSERM U917, University of Rennes, Rennes, France. Drs Grolleau and Garrido are Professors, Department of Plastic, Aesthetic, and Reconstructive Surgery, Toulouse University Hospital, Toulouse, France
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14
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Nojomi M, Moradi-Lakeh M, Velayati A, Naghibzadeh-Tahami A, Dadgostar H, Ghorabi G, Moradi-Joo M, Yaghoubi M. Health technology assessment of non-invasive interventions for weight loss and body shape in Iran. Med J Islam Repub Iran 2016; 30:348. [PMID: 27390717 PMCID: PMC4898871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 11/12/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The burden of obesity and diet-related chronic diseases is increasing in Iran, and prevention and treatment strategies are needed to address this problem. The aim of this study was to determine the outcome, cost, safety and cost-consequence of non-invasive weight loss interventions in Iran. METHODS We performed a systematic review to compare non-invasive interventions (cryolipolysis and radiofrequency/ ultrasonic cavitation) with semi-invasive (lipolysis) and invasive (liposuction). A sensitive electronic searching was done to find available interventional studies. Reduction of abdomen circumference (cm), reduction in fat layer thickness (%) and weight reduction (kg) were outcomes of efficacy. Meta-analysis with random models was used for pooling efficacy estimates among studies with the same follow-up duration. Average cost per intervention was estimated based on the capital, maintenance, staff, consumable and purchase costs. RESULTS Of 3,111 studies identified in our reviews, 13 studies assessed lipolysis, 10 cryolipolysis and 8 considered radiofrequency. Nine studies with the same follow-up duration in three different outcome group were included in meta-analysis. Radiofrequency showed an overall pooled estimate of 2.7 cm (95% CI; 2.3-3.1) of mean reduction in circumference of abdomen after intervention. Pooled estimate of reduction in fat layer thickness was 78% (95% CI; 73%-83%) after Lipolysis and a pooled estimate of weight loss was 3.01 kg (95% CI; 2.3-3.6) after lipousuction. The cost analysis revealed no significant differences between the costs of these interventions. CONCLUSION The present study showed that non-invasive interventions appear to have better clinical efficacy, specifically in the body shape measurement, and less cost compared to invasive intervention (liposuction).
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Affiliation(s)
- Marzieh Nojomi
- 1 MD, MPH, Professor of Community Medicine, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Maziar Moradi-Lakeh
- 2 MD, MPH, Associate Professor of Community Medicine, Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran.
| | - Ashraf Velayati
- 3 MSc of Health Technology Assessment, Department of Educational Management, Economics and Policy, School of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ahmad Naghibzadeh-Tahami
- 4 MSc of Epidemiology, Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
| | - Haleh Dadgostar
- 5 MD, Sport Medicine Specialist, Department of Sport Medicine, Rasoul-Akaram Hospital, Iran University of Medical Science, Tehran, Iran.
| | | | - Mohammad Moradi-Joo
- 7 MSc of Health Technology Assessment, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohsen Yaghoubi
- 8 MSc of Health Economic, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. ,(Corresponding author) MSc of Health Economic, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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15
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Duscher D, Atashroo D, Maan ZN, Luan A, Brett EA, Barrera J, Khong SM, Zielins ER, Whittam AJ, Hu MS, Walmsley GG, Pollhammer MS, Schmidt M, Schilling AF, Machens HG, Huemer GM, Wan DC, Longaker MT, Gurtner GC. Ultrasound-Assisted Liposuction Does Not Compromise the Regenerative Potential of Adipose-Derived Stem Cells. Stem Cells Transl Med 2015; 5:248-57. [PMID: 26702129 PMCID: PMC4729547 DOI: 10.5966/sctm.2015-0064] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 10/28/2015] [Indexed: 01/19/2023] Open
Abstract
The regenerative abilities of adipose-derived mesenchymal stem cells (ASCs) harvested via a third-generation ultrasound-assisted liposuction (UAL) device versus ASCs obtained via standard suction-assisted lipoaspiration were evaluated. ASC yield and viability, and expression of most osteogenic, adipogenic, and key regenerative genes were equivalent between the two methods. Cells harvested via UAL showed comparable abilities to enhance cutaneous regeneration and appear suitable for cell therapy and tissue engineering applications. Human mesenchymal stem cells (MSCs) have recently become a focus of regenerative medicine, both for their multilineage differentiation capacity and their excretion of proregenerative cytokines. Adipose-derived mesenchymal stem cells (ASCs) are of particular interest because of their abundance in fat tissue and the ease of harvest via liposuction. However, little is known about the impact of different liposuction methods on the functionality of ASCs. Here we evaluate the regenerative abilities of ASCs harvested via a third-generation ultrasound-assisted liposuction (UAL) device versus ASCs obtained via standard suction-assisted lipoaspiration (SAL). Lipoaspirates were sorted using fluorescent assisted cell sorting based on an established surface-marker profile (CD34+/CD31−/CD45−), to obtain viable ASCs. Yield and viability were compared and the differentiation capacities of the ASCs were assessed. Finally, the regenerative potential of ASCs was examined using an in vivo model of tissue regeneration. UAL- and SAL-derived samples demonstrated equivalent ASC yield and viability, and UAL ASCs were not impaired in their osteogenic, adipogenic, or chondrogenic differentiation capacity. Equally, quantitative real-time polymerase chain reaction showed comparable expression of most osteogenic, adipogenic, and key regenerative genes between both ASC groups. Cutaneous regeneration and neovascularization were significantly enhanced in mice treated with ASCs obtained by either UAL or SAL compared with controls, but there were no significant differences in healing between cell-therapy groups. We conclude that UAL is a successful method of obtaining fully functional ASCs for regenerative medicine purposes. Cells harvested with this alternative approach to liposuction are suitable for cell therapy and tissue engineering applications. Significance Adipose-derived mesenchymal stem cells (ASCs) are an appealing source of therapeutic progenitor cells because of their multipotency, diverse cytokine profile, and ease of harvest via liposuction. Alternative approaches to classical suction-assisted liposuction are gaining popularity; however, little evidence exists regarding the impact of different liposuction methods on the regenerative functionality of ASCs. Human ASC characteristics and regenerative capacity were assessed when harvested via ultrasound-assisted (UAL) versus standard suction-assisted liposuction. ASCs obtained via UAL were of equal quality when directly compared with the current gold standard harvest method. UAL is an adjunctive source of fully functional mesenchymal stem cells for applications in basic research and clinical therapy.
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Affiliation(s)
- Dominik Duscher
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany
| | - David Atashroo
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Zeshaan N Maan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Anna Luan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Elizabeth A Brett
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Janos Barrera
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Sacha M Khong
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Elizabeth R Zielins
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Alexander J Whittam
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Michael S Hu
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Graham G Walmsley
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA Institute for Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Stanford, California, USA
| | - Michael S Pollhammer
- Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria
| | - Manfred Schmidt
- Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria
| | - Arndt F Schilling
- Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany
| | - Hans-Günther Machens
- Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich, Germany
| | - Georg M Huemer
- Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz, Austria
| | - Derrick C Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Michael T Longaker
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA Institute for Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Stanford, California, USA
| | - Geoffrey C Gurtner
- Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, School of Medicine, Stanford University, Stanford, California, USA
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16
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Petti C, Stoneburner J, McLaughlin L. Laser cellulite treatment and laser-assisted lipoplasty of the thighs and buttocks: Combined modalities for single stage contouring of the lower body. Lasers Surg Med 2015; 48:14-22. [PMID: 26581783 DOI: 10.1002/lsm.22437] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Cellulite and lipodystrophy are often found together, especially in areas of the buttocks and thighs, causing skin surface irregularities. Each of these conditions is currently treated independently as two separate surgical procedures. In our practice, we developed a novel combined approach for the simultaneous treatment of cellulite and lipodystrophy, as a single stage procedure in the same anatomic area. For the treatment of cellulite, we used the Nd:YAG laser at a wavelength of 1,440-nm, along with an innovative 1,000-micron directional side-firing fiber optic laser system. For the treatment of lipodystrophy, the Nd:YAG laser with a 1,440 nm wavelength, along with a fiber optic laser system was used. The objective of this study is to determine the efficacy and safety of a combined approach for the simultaneous treatment of cellulite and lipodystrophy. STUDY DESIGN, PATIENTS AND METHODS In 2012, 16 subjects with noticeable cellulite, Grade II and Grade III, accompanied by mild-to-moderate lipodystrophy of the lower body received single treatments of the Nd:YAG laser at a wavelength of 1,440-nm along with the 1,000-micron side-firing fiber optic laser system for simultaneous treatments of both cellulite and lipodystrophy. Patients were assessed at baseline and 3-6 months post-treatment by a modified Nurnberger-Muller scale utilized to quantify the cellulite severity. Additionally, patient satisfaction and a global aesthetic improvement scale were used to measure the improvement in lipodystrophy. RESULTS Blinded reviewers identified the correct baseline photographs 97% of the time when presented with a set of photographs. The median modified Nurnberger-Muller scale score at baseline was 4.75 ± 1.2 and the average improvement was 2.0 ± 1.2. Global aesthetic improvement scores ranged from 1 to 3 with an average of 1.58 indicating a much-improved overall appearance. Satisfaction was high for both physicians and patients with scores corresponding to extremely satisfied/satisfied. CONCLUSION Precise, effective delivery of laser energy to the dermal-adipose tissue, as well as the deep adipose lipodystrophy is feasible as a safe modality for the simultaneous treatment of cellulite and lipodystrophy in the buttocks and thighs, as a single stage procedure.
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Affiliation(s)
- Christine Petti
- Palos Verdes Plastic Surgery Medical Center, Torrance, California
| | | | - Laura McLaughlin
- Palos Verdes Plastic Surgery Medical Center, Torrance, California
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You JS, Chung YE, Baek SE, Chung SP, Kim MJ. Imaging Findings of Liposuction with an Emphasis on Postsurgical Complications. Korean J Radiol 2015; 16:1197-206. [PMID: 26576108 PMCID: PMC4644740 DOI: 10.3348/kjr.2015.16.6.1197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 08/02/2015] [Indexed: 12/17/2022] Open
Abstract
Liposuction is one of the most frequently performed cosmetic surgeries worldwide for reshaping the body contour. Although liposuction is minimally invasive and relatively safe, it is a surgical procedure, and it carries the risk of major and minor complications. These complications vary from postoperative nausea to life-threatening events. Common complications include infection, abdominal wall injury, bowel herniation, bleeding, haematoma, seroma, and lymphoedema. Life-threatening complications such as necrotizing fasciitis, deep vein thrombosis, and pulmonary embolism have also been reported. In this paper, we provide a brief introduction to liposuction with the related anatomy and present computed tomography and ultrasonography findings of a wide spectrum of postoperative complications associated with liposuction.
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Affiliation(s)
- Je Sung You
- Department of Emergency Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Yong Eun Chung
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Song-Ee Baek
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Sung Phil Chung
- Department of Emergency Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Myeong-Jin Kim
- Department of Emergency Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
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18
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Liu CE, Lu Y, Yao DS. Feasibility and Safety of Video Endoscopic Inguinal Lymphadenectomy in Vulvar Cancer: A Systematic Review. PLoS One 2015; 10:e0140873. [PMID: 26496391 PMCID: PMC4619862 DOI: 10.1371/journal.pone.0140873] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 10/01/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To systematically review previous studies and to evaluate the feasibility and safety of video endoscopic inguinal lymphadenectomy (VEIL) in vulvar cancer. METHODS We conducted a comprehensive review of studies published through September 2014 to retrieve all relevant articles. The PubMed, EMBASE, Web of Science, Cochrane Library, Wan Fang Data and Chinese National Knowledge Infrastructure databases were systematically searched for all relevant studies published in English or Chinese through September 2014. Data were abstracted independently by two reviewers, and any differences were resolved by consensus. RESULTS A total of 9 studies containing 249 VEIL procedures involving 138 patients were reviewed. Of the 249 VEIL procedures, only 1 (0.4%) was converted to an open procedure for suturing because of injury to the femoral vein. The range of operative time was 62 to 110 minutes, and the range of estimated blood loss was 5.5 to 22 ml. The range of the number of harvested lymph nodes was 7.3 to 16. The length of hospital stay varied from 7 to 13.6 days across reports. The incidence of lymph node metastasis was 19.7% (27/138), and the recurrence rate was 4.3% (3/70) within 3 to 41 months of follow-up. One or more short-term complications were documented in 18 of 138 (13.0%) patients. Complications after VEIL were observed in 14 (10.13%) patients and in 15 (6.0%) of the VEIL cases, including major lymphocyst formation in 9 (3.6%), lymphorrhea in 2 (0.8%), inguinal wound infection without wound breakdown in 3 (1.2%) and lymphedema in 1 (0.4%). CONCLUSIONS VEIL appears to be a feasible procedure in the management of vulvar cancer. There may be potential benefits that result in lower morbidity compared to traditional methods, but this has yet to be objectively proven.
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Affiliation(s)
- Chai-e Liu
- Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guang Xi Medical University, Nanning, People’s Republic of China
| | - Yan Lu
- Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guang Xi Medical University, Nanning, People’s Republic of China
| | - De-Sheng Yao
- Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guang Xi Medical University, Nanning, People’s Republic of China
- * E-mail:
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New body contouring technique in male: the muscular sculpture. Aesthetic Plast Surg 2015; 39:199-202. [PMID: 25631785 DOI: 10.1007/s00266-015-0448-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/06/2015] [Indexed: 01/01/2023]
Abstract
UNLABELLED Optimal male body contouring considers the entire body and drapes tight skin over the muscles. Males have pride in the appearance of their muscular development. There should be a deliberate effort to achieve an athletic body contour that reveals superficial musculature and selectively highlights adherences. We describe a new technique of male body contouring to achieve tight skin that very well reveals muscular bulk and accentuates adherences; minimal observable scars; a male muscular and athletic body, even for patients who are not, nor have been in the past, bodybuilders. Normal-weight and overweight patients need one operative step, in which the fat is removed and the muscles are sculpted at the same time by using selective liposuction, and if necessary, the fat is repositioned through lipofilling. The ex-obese patients need two operative steps: in the first, we perform abdominoplasty with inguinal scar (to remove the excess abdominal tissue and to lift the pubis) and periareolar scar (to breast lift and reduction); in the second, we sculpt the muscles and the adherences by selective liposuction. In all male patients, the authors strive to achieve a trapezoid chest and sculpted pectoralis major muscle, pronounced alba and semilunar lines, evident muscular bulk, and adherences in both the abdomen and extremities. LEVEL OF EVIDENCE V 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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Multimodal Imaging and Theranostic Application of Disease-Directed Agents. TOPICS IN MEDICINAL CHEMISTRY 2015. [DOI: 10.1007/7355_2015_91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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