Canadian Society of Plastic Surgeons

Abstract

Atrophy plays an extremely important role in facial aging. The current model of aging is based upon loss of volume in the face as the primary physical sign of aging followed or accompanied by sagging or descent of soft tissues. Restoration of fullness to the atrophic, aging upper and mid-face is essential for successful rejuvenation. Adding fullness to the face is a natural, logical approach to rejuvenation. In the early 1990’s, I first noted that transplanted fat did more than just create fullness. The implanted fat improved the quality of the tissues into which it was grafted. This initial improvement is then usually followed by a continued, gradual long-term improvement in the quality of the skin. Wrinkles soften, pore size decreases and pigmentation improves in patients followed over ten years. In addition, fat grafted under depressed scars not only relieves the depression, but also softens or even completely eliminates the specific scar tissue, making it look like normal skin. More recently we have noted the effect of fat grafts on therapeutic radiation injuries. But grafted fat does more than simply restore fullness. Changes occur in skin overlying the grafted sites over time (for instance, immediately after implantation, in the first months, at one year, three years, five years, eight years etc). The volume of the fat appears to stabilize four months after the procedure, but the texture of sun damaged or scarred skin continues to improve dramatically in the ensuing months. The improvement usually continues up to five years and in many cases for almost a decade. While fat grafting was used mainly in aesthetic surgery for many years, we are now applying these same techniques for reconstructive surgery to restore or create facial or corporal forms by manipulation of soft tissues. Examples of facial and body reconstruction will be presented. Structural fat grafting can be a relatively predictable and safe procedure with a low rate of complications and a high degree of patient satisfaction. Further studies are essential to understand more clearly the mechanism of grafted fat tissue and increase predictability. Learning Objectives: To better appreciate the potential of structural fat grafting in facial rejuvenation. To identify the potential effect of fat grafts on scarring. To understand the potential uses in facial and corporal reconstruction. To introduce recent advances in the use of fat grafting. Disclosure of Interest: Dr. Coleman has noted the following: I have the potential for stock options with Cytori Therapeutics and Brava. I do research into techniques using products from Mentor. I receive royalties and consulting fees from Mentor. Can J Plast Surg. 2010 Summer; 18(2): 41–76. » 01 An Audit of Primary Palatoplasty; Results from One Surgeon and 485 Cases Over 10 Years Can J Plast Surg. 2010 Summer; 18(2): 41. 01 An Audit of Primary Palatoplasty; Results from One Surgeon and 485 Cases Over 10 Years Mh Mahoney and D Fisher Copyright and License information ► Copyright © 2010, Pulsus Group Inc. All rights reserved Abstract PURPOSE: The purpose of this study is the review of a single surgeon’s protocol and experience in primary palatoplasty over a 10 year period at a single cleft centre.