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Rageh MA, Ibrahim SMA, Abdallah N, Tawfik AA. Autologous Nanofat Injection Combined with Fractional CO2 Laser in the Treatment of Atrophic Acne Scars. Clin Cosmet Investig Dermatol 2024; 17:697-705. [PMID: 38524394 PMCID: PMC10961075 DOI: 10.2147/ccid.s454514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/16/2024] [Indexed: 03/26/2024]
Abstract
Background Atrophic acne scarring is a widely prevalent condition and one of the most distressing complications of acne vulgaris. Numerous options with variable outcomes are available for the treatment of acne scarring. Laser is considered a first-line therapy for acne scars, and recently there has been a growing interest in using stem cells and their derivatives for treating acne scars. In addition, combined therapeutic modalities often achieve more satisfactory results than a single treatment. Objective We tried to evaluate the role of nanofat and fractional CO2 laser as a combined treatment approach for atrophic acne scarring. Methods Twenty-five patients with atrophic acne scarring were enrolled. They received a single session of intradermal nanofat injection, at different points 1 cm apart, for acne scars. Two weeks later, they were treated with three sessions of fractional CO2 laser at monthly intervals. Patients were evaluated three months after the last session using the quantitative Goodman and Baron scoring system. Pain, side effects, and patients' satisfaction were also evaluated. Results There were two males and 23 females with a mean age of 25.96 years. Their skin type ranged between Fitzpatrick skin type III, IV, and V. Boxcar scars were the most common scar type in 13 patients (52%). After treatment, there was a significant reduction (p <0.05) in the quantitative Goodman and Baron scores. The improvement was more evident in rolling scars. Seven patients reported significant improvement, and 12 reported marked improvement. Conclusion This study showed that combining nanofat and fractional CO2 laser is a safe and effective treatment modality for atrophic acne scars.
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Affiliation(s)
- Mahmoud A Rageh
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Noha Abdallah
- Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Abeer Attia Tawfik
- Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
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Akbari F, Hadibarhaghtalab M, Parvar SY, Dehghani S, Namazi MR. Toward facial rejuvenation; A clinical trial to assess the efficacy of nano fat grafting on wrinkles. J Cosmet Dermatol 2024; 23:600-606. [PMID: 37822183 DOI: 10.1111/jocd.16004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION With increasing age, patients' facial volume decrease. For this reason, nano fat grafting has recently gained popularity as adjunctive treatment to facial rejuvenation procedures. However, few quantitative studies have been conducted to investigate the impact of nano fat on facial wrinkles. AIMS In the present study, authors aim to investigate the therapeutic effect of intradermal injection of nano fat on fine facial wrinkles and assess their changes over 7 months of follow-up. METHODS In this randomized trial, 15 patients with fine facial wrinkles were enrolled. The fat was harvested from the abdomen and processed into nano fat. Nano fat was injected into the facial wrinkles intradermally with a needle of 27 gauge. The patients were evaluated before and 7 months postinjection utilizing Visio face 1000D (CK electronic, manufactured in Germany); and four parameters of wrinkles (area, volume, depth, and percent area) were evaluated before and after the nano fat injection. RESULTS Our evaluation with Visio face showed that nano fat injection was significantly reduced the volume, area, depth, and percent area of wrinkles after 7 months of follow-up without serious long-lasting adverse effects. Moreover, wrinkles with higher percent area, depth and volume loss show greater improvement after the treatment. Our results also indicate that males and females equally benefit from this treatment except for the percent area parameter that was improved more significantly in male patients. CONCLUSION Our study showed that intradermal injection of nano fat significantly decreases the volume, area, depth, and percent area of fine facial wrinkles. Further quantitative studies with control groups and larger sample sizes are required.
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Affiliation(s)
- Farzaneh Akbari
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student research committee, Shiraz University of medical sciences, Shiraz, Iran
| | - Sara Dehghani
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Namazi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Limido E, Weinzierl A, Ampofo E, Harder Y, Menger MD, Laschke MW. Nanofat Accelerates and Improves the Vascularization, Lymphatic Drainage and Healing of Full-Thickness Murine Skin Wounds. Int J Mol Sci 2024; 25:851. [PMID: 38255932 PMCID: PMC10815416 DOI: 10.3390/ijms25020851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
The treatment of wounds using the body's own resources is a promising approach to support the physiological regenerative process. To advance this concept, we evaluated the effect of nanofat (NF) on wound healing. For this purpose, full-thickness skin defects were created in dorsal skinfold chambers of wild-type mice. These defects were filled with NF generated from the inguinal subcutaneous adipose tissue of green fluorescent protein (GFP)+ donor mice, which was stabilized using platelet-rich plasma (PRP). Empty wounds and wounds solely filled with PRP served as controls. Wound closure, vascularization and formation of granulation tissue were repeatedly analyzed using stereomicroscopy, intravital fluorescence microscopy, histology and immunohistochemistry over an observation period of 14 days. PRP + NF-treated wounds exhibited accelerated vascularization and wound closure when compared to controls. This was primarily due to the fact that the grafted NF contained a substantial fraction of viable GFP+ vascular and lymph vessel fragments, which interconnected with the GFP- vessels of the host tissue. Moreover, the switch from inflammatory M1- to regenerative M2-polarized macrophages was promoted in PRP + NF-treated wounds. These findings indicate that NF markedly accelerates and improves the wound healing process and, thus, represents a promising autologous product for future wound management.
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Affiliation(s)
- Ettore Limido
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg, Germany; (E.L.); (A.W.); (E.A.); (M.D.M.)
| | - Andrea Weinzierl
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg, Germany; (E.L.); (A.W.); (E.A.); (M.D.M.)
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Emmanuel Ampofo
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg, Germany; (E.L.); (A.W.); (E.A.); (M.D.M.)
| | - Yves Harder
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), 6900 Lugano, Switzerland;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Michael D. Menger
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg, Germany; (E.L.); (A.W.); (E.A.); (M.D.M.)
| | - Matthias W. Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, 66421 Homburg, Germany; (E.L.); (A.W.); (E.A.); (M.D.M.)
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张 铭, 于 浩, 邵 阳, 宋 国, 陈 铭, 刘 顺. [Effect of nanofat combined with platelet-rich plasma for treatment of pressure injury wounds in rats]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:2061-2070. [PMID: 38189392 PMCID: PMC10774102 DOI: 10.12122/j.issn.1673-4254.2023.12.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To investigate the effect of allogeneic nanofat combined with platelet-rich plasma (PRP) for treatment of pressure injury wounds in rats. METHODS Forty SD rat models with pressure injury wounds were randomly divided into 4 groups (n=10) for treatment with nanofat, PRP (platelet count about 6.2 times that of normal whole blood), nanofat combined with PRP, or PBS only (control group).Wound healing was observed on days 1, 3, 5, 7, 10 and 14 and wound healing rate was calculated. On days 5, 10 and 14, tissue samples were taken from the wounds for HE staining, Masson staining, immunohistochemistry, and Western blotting to observe inflammatory cell infiltration, collagen formation, deposition and arrangement, angiogenesis, inflammatory factor expression and VEGF expression in the wounds. RESULTS The combined treatment with nanofat and PRP achieved the highest wound healing rates at all the time points of observation (P < 0.05), enhanced inflammatory cell infiltration on day 5, and accelerated dermal and epidermal growth compared with the other treatments (P < 0.05). The combined treatment also more effectively promoted collagen expression and its regular arrangement (P < 0.05) and enhanced angiogenesis in the wounds than nanofat and PRP alone, without significant difference between the latter two treatments (P > 0.05). Immunohistochemistry and Western blotting showed that the expressions of MCP-1 and VEGF in the wounds were the highest in the combined treatment group (P < 0.05) and were higher in nanofat and PRP treatment groups than in the control group (P < 0.05). CONCLUSION Nanofat combined with PRP can significantly promote healing of pressure injury wounds in rats, and their synergistic effect sheds light on a new strategy for treatment of pressure injury wounds.
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Affiliation(s)
- 铭 张
- 解放军第九六〇医院烧伤整形科,山东 济南 250031Department of Burn and Plastic Surgery, 960th Hospital of PLA, Jinan 250031, China
| | - 浩 于
- 解放军第九六〇医院烧伤整形科,山东 济南 250031Department of Burn and Plastic Surgery, 960th Hospital of PLA, Jinan 250031, China
- 潍坊医学院临床医学院,山东 潍坊 261053Clinical Medical College of Weifang Medical College, Weifang 261053, China
| | - 阳 邵
- 济南市中心医院烧伤整复外科,山东 济南 250013Department of Burn and Plastic Surgery, Jinan Central Hospital, Jinan 250013, China
| | - 国栋 宋
- 济南市中心医院烧伤整复外科,山东 济南 250013Department of Burn and Plastic Surgery, Jinan Central Hospital, Jinan 250013, China
| | - 铭锐 陈
- 解放军第九六〇医院烧伤整形科,山东 济南 250031Department of Burn and Plastic Surgery, 960th Hospital of PLA, Jinan 250031, China
| | - 顺利 刘
- 解放军第九六〇医院烧伤整形科,山东 济南 250031Department of Burn and Plastic Surgery, 960th Hospital of PLA, Jinan 250031, China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Qari S, Bader M, Farran E, Borrah R, Khamis S, Alharbi Z. Combined Synergetic Effect of Lipoconcentrate Fat Grafting, Nanofat Transfer, Platelet-Rich Plasma, Microneedling, and CO2 Fractional Laser for Plastic Regenerative and Esthetic Surgery and Cosmetic Care. Cureus 2023; 15:e44035. [PMID: 37746505 PMCID: PMC10517633 DOI: 10.7759/cureus.44035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
The advancements in skin care methods and products show the rising interest in cosmetics. Recent studies emphasize the regenerative potential of fat grafting, platelet-rich plasma (PRP), microneedling, and carbon dioxide (CO2) fractional laser techniques. Combining these strategies into a protocol is yet to be explored. In this article, we demonstrate different types of fat grafts and their versatility in treating different facial problems found in our patient. This study evaluated the synergistic effect of lipoconcentrate and nanofat grafting, PRP, microneedling, and CO2 fractional laser to provide esthetic and regenerative facial skin care. This case report was conducted in Dr. Soliman Fakeeh Hospital, Saudi Arabia. Our case involved a 53-year-old woman who had traumatic facial injuries due to a car accident years ago that buried asphalt particles in her facial scars, causing bluish skin discoloration. She suffered from multiple deep atrophic scars in several areas on the left side of her face, causing asymmetry. She was treated using lipoconcentrate and nanofat grafting, followed by three PRP with microneedling sessions and then a final CO2 fractional laser session. The evaluation was based on the physician's clinical assessment, image documentation, and patient satisfaction, which revealed significant improvement in skin appearance with respect to texture, color, symmetry, and overall health of the skin over a period of four months. The potentiality and efficacy of the combination therapy of lipoconcentrate, nanofat, PRP, microneedling, and CO2 fractional laser for skin rejuvenation and scar treatment showed promising results in this case report.
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Affiliation(s)
- Sarah Qari
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
| | - Maryam Bader
- Plastic Surgery and Burn Unit, King Fahad General Hospital, Jeddah, SAU
| | - Eyas Farran
- College of Medicine, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Renad Borrah
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
| | - Sherif Khamis
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
- Clinical Sciences Department, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Ziyad Alharbi
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
- Clinical Sciences Department, Fakeeh College for Medical Sciences, Jeddah, SAU
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Castro-Govea Y, García-Garza JA, Vázquez-Lara SE, González-Cantú CM, Chacón-Moreno H, Cervantes-Kardasch VH. Lipoinjection with Adipose Stem Cells for Nasal Modeling: Rhino Cell, a Highly Versatile Alternative. Arch Plast Surg 2023; 50:335-339. [PMID: 37564724 PMCID: PMC10411243 DOI: 10.1055/a-2067-5481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
It is undeniable that a significant number of patients who want to improve their facial appearance is increasingly interested in nonsurgical procedures. Without a doubt, the use of autologous fat could not be left out as a magnificent alternative for nasal modeling simply because of four influential factors: ease of collection, compatibility, the temporality of the results, and safety. This work describes an innovative alternative technique for nasal modeling using micrografts enriched with adipose-derived mesenchymal stem cells (ASCs). With this technique, fat was collected and divided into two samples, nanofat and microfat. Nanofat was used to isolate the ASCs; microfat was enriched with ASCs and used for nasal modeling. Lipoinjection was performed in a supraperiosteal plane on the nasal dorsum. Through a retrolabial access, the nasal tip and base of the columella were lipoinjected. We consider that nonsurgical nasal modeling using micrografts enriched with ASCs can be an attractive and innovative alternative. This technique will never be a substitute for surgical rhinoplasty. It can be performed in a minor procedure area with rapid recovery and return to the patient's daily activities the next day. If necessary, the procedure can be repeated.
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Affiliation(s)
- Yanko Castro-Govea
- Service of Plastic Surgery, School of Medicine and “Dr. Jose E. González” University Hospital, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Jorge A. García-Garza
- Service of Plastic Surgery, School of Medicine and “Dr. Jose E. González” University Hospital, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Sergio E. Vázquez-Lara
- Service of Plastic Surgery, School of Medicine and “Dr. Jose E. González” University Hospital, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Cynthia M. González-Cantú
- Service of Plastic Surgery, School of Medicine and “Dr. Jose E. González” University Hospital, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Hernán Chacón-Moreno
- Service of Plastic Surgery, School of Medicine and “Dr. Jose E. González” University Hospital, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
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La Padula S, Ponzo M, Lombardi M, Iazzetta V, Errico C, Polverino G, Russo F, D'Andrea L, Hersant B, Meningaud JP, Salzano G, Pensato R. Nanofat in Plastic Reconstructive, Regenerative, and Aesthetic Surgery: A Review of Advancements in Face-Focused Applications. J Clin Med 2023; 12:4351. [PMID: 37445386 DOI: 10.3390/jcm12134351] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/19/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Nanofat is a relatively novel technique in fat grafting that has gained significant interest in the fields of regenerative medicine, aesthetic and translational research. It involves the extraction of autologous fat from a patient, which is then transformed into "nanofat", consisting of small fat particles with a diameter of less than 0.1 mm and containing high concentrations of stem cells and growth factors. This article focuses on the use of nanofat in facial rejuvenation and its potential for lipomodelling. Fat tissue is a "stem cell depot" and nanofat contains many stem cells that can differentiate into various cell types. The Lipogem technology, developed in 2013, enables the isolation of nanofat with an intact perivascular structure, utilizing the high concentration of mesenchymal stromal cells near the pericytes of the adipose vascular system. Nowadays nanofat is used primarily for cosmetic purposes particularly in rejuvenating and improving the appearance of the skin, especially the face. Indeed, it has wide applicability; it can be used to treat fine lines, wrinkles, acne scars, sun-damaged skin, scar repair, and as an alopecia treatment. However, further studies are needed to assess the long-term efficacy and safety of this technique. In conclusion, nanofat is a safe and minimally invasive option for tissue regeneration with considerable therapeutic potential. This study reviews the application and effects of nanofat in regenerative medicine and facial cosmetic surgery.
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Affiliation(s)
- Simone La Padula
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Martina Ponzo
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Mariagiovanna Lombardi
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Vincenzo Iazzetta
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Concetta Errico
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Gianmarco Polverino
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Francesca Russo
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Luca D'Andrea
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Barbara Hersant
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Jean Paul Meningaud
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Federico II University of Naples, 80131 Naples, Italy
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
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Alharbi Z, Qari S, Bader M, Khamis S, Almarzouqi F, Vogt M, Opländer C. The LipoDerm Method for Regeneration and Reconstruction in Plastic Surgery: A Technical Experimental Ex Vivo Note. Med Sci (Basel) 2023; 11. [PMID: 36810483 DOI: 10.3390/medsci11010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/23/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
The combination of adipose-derived stem cells (ASCs) and dermal scaffolds has been shown to be an approach with high potential in soft tissue reconstruction. The addition of dermal templates to skin grafts can increase graft survival through angiogenesis, improve regeneration and healing time, and enhance the overall appearance. However, it remains unknown whether the addition of nanofat-containing ASCs to this construct could effectively facilitate the creation of a multi-layer biological regenerative graft, which could possibly be used for soft tissue reconstruction in the future in a single operation. Initially, microfat was harvested using Coleman's technique, then isolated through the strict protocol using Tonnard's technique. Finally, centrifugation, emulsification, and filtration were conducted to seed the filtered nanofat-containing ASCs onto Matriderm for sterile ex vivo cellular enrichment. After seeding, a resazurin-based reagent was added, and the construct was visualized using two-photon microscopy. Within 1 h of incubation, viable ASCs were detected and attached to the top layer of the scaffold. This experimental ex vivo note opens more dimensions and horizons towards the combination of ASCs and collagen-elastin matrices (i.e., dermal scaffolds) as an effective approach in soft tissue regeneration. The proposed multi-layered structure containing nanofat and dermal template (Lipoderm) may be used, in the future, as a biological regenerative graft for wound defect reconstruction and regeneration in a single operation and can also be combined with skin grafts. Such protocols may optimize the skin graft results by creating a multi-layer soft tissue reconstruction template, leading to more optimal regeneration and aesthetic outcomes.
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Quintero Sierra LA, Biswas R, Conti A, Busato A, Ossanna R, Zingaretti N, Parodi PC, Conti G, Riccio M, Sbarbati A, De Francesco F. Highly Pluripotent Adipose-Derived Stem Cell-Enriched Nanofat: A Novel Translational System in Stem Cell Therapy. Cell Transplant 2023; 32:9636897231175968. [PMID: 37243545 DOI: 10.1177/09636897231175968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Fat graft is widely used in plastic and reconstructive surgery. The size of the injectable product, the unpredictable fat resorption rates, and subsequent adverse effects make it tricky to inject untreated fat into the dermal layer. Mechanical emulsification of fat tissue, which Tonnard introduced, solves these problems, and the product obtained was called nanofat. Nanofat is widely used in clinical and aesthetic settings to treat facial compartments, hypertrophic and atrophic scars, wrinkle attenuation, skin rejuvenation, and alopecia. Several studies demonstrate that the tissue regeneration effects of nanofat are attributable to its rich content of adipose-derived stem cells. This study aimed to characterize Hy-Tissue Nanofat product by investigating morphology, cellular yield, adipose-derived stem cell (ASC) proliferation rate and clonogenic capability, immunophenotyping, and differential potential. The percentage of SEEA3 and CD105 expression was also analyzed to establish the presence of multilineage-differentiating stress-enduring (MUSE) cell. Our results showed that the Hy-Tissue Nanofat kit could isolate 3.74 × 104 ± 1.31 × 104 proliferative nucleated cells for milliliter of the treated fat. Nanofat-derived ASC can grow in colonies and show high differentiation capacity into adipocytes, osteocytes, and chondrocytes. Moreover, immunophenotyping analysis revealed the expression of MUSE cell antigen, making this nanofat enriched of pluripotent stem cell, increasing its potential in regenerative medicine. The unique characteristics of MUSE cells give a simple, feasible strategy for treating a variety of diseases.
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Affiliation(s)
| | - Reetuparna Biswas
- Human Anatomy and Histology Section, Department of Neuroscience, Biomedicine, and Movement, University of Verona, Verona, Italy
| | - Anita Conti
- Human Anatomy and Histology Section, Department of Neuroscience, Biomedicine, and Movement, University of Verona, Verona, Italy
| | - Alice Busato
- Human Anatomy and Histology Section, Department of Neuroscience, Biomedicine, and Movement, University of Verona, Verona, Italy
- Safety Assessment Department, Aptuit (Verona) S.r.l., an Evotec Company, Verona, Italy
| | - Riccardo Ossanna
- Human Anatomy and Histology Section, Department of Neuroscience, Biomedicine, and Movement, University of Verona, Verona, Italy
| | - Nicola Zingaretti
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy
| | - Pier Camillo Parodi
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy
- Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Montelabbate, Italy
| | - Giamaica Conti
- Human Anatomy and Histology Section, Department of Neuroscience, Biomedicine, and Movement, University of Verona, Verona, Italy
| | - Michele Riccio
- Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Montelabbate, Italy
- Department of General and Specialties Surgery, SOD of Reconstructive Surgery and Hand Surgery, Azienda Ospedaliera Universitaria delle Marche, Ancona, Italy
| | - Andrea Sbarbati
- Human Anatomy and Histology Section, Department of Neuroscience, Biomedicine, and Movement, University of Verona, Verona, Italy
- Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Montelabbate, Italy
| | - Francesco De Francesco
- Department of General and Specialties Surgery, SOD of Reconstructive Surgery and Hand Surgery, Azienda Ospedaliera Universitaria delle Marche, Ancona, Italy
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11
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Barisic G, Andjelkov K, Rosic J, Miladinov M, Kotur-Stеvuljevic J, Dinic T, Jelenkovic J, Krivokapic Z. Application of nanofat for treatment of traumatic faecal incontinence after sphincteroplasty - A pilot study. Colorectal Dis 2022; 24:1054-1062. [PMID: 35426481 DOI: 10.1111/codi.16148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/14/2022] [Accepted: 04/07/2022] [Indexed: 02/08/2023]
Abstract
AIM The aim of this study was to investigate whether the application of nanofat containing stem cells improves continence in women who had previously undergone anal sphincteroplasty with unsatisfactory long-term outcomes. METHOD This prospective pilot study included nine women with various degrees of anal incontinence who had previously undergone anal sphincteroplasty due to obstetric trauma. In all patients, the Wexner Incontinence Score (WS) and Faecal Incontinence Quality of Life Score (FIQLS), as well as anal manometry and endoanal ultrasound measurements, were performed before the procedure and during follow-up. In all patients, liposuction was performed and 50 ml of raw lipoaspirate was obtained and processed using a NanoFat Kit device. Approximately 20 ml of the mechanically emulsified and filtrated fat was obtained and the anal sphincter complex was infiltrated with it. Patient follow-up was conducted in person or via telephone 6 and 12 months after the procedure. RESULTS The squeeze pressure was significantly increased 6 months after the procedure (p = 0.01). The external anal sphincter measured at the 12 o'clock position was significantly thicker (p = 0.04). A significant decrease in the WS was observed both 6 and 12 months after the procedure compared with baseline values (p < 0.05 for both). CONCLUSION This study is the first to show that the application of nanofat as an injectable product improves continence in patients with unsatisfactory results after sphincteroplasty, suggesting it to be a promising and effective therapeutic tool. The procedure is safe and can be easily performed as an ambulatory procedure.
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Affiliation(s)
- Goran Barisic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Digestive Surgery - First Surgical Clinic, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Jovana Rosic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko Miladinov
- Clinic for Digestive Surgery - First Surgical Clinic, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Tanja Dinic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelenko Jelenkovic
- COVID Hospital Batajnica, University Clinical Center of Serbia, Belgrade, Serbia
| | - Zoran Krivokapic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Digestive Surgery - First Surgical Clinic, University Clinical Center of Serbia, Belgrade, Serbia.,Serbian Academy of Sciences and Arts, Belgrade, Serbia
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12
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Ding P, Lu E, Li G, Sun Y, Yang W, Zhao Z. Research progress on preparation, mechanism, and clinical application of nanofat. J Burn Care Res 2022; 43:1140-1144. [PMID: 35015870 PMCID: PMC9435497 DOI: 10.1093/jbcr/irab250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Autologous adipose tissue is an ideal soft tissue filling material in theory, which has the advantages of easy access, comprehensive source, and high biocompatibility and is now widely used in clinical practice. Based on the above benefits of autologous fat, autologous fat grafting is an essential technique in plastic surgery. Conventional macrofat is used to improve structural changes after soft tissue damage or loss caused by various causes such as disease, trauma, or aging. Due to the large diameter of particles and to avoid serious complications such as fat embolism, blunt needles with larger diameters (2 mm) are required, making the macrofat grafting difficult to the deep dermis and subdermis. Nanofat grafting is a relatively new technology that has gained popularity in cosmetic surgery in recent years. Nanofat is produced by mechanical shuffling and filtration of microfat, which is harvested by liposuction. The harvesting and processing of nanofat are cost-effective as it does not require additional equipment or culture time. Unlike microfat, nanofat particles are too small to provide a notable volumizing effect. Studies have shown that nanofat contains abundant stromal vascular fraction cells and adipose-derived stem cells, which help reconstruct dermal support structures, such as collagen, and regenerate healthier, younger-looking skin. Moreover, the fluid consistency of nanofat allows application in tissue regeneration, such as scars, chronic wounds, and facial rejuvenation. This article reviews the current research progress on the preparation, mechanism, and clinical application of nanofat.
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Affiliation(s)
- Pengbing Ding
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Enhang Lu
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Guan Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Yidan Sun
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Wenhui Yang
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Zhenmin Zhao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China
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13
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Mysore V, Alexander S, Nepal S, Venkataram A. Regenerative Medicine Treatments for Androgenetic Alopecia. Indian J Plast Surg 2022; 54:514-520. [PMID: 34984094 PMCID: PMC8719950 DOI: 10.1055/s-0041-1739257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/05/2021] [Indexed: 11/16/2022] Open
Abstract
Regenerative medicine and the role of stem cells are being studied for applications in nearly every field of medicine. The pluripotent nature of stem cells underlies their vast potential for treatment of androgenic alopecia. Several advances in recent years have heightened interest in this field, chief among them are the evolution of simpler techniques to isolate regenerative elements and stems cells. These techniques are easy, outpatient procedures with immediate injection, often single session with harvest, and minimal manipulation (usually physical). This paper seeks to critically review the existing data and determine the current evidence and their role in practice.
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Affiliation(s)
- Venkataram Mysore
- The Venkat Center for Skin ENT and Plastic Surgery, Bangalore, India
| | - Sajin Alexander
- Department of Dermatology, Sony Memorial Hospital, Erumely, Kottayam, Kerala, India
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14
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Nepal S, Venkataram A, Mysore V. The Role of Adipose Tissue in Hair Regeneration: A Potential Tool for Management? J Cutan Aesthet Surg 2021; 14:295-304. [PMID: 34908771 PMCID: PMC8611710 DOI: 10.4103/jcas.jcas_47_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Human adipose tissue (AT) is a rich and easily harvestable source of stem cells and various growth factors (GFs). It has been widely used hitherto for facial rejuvenation and volumization. Increasing evidence shows that dermal adipocytes are intricately associated with hair follicles (HFs) and may be necessary to drive follicular stem cell activation. Early published data have shown encouraging preliminary results for the use of adipocytes and their stem cells as a treatment option for hair growth. The aim of this review study is to analyze published literature on the effect of fat on hair growth and to summarize the current evidence.
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Affiliation(s)
- Suman Nepal
- The Venkat Center for Skin, ENT and Plastic Surgery, Bengaluru, Karnataka, India
| | - Aniketh Venkataram
- The Venkat Center for Skin, ENT and Plastic Surgery, Bengaluru, Karnataka, India
| | - Venkataram Mysore
- The Venkat Center for Skin, ENT and Plastic Surgery, Bengaluru, Karnataka, India
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Abstract
Background Lipofilling is currently a fundamental component of rhytidoplasty and fat harvesting has become a common procedure. Tonnard introduced the concept of nanofat grafting, a revolutionary milestone, in which adipocytes are mechanically separated from the stromal vascular fraction and the latter is injected, adding the possibility of cellular therapies to the surgical field. Later, Verpaele et al. published a report using a new device to apply this nanofat in a uniform manner, which they termed nanofat needling. The device has 24 microneedles of 1.5 mm length and is applied as a stamp, in a tapping motion. The same manufacturer offers a similar model with 64 microneedles, 1.0 mm length, and available as a roller. Objectives We sought to evaluate the combination of the above-mentioned microneedling devices to achieve faster nanofat delivery. Materials and Methods A prospective evaluation of patients undergoing a combined nanofat microneedling approach for skin rejuvenation and scar revision, using both a stamp device as well as a roller, was performed in a private practice setting, from January 2019 to January 2020. Patient satisfaction, complications, and surgical time were evaluated. Results We applied this combination treatment to over 100 treatment areas in 86 patients over a 12-month period, with a short operative time, no increase in complications, consistent results, and good patient satisfaction. Conclusions We recommend the use of this new device in association with the original one, in order to decrease the procedure time. We designate this strategy "fast nanofat microneedling."
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Affiliation(s)
- Ronaldo Righesso
- Brazilian Society of Plastic Surgery, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Pedro Salomao Piccinini
- Brazilian Society of Plastic Surgery, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Oscar Uebel
- Brazilian Society of Plastic Surgery, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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16
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Stachura A, Paskal W, Pawlik W, Mazurek MJ, Jaworowski J. The Use of Adipose-Derived Stem Cells (ADSCs) and Stromal Vascular Fraction (SVF) in Skin Scar Treatment-A Systematic Review of Clinical Studies. J Clin Med 2021; 10:3637. [PMID: 34441935 PMCID: PMC8396936 DOI: 10.3390/jcm10163637] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
In recent years, lipofilling became a popular scar treatment method. Its beneficial outcomes have been partly attributed to the regenerative capacity of adipose-derived stem cells (ADSCs), suspended in an extracellular matrix-the stromal vascular fraction (SVF). The aim of this review was to verify if existing data support the clinical use of ADSC-related interventions in scar treatment. A systematic search of the literature was performed in July 2020 in five databases (Medline, Cochrane, Web of Science, Scopus and Embase). Articles written in English, except for reviews, letters and editorials, were identified and screened for eligibility. We looked for reports of any outcomes in scars treated with ADSCs or SVF. Data from selected articles were extracted and the quality of each study was assessed. Five hundred and fourteen studies were identified in the primary search, of which nineteen were eventually included in the systematic review. Extracted data pointed to beneficial microscopic, functional and aesthetic outcomes in a total of 665 patients. Six studies included comparative interventions-platelet-rich plasma or CO2 fractional laser. Collected data give low-to-average quality evidence for beneficial effects of ADSC-related interventions in scar treatment. Some studies suggest that these interventions are noninferior to PRP or fractional CO2 laser.
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Affiliation(s)
- Albert Stachura
- Center for Preclinical Research, Department of Methodology, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Timeless Plastic Surgery Clinic, 02-091 Warsaw, Poland; (M.J.M.); (J.J.)
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Wiktor Paskal
- Center for Preclinical Research, Department of Methodology, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Timeless Plastic Surgery Clinic, 02-091 Warsaw, Poland; (M.J.M.); (J.J.)
| | - Weronika Pawlik
- Faculty of Medicine and Dentistry, Pomeranian Medical University, 70-204 Szczecin, Poland;
| | - Maciej J. Mazurek
- Timeless Plastic Surgery Clinic, 02-091 Warsaw, Poland; (M.J.M.); (J.J.)
- West Pomeranian Center for Severe Burns and Plastic Surgery, 72-300 Gryfice, Poland
- Plastic Surgery Department, Centre for Postgraduate Medical Education, 02-091 Warsaw, Poland
| | - Janusz Jaworowski
- Timeless Plastic Surgery Clinic, 02-091 Warsaw, Poland; (M.J.M.); (J.J.)
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17
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Laschke MW, Menger MD. The simpler, the better: tissue vascularization using the body's own resources. Trends Biotechnol 2021; 40:281-290. [PMID: 34404555 DOI: 10.1016/j.tibtech.2021.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022]
Abstract
Tissue regeneration is crucially dependent on sufficient vascularization. In regenerative medicine, this can be effectively achieved by autologous vascularization strategies using the body's own resources. These strategies include the administration of blood-derived factor preparations, adipose tissue-based vascularization, and the in situ engineering of vascularized tissue. Due to their simplicity, the translation of these strategies into clinical practice is easier in terms of feasibility, safety requirements, and regulatory hurdles compared with complex and time-consuming procedures involving intensive cell manipulation. Hence, they are close to clinical application or are already being used to successfully treat patients by distinct personalized medicine concepts.
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Affiliation(s)
- Matthias W Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany.
| | - Michael D Menger
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany
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18
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Rageh MA, El-Khalawany M, Ibrahim SMA. Autologous nanofat injection in treatment of scars: A clinico-histopathological study. J Cosmet Dermatol 2021; 20:3198-3204. [PMID: 34357682 DOI: 10.1111/jocd.14363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/18/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Scars are the unfortunate outcome of most injuries and some diseases. Its psychological impact on patients can deeply affect their quality of life. AIM The aim of this study was to evaluate the efficacy of autologous nanofat injection in improving the aesthetic outcome of scars, combined with histopathological correlation of the response. PATIENTS AND METHODS Thirty patients with scars of different etiologies undergone one session of nanofat injection and evaluation was done 6 months after the session. Efficacy of treatment was assessed clinically using Vancouver scar scale by two independent blinded dermatologists and histopathologically using image analysis system. RESULTS The age of enrolled patients ranged from 18 to 40 years old. There was a statistically significant improvement on the total Vancouver scar scale regarding the height and pliability of the scars. Pathological evaluation showed an increase in epidermal thickness, increased number and density of collagen and elastic fibers along with neovascularization. CONCLUSION Evidenced by clinical and pathological improvement, autologous nanofat injection is an effective strategy for treating scars of different etiologies.
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Affiliation(s)
- Mahmoud A Rageh
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed El-Khalawany
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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19
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Xiao S, Zhang F, Zheng Y, Liu Z, Wang D, Wei Z, Deng C. Synergistic effect of nanofat and mouse nerve-growth factor for promotion of sensory recovery in anterolateral thigh free flaps. Stem Cells Transl Med 2020; 10:181-189. [PMID: 33043628 PMCID: PMC7848322 DOI: 10.1002/sctm.20-0226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/18/2020] [Accepted: 09/12/2020] [Indexed: 12/12/2022] Open
Abstract
Anterolateral thigh (ALT) free flaps are widely used for reconstruction, but poor sensory recovery of the flap tissue can cause unsatisfactory outcomes and poor function. Adipose‐derived mesenchymal stem cells (ADSCs) promote neural regeneration, but the clinical use of stem‐cell therapy has been limited by lack of regulatory approval. Nanofat is an autologous product that is prepared mechanically from harvested fat. It is enriched in ADSCs and does not contain any exogenous substances. The developmental and adult neurobiology of nerve‐growth factor (NGF) are well investigated, and mouse (m)NGF has been used to promote recovery following peripheral nerve injury. We investigated the promotion of nanofat and mNGF as either mono‐ or combined therapy on the sensory recovery of ALT free flaps. We found that nanofat and mNGF had a synergistic effect on sensory recovery that was associated with stimulation of angiogenesis and neurogenesis. Nanofat combined with mNGF was better at promoting neural regeneration and improving sensory recovery than treatment with either agent alone. The results provide a theoretical rationale for further study of the clinical use of nanofat combined with mNGF to promote the sensory recovery of ALT free flaps.
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Affiliation(s)
- Shune Xiao
- Department of Plastic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiPeople's Republic of China
| | - Fengling Zhang
- Department of Plastic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiPeople's Republic of China
| | - Yongjian Zheng
- Department of Plastic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiPeople's Republic of China
| | - Zhiyuan Liu
- Department of Plastic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiPeople's Republic of China
| | - Dali Wang
- Department of Plastic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiPeople's Republic of China
| | - Zairong Wei
- Department of Plastic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiPeople's Republic of China
| | - Chengliang Deng
- Department of Plastic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiPeople's Republic of China
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20
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Rao AYN, Reddy SN, Chandrappa AB, Vasudevan S, Batth R. A Study of Aesthetic and Functional Outcome Following Structural Fat Grafting for Facial Scars and Contour Deformity. Craniomaxillofac Trauma Reconstr 2020; 13:305-312. [PMID: 33456702 DOI: 10.1177/1943387520948709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Study Design This is a prospective observational study of 60 consecutive cases with facial scars and contour deformity who underwent structural fat grafting. Objectives The aim of the present article is to highlight how fat grafting helps to improve aesthetic and functional outcome in facial scars and contour deformities. It also highlights the factors that need to be considered while planning autologous fat grafting to get better aesthetic results. Methods This is a prospective observational study of 60 consecutive cases with facial scars and contour deformity. The study was conducted from May 2014 to April 2019 in a tertiary care hospital. All the patients were followed up for a minimum period of 1 year from the date of surgery. Assessment of post-operative aesthetic outcome, in terms of satisfaction, was done using the Visual Analogue Scale (VAS), which ranges from 1 to 10 by the patient and operative surgeon. Results The mean age was 30.8 9.8 years. Out of 60 patients, 20 patients underwent additional procedure like dermabrasion and collagen dressing to improve aesthetic outcome. Among 60 patients, 24 patients had transient edema and 10 patients had bruising at the recipient site. There were no major donor site complications except pain which was managed conservatively. Mean patient satisfaction score is 7 and mean surgeon satisfaction score is 7.25. Conclusion Despite the ongoing concerns about survival and longevity of fat grafts and also unpredictability of long-term outcomes, fat grafting has become a very useful surgical tool to improve the quality of facial scars and correct contour deformity. Our series shows excellent outcome both clinically as well as from the patient satisfaction. Future research is warranted in the fields of the adipocyte derived stem cells and to expand the clinical application of fat grafting.
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Affiliation(s)
- Anantheswar Y N Rao
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Sudarshan Nagireddy Reddy
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Ashok Basroor Chandrappa
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Srikanth Vasudevan
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
| | - Rittu Batth
- Plastic, Micro & Craniofacial Surgery, Manipal Education and Medical Group International India Pvt Ltd, Bangalore, Karnataka, India
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Kamat P, Frueh FS, McLuckie M, Sanchez-Macedo N, Wolint P, Lindenblatt N, Plock JA, Calcagni M, Buschmann J. Adipose tissue and the vascularization of biomaterials: Stem cells, microvascular fragments and nanofat-a review. Cytotherapy 2020; 22:400-411. [PMID: 32507607 DOI: 10.1016/j.jcyt.2020.03.433] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/27/2020] [Accepted: 03/12/2020] [Indexed: 12/13/2022]
Abstract
Tissue defects in the human body after trauma and injury require precise reconstruction to regain function. Hence, there is a great demand for clinically translatable approaches with materials that are both biocompatible and biodegradable. They should also be able to adequately integrate within the tissue through sufficient vascularization. Adipose tissue is abundant and easily accessible. It is a valuable tissue source in regenerative medicine and tissue engineering, especially with regard to its angiogenic potential. Derivatives of adipose tissue, such as microfat, nanofat, microvascular fragments, stromal vascular fraction and stem cells, are commonly used in research, but also clinically to enhance the vascularization of implants and grafts at defect sites. In plastic surgery, adipose tissue is harvested via liposuction and can be manipulated in three ways (macro-, micro- and nanofat) in the operating room, depending on its ultimate use. Whereas macro- and microfat are used as a filling material for soft tissue injuries, nanofat is an injectable viscous extract that primarily induces tissue remodeling because it is rich in growth factors and stem cells. In contrast to microfat that adds volume to a defect site, nanofat has the potential to be easily combined with scaffold materials due to its liquid and homogenous consistency and is particularly attractive for blood vessel formation. The same is true for microvascular fragments that are easily isolated from adipose tissue through collagenase digestion. In preclinical animal models, it has been convincingly shown that these vascular fragments inosculate with host vessels and subsequently accelerate scaffold perfusion and host tissue integration. Adipose tissue is also an ideal source of stem cells. It yields larger quantities of cells than any other source and is easier to access for both the patient and doctor compared with other sources such as bone marrow. They are often used for tissue regeneration in combination with biomaterials. Adipose-derived stem cells can be applied unmodified or as single cell suspensions. However, certain pretreatments, such as cultivation under hypoxic conditions or three-dimensional spheroids production, may provide substantial benefit with regard to subsequent vascularization in vivo due to induced growth factor production. In this narrative review, derivatives of adipose tissue and the vascularization of biomaterials are addressed in a comprehensive approach, including several sizes of derivatives, such as whole fat flaps for soft tissue engineering, nanofat or stem cells, their secretome and exosomes. Taken together, it can be concluded that adipose tissue and its fractions down to the molecular level promote, enhance and support vascularization of biomaterials. Therefore, there is a high potential of the individual fat component to be used in regenerative medicine.
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Affiliation(s)
- Pranitha Kamat
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, University of Zurich, Zurich, Switzerland
| | - Florian S Frueh
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Michelle McLuckie
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nadia Sanchez-Macedo
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Petra Wolint
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nicole Lindenblatt
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Jan A Plock
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, University of Zurich, Zurich, Switzerland
| | - Maurizio Calcagni
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Johanna Buschmann
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
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22
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Shaker R, Abdel Aal AR, El Gazzar KM, Abu Zahra FAK, Elshahat A. In Vitro Comparative Study of Emulsified Fat Grafts. Eplasty 2020; 20:e1. [PMID: 32362987 PMCID: PMC7181372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Fat grafting is considered one of the most precious armamentarium in the hand of plastic surgeons. The fat grafts consist of 2 components, adipocytes and stromal cells. The adipose tissue is a reserve of stem cells. Aim: The aim of this study was to compare the adipocyte and stem cell viability in both mechanically processed and enzymatically digested fats. Patients and Methods: This in vitro study was conducted using 40 specimens collected from 20 patients who underwent liposuction procedures. Twenty specimens were mechanically processed (group A), whereas the remaining specimens were processed enzymetically (group B). Results: There were no statistically significant differences between fat cell viability between the 2 groups. On the contrary, there was statistically significant increase in stem cells in mechanically processed fat specimens (P = .001). Conclusion: Both the mechanically and chemically processed fat techniques are reliable techniques that provide fat and stem cells. Mechanical processing is easier and provides more stem cells.
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Affiliation(s)
- Raghda Fayek Shaker
- aPlastic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Abdel Rahman M. Abdel Aal
- aPlastic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt,Correspondence:
| | | | | | - Ahmed Elshahat
- aPlastic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Bhooshan LS, Devi MG, Aniraj R, Binod P, Lekshmi M. Autologous emulsified fat injection for rejuvenation of scars: A prospective observational study. Indian J Plast Surg 2019; 51:77-83. [PMID: 29928084 PMCID: PMC5992940 DOI: 10.4103/ijps.ijps_86_17] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: The skin rejuvenation potential of the autologous emulsified nanofat was studied by Tonnard et al. in 2013. This property is due to the viable adipose-derived stem cells present in the nanofat; although, there are no viable adipocytes. The aim of this study was to determine the aesthetic outcome of autologous emulsified nanofat injection in scars using a standardised and validated Patient Observer Scar Assessment Scale (POSAS) and photographs. Materials and Methods: A total of 34 patients with scars of varied aetiologies were included in the study as per inclusion criteria. Pre-operative scoring of the scars with the POSAS scale was done, and photographs were taken. Fat aspiration was done from the lower abdominal wall using syringe liposuction under tumescent anaesthesia. The lipoaspirate was mechanically emulsified, filtered and injected intralesionally into the scar using 26G needle and insulin syringe. Post-operative scar reassessment was done at 3 months with the POSAS scale score and photographs. The improvement in scar characteristics and symptoms were tested statistically using a paired t-test. Pre-operative and post-operative photographic comparison was also done. Results: Out of the 34 patients included in the study, male:female ratio was 22:12. Majority (79.4%) had post-traumatic facial scars. On statistical analysis, there was statistically significant improvement in symptoms such as pain (P = 0.001), itching (P = 0.001), stiffness (P = 0.001), thickness (P = 0.001), colour (P = 0.001), irregularity (P = 0.001) and scar characteristics such as vascularity (P = 0.005), relief (P = 0.001), pliability (P = 0.001), thickness (P = 0.001) and pigmentation (P = 0.001) 3 months after injection. The photographic comparison also showed good aesthetic outcome. Conclusion: Autologous emulsified nanofat injection is effective in improving the scar characteristics as well as symptoms and helps in scar rejuvenation.
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Affiliation(s)
- Lekshmi S Bhooshan
- Department of Plastic Surgery, Government Medical College, Kottayam, Kerala, India
| | - M Geetha Devi
- Department Of Community Medicine, Government Medical College, Kottayam, Kerala, India
| | - R Aniraj
- Department of Plastic Surgery, Government Medical College, Trivandrum, Kerala, India
| | - P Binod
- Department of Plastic Surgery, Government Medical College, Kottayam, Kerala, India
| | - M Lekshmi
- Department of Plastic Surgery, Government Medical College, Kottayam, Kerala, India
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Wei H, Gu SX, Liang YD, Liang ZJ, Chen H, Zhu MG, Xu FT, He N, Wei XJ, Li HM. Nanofat-derived stem cells with platelet-rich fibrin improve facial contour remodeling and skin rejuvenation after autologous structural fat transplantation. Oncotarget 2017; 8:68542-68556. [PMID: 28978136 PMCID: PMC5620276 DOI: 10.18632/oncotarget.19721] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/19/2017] [Indexed: 12/28/2022] Open
Abstract
Traditional autologous fat transplantation is a common surgical procedure for treating facial soft tissue depression and skin aging. However, the transplanted fat is easily absorbed, reducing the long-term efficacy of the procedure. Here, we examined the efficacy of nanofat-assisted autologous fat structural transplantation. Nanofat-derived stem cells (NFSCs) were isolated, mechanically emulsified, cultured, and characterized. Platelet-rich fibrin (PRF) enhanced proliferation and adipogenic differentiation of NFSCs in vitro. We then compared 62 test group patients with soft tissue depression or signs of aging who underwent combined nanofat, PRF, and autologous fat structural transplantation to control patients (77 cases) who underwent traditional autologous fat transplantation. Facial soft tissue depression symptoms and skin texture were improved to a greater extent after nanofat transplants than after traditional transplants, and the nanofat group had an overall satisfaction rate above 90%. These data suggest that NFSCs function similarly to mesenchymal stem cells and share many of the biological characteristics of traditional fat stem cell cultures. Transplants that combine newly-isolated nanofat, which has a rich stromal vascular fraction (SVF), with PRF and autologous structural fat granules may therefore be a safe, highly-effective, and long-lasting method for remodeling facial contours and rejuvenating the skin.
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Affiliation(s)
- Hua Wei
- Department of Endocrinology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Shi-Xing Gu
- Department of Burns & Plastic Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Yi-Dan Liang
- Central Laboratory of Medical Science, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Zhi-Jie Liang
- Department of Gland Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Hai Chen
- Department of Gland Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Mao-Guang Zhu
- Department of Gland Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Fang-Tian Xu
- Department of Orthopedics, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Ning He
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
| | - Xiao-Juan Wei
- Department of Urinary Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Hong-Mian Li
- Department of Plastic and Aesthetic Surgery, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning 530022, China
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D SLM, Lhotsky R, Mestak O. AUTOLOGOUS FAT TRANSFER, BREAST LIPOMODELLING AND FAT TRANSFER TO THE FACE: CURRENT GOLD STANDARDS AND EMERGING NEW DATA. Acta Chir Plast 2017; 59:97-108. [PMID: 29446310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Autologous fat transfer techniques have experienced tremendous boom in the recent years. Plastic surgeons use these techniques to enhance both the features of the face and of the body. Over the years, controversies concerning fat harvesting, fat processing and fat injection came up. The authors of this review article describe their own experience with fat harvesting, processing and injection and show some of their own results. In addition, they discuss contemporary data from literature regarding the use and complications of fat grafting to the most common areas treated with fat grafting: breast and face.
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Lindenblatt N, Uyulmaz S. [Not Available]. Praxis (Bern 1994) 2016; 105:1319-1324. [PMID: 27805862 DOI: 10.1024/1661-8157/a002511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. Die Eigenfett-Therapie hat in der ästhetischen und plastisch-rekonstruktiven Chirurgie in den letzten Jahren zunehmend an Popularität gewonnen. Grundsätzlich können mit der Eigenfettmethode Volumendefizite behandelt werden. Die Brustrekonstruktion und Brustvergrösserung mit Eigenfett hat sich in den letzten Jahren als Alternative zur Verwendung von Silikongel-Implantaten entwickelt. Als Nebeneffekt zeigte sich eine Verbesserung der Hautqualität. Diese Beobachtungen schafften die Grundlage für die Anwendung von Eigenfett zur Narbentherapie. So kann das Fett nicht nur Volumen liefern, sondern durch seine regenerativen Eigenschaften auch in der Behandlung rigider und unschöner Narben eingesetzt werden. Die zugrundeliegenden Mechanismen sind nicht abschliessend geklärt. Klinische Studien zeigten gute Ergebnisse, sodass das Verfahren kontinuierlich weiterentwickelt wird.
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Affiliation(s)
- Nicole Lindenblatt
- 1 Klinik für Plastische Chirurgie und Handchirurgie, Universitätsspital Zürich
| | - Semra Uyulmaz
- 1 Klinik für Plastische Chirurgie und Handchirurgie, Universitätsspital Zürich
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