Transplantation Treatment for Glabellar Frown Lines Using Autologous Fascial Adipose Tissue.

Utilization of autologous adipose tissue transplantation in plastic and orthopedic surgery such as breast reconstruction and intra-articular injection has become an attractive surgical treatment with satisfactory clinical outcomes. Nevertheless, repeated liposuctions necessary to harvest fatty tissue, normally performed with sedation or general anesthesia, may represent a noteworthy concern. The aim of this study was to demonstrate through an in vitro characterization the validity of the surgical option of cryopreserved autologous adipose tissue harvested in a single shot for repeated graft transfer in breast reconstruction without impairment of cell viability and sterility. Adipose tissue was collected by standard liposuction from patients who needed numerous fat grafting procedures for breast reconstruction. According to an innovative and patented cryopreservation method, autologous adipose tissue was subsequently fractioned in a sterile bag system and frozen at the RER Tissue Bank of the Emilia Romagna Region. Each graft was evaluated for sterility and cell viability immediately after harvesting, and 1, 3, 6, 12, and preliminarily 18 months after cryopreservation and thawing. In vitro results showed that after processing, middle-term and long-term cryopreservation, and subsequent thawing, autologous cryopreserved adipose tissue retained absence of bacterial contamination, high cellular viability, and unmodified histomorphological properties, thereby ensuring maintenance of the stromal vascular niche and the filling properties in different multistep surgical procedures. In vitro study and sterility assessment showed that autologous cryopreserved adipose tissue grafting is a safe procedure, making it possible to avoid multiple liposuction surgery. No impairment of sterility, cell viability, or morphology was observed over time.

Long‐term dietary and pharmacological treatments for obesity have been questioned, particularly in individuals with severe obesity, so a new approach may involve adipose tissue transplants, particularly autologous transplants. Thus, the aim of this study was to evaluate the metabolic effects of autologous subcutaneous adipose tissue (SAT) transplants into two specific intraabdominal cavity sites (omental and retroperitoneal) after 90 days. The study was performed using two different diet‐induced obesity (DIO) rat models: one using a high‐fat diet (HFD) and the other using a high‐carbohydrate diet (HCHD). Autologous SAT transplant reduced hypertrophic adipocytes, improved insulin sensitivity, reduced hepatic lipid content, and fasting serum‐free fatty acids (FFAs) concentrations in the two DIO models. In addition, the reductions in FFAs and glycerol were accompanied by a greater reduction in lipolysis, assessed via the phosphorylation status of HSL, in the transplanted adipose tissue localized in the omentum compared with that localized in the retroperitoneal compartment. Therefore, the improvement in hepatic lipid content after autologous SAT transplant may be partially attributed to a reduction in lipolysis in the transplanted adipose tissue in the omentum due to the direct drainage of FFAs into the liver. The HCHD resulted in elevated fasting and postprandial serum insulin levels, which were dramatically reduced by the autologous SAT transplant. In conclusion, the specific intraabdominal localization of the autologous SAT transplant improved the carbohydrate and lipid metabolism of adipose tissue in obese rats and selectively corrected the metabolic parameters that are dependent on the type of diet used to generate the DIO model.

The aim of considered the implementation of soft tissue defects correction by means of autologous adipose tissue transplantation after liposuction surgery. Materials and methods . The study was conducted by the authors from 2016 to 2020 and included 26 consecutive operations in female patients. The age limits of the patients ranged from 20 to 59 years. The preoperative body mass index of the patients was 17.4–26.5 kg/m 2 , on average 21.6 kg/m 2 and was determined during the first application. Liposuction surgery was performed 1–3 times on all patients included in the study. The total amount of transplanted autologous adipose tissue was 20–200 ml. Results . Over 24 months, 58.8 % of patients rated their appearance after autologous adipose tissue transplantation as «very good» and «excellent» and 29.4 % rated their appearance as «good». Only 11.8% of patients felt that their appearance was good at first, and then worsened. Discussion . In order to obtain a predictable result, the surgeon must inject adipose tissue into living tissue under sterile conditions and refrain from external contact in order to prevent infection. Transplants with a high percentage of components, such as blood and local factors, reduce the ability to predict accurate body volume. Conclusion . Have shown that the degree of satisfaction observed in patients after autologous adipose tissue grafting gives aesthetically acceptable results in terms of correction of deformities after liposuction. With the acceptance of aesthetic surgery in general and the increasing number of liposuction patients, it is clear that plastic surgeons in the future will face patients seeking secondary contouring surgery. Successful autologous adipose tissue transplantation is based on the appropriate technique, awareness of limitations and understanding of the patient's goals.

Repair of volumetric muscle loss (VML) lesions tends to be poor, leading to fibrosis and functional loss. Here we investigated the effectiveness of fresh versus cryopreserved autologous adipose tissue transplantation to facilitate repair. Wistar rats were distributed into four experimental groups: normal control, VML lesions, VML lesions treated with a fresh autologous adipose tissue graft, and VML treated with a cryopreserved autologous adipose tissue graft. At 60 days post-intervention, a histological, histochemical, and immunohistochemical analysis was performed to assess changes related to the degree of fibrosis, vascularization, and innervation. These changes were quantified and statistically analyzed. The changes generated by the two types of adipose tissue implanted in the VML lesion were highly similar, with some significant differences favoring the use of cryopreserved adipose tissue. Compared with the VML group, the following outcomes were observed: (1) significant presence of regenerated muscle fibers; (2) significant reduction of fibrosis, albeit with a higher proportion of type III collagen; (3) significant increase in the microvascular pattern; and (4) significant reduction in the number of angulated atrophic muscle fibers and increase in cytoarchitectural changes indicative of reinnervation. This study suggests that autologous adipose tissue transplantation in VML lesions promotes reintegrative processes, facilitating the regeneration and formation of new muscle fibers. Furthermore, the freezing did not diminish outcomes in the CAAT group, highlighting its potential for preservation in tissue banks and applications in regenerative medicine.

The information given in the scientific literature sources about the transplantation of autologous adipose tissue (AAT) enriched with stem cells (SC) in cases of breast shape and volume correction (in both aesthetic indications and elimination of postoperative deformities) is characterized by versatile results. This circumstance promotes the purposeful study about the possibilities of modern surgical technologies in use of mesenchymal SC (MSCs) of autologous adipose tissue in cases of mammoplasty. The information on the basic techniques of mesenchymal SC isolation from the AAT has been analyzed. The data of cytological criteria were studied separately that allow to relate this biological substance to the SC. Technical features of stem cells transplantation derived from the autologous adipose transplant in cases of mammoplasty are demonstrated. According to opinion among the competent researchers, elimination of postoperative deformities using cellular technologies is a promising scientific direction of medicine.

Abstract. Introduction. Radiation-induced ulcerative proctitis is a serious complication of cancer radiotherapy for prostate, cervix, uterine body, anal canal, and other pelvic tumors. Given the development pattern, there are currently no pathogenetic methods for the treatment of radiation-induced ulcerative proctitis. Aim: To develop a technique for and evaluate its effectiveness in the treatment of patients with radiation-induced rectal ulcers using autologous microfragmented adipose tissue. Materials and Methods. The study included 30 patients, of which 24 (80.0%) were women and 6 (20.0%) were men. Manual lipoaspiration was used to obtain autologous adipose tissue. Then we performed its microfragmentation via transfers. Concentrated autologous adipose tissue was introduced into the edges of the radiation-induced ulcerative defect on the rectal wall under endoscopic control. При контрольной ректоскопии через 6 месяцев у 28 (93,3 %) пациентов была отмечена полная эпителизация постлучевых язвенных дефек- тов прямой кишки. Results and Discussion. The manipulation, from sampling the adipose tissue through the end of injection lasted a little more than an hour (Me = 75.0 min). No intraoperative complications were detected. In one female patient (3.3%), a local recurrence of cervical cancer was found, and therefore that patient was excluded from the study. Control rectoscopy showed the complete epithelialization of post-radiation ulcerative rectal defects in 28 (93.3%) patients after 6 months. Conclusions. The technique proposed to use autologous microfragmented adipose tissue is affordable and effective in the treatment of patients with radiation-induced ulcerative proctitis.

BackgroundAutologous adipose tissue grafting is a valuable strategy for breast reconstruction in breast cancer patients. However, adipose tissue is absorbed and liquefies easily, and the cosmetic effects do not last. The purpose of this study is to evaluate the cosmetic effects and histopathologic changes of the prostheses produced by inactivated autologous subcutaneous adipose tissue and dermal outer capsule in the mini-pig model.MethodsThis prospective study was conducted in 6 Bama adult female mini-pigs weighing 15.5–20 kg. Autologous subcutaneous adipose tissue and dermis were harvested and made into the different prostheses. Then, the prostheses were implanted into abdominal subcutaneous tissue of the mini-pigs. At the 14th and 30th day after implantation, the skin appearances were observed, and the prostheses were harvested. The histopathologic changes of adipocytes and dermis in the different prostheses were evaluated.ResultsIn vitro experiments showed that there were no significant changes in the size and histomorphology of autologous adipose tissue and/or dermis in the different prostheses. However, the results of the in vivo experiment found that the prosthesis produced by the inactivated adipose tissue with a dermal outer capsule produced the best cosmetic effect and the least fibrous connective tissue proliferation around the prosthesis. Moreover, the fewest proliferative fibrous connective tissues and infiltrated inflammatory cells were found in the adipocytes wrapped by dermis. The adipocyte morphology was normal.ConclusionsResults in this animal model indicated that the prosthesis produced by inactivated autologous subcutaneous adipose tissue with a dermal outer capsule may be a promising prosthesis for breast reconstruction. Validation of this new prosthesis requires more experiments to assess the long-term cosmetic effects and histopathologic changes.

Traditional autologous adipose tissue grafting is commonly used for volume augmentation and tissue regeneration. However, the uniform physical and biological properties of fat grafts often lead to suboptimal performance in diverse patient scenarios and multifaceted requirements. Expanding upon the foundations of autologous fat transplantation, we introduce a pioneering approach termed autologous adipose component transplantation. This innovative concept integrates a meticulously designed protocol aimed at converting autologous adipose tissue into a diverse array of adipose components, each characterized by unique physicochemical properties tailored to address specific applications across varied clinical contexts. Through a series of physical methods, adipose tissue can be transformed into an Adipose Matrix Complex (AMC) providing sufficient rigid support, High-Density Fat (HDF) for further filling, Stromal Vascular Fraction (SVF)-gel for small and/or precise injections, and Adipose Collagen Fragment (ACF) for fine wrinkles and/or facial rejuvenation needs. These distinct adipose components possess inherent characteristics that lend themselves to precise and targeted transplantation strategies, catering to the nuanced demands of individual patient needs. The novel adipose tissue fractionation protocol shows great potential in revolutionizing adipose tissue grafting. It offers a new perspective and methodology for more refined and tailored transplantation.

Simple SummaryOsteoarthritis (OA) is a very common musculoskeletal condition that affects dogs, as well as humans and other species, and causes pain, lameness, and disability. Since therapy is not always effective and is definitive only in some cases, OA is still a leading cause of euthanasia in dogs and a challenge for orthopedic surgeons. Recently, new therapeutic approaches, such as the use of autologous mesenchymal stem cells, have been developed. The purpose of this prospective, randomized, controlled, in vivo clinical study was to estimate the safety, feasibility, and efficacy of the intra-articular treatment of autologous microfragmented adipose tissue in dogs affected by spontaneous OA in comparison with a treatment with hyaluronic acid. Pain, lameness, the radiographic progression of OA, and synovial fluid inflammation were assessed. The results suggest that intra-articular injection of microfragmented autologous adipose tissue is safe, timesaving, cost-effective, minimally invasive, and can be easily done in one step. This treatment, compared with the hyaluronic acid treatment, showed better long-term pain control and an amelioration of synovial fluid quality, resulting in an improvement in joint function. This new treatment can be included among the effective therapies for OA. Additionally, the canine spontaneous OA model adopted in this study could play a key role in developing successful treatments for translational medicine.The purpose of this study was to estimate the safety, feasibility, and efficacy of the intra-articular treatment of autologous microfragmented adipose tissue in dogs with spontaneous osteoarthritis (OA) in comparison with hyaluronic acid (HA), the standard intra-articular treatment. Specifically, it clinically evaluated pain and lameness, the radiographic progression of osteoarthritis, and synovial fluid inflammation. This was a prospective, single-center, parallel-group, randomized, controlled, in vivo clinical study. Participants (n = 40) received either a single intra-articular injection of microfragmented adipose tissue or a single intra-articular injection of HA (1:1). Clinical outcomes were determined using a specialistic clinician assessment obtained by the completion of a specific clinical form based on the Vesseur modified lameness classification system, a pain evaluation using the Visual Analogue Scale (VAS), the measurement of the range of motion (ROM) of the affected joint, limb circumference, and the owners’ score evaluation using the Canine Brief Pain Inventory (CBPI) for up to 6 months after the time of injection. Patients underwent a radiographic examination to establish the degree of OA in the affected joint, and synovial fluid samples were collected to assess the biochemical environment of the joint and evaluate and quantify the cellular population and the presence of three specific inflammation biomarkers for up to 60 days. The results of this study suggest that microfragmented autologous adipose tissue is safe and can effectively relieve pain and improve function in dogs with spontaneous articular OA. This one-step procedure is simple, timesaving, cost-effective, minimally invasive, and eliminates the need for complex and time-intensive cell culture processing. Furthermore, the clinical evidence and cytological results suggest better long-term pain control, resulting in an improvement in joint function, compared to HA treatment. The canine spontaneous OA model could play a key role in developing successful treatments for human medicine.

Introduction. Post-radiation ulcerative proctitis is a serious complication after radiotherapy for cancer of the prostate, cervix and uterine body, anal canal, and other pelvic tumors. Given the mechanism of occurrence, there are currently no pathogenetic methods for the treatment of post-radiation ulcerative proctitis. Aim. Is to develop a technique and evaluate its effectiveness in the treatment of patients with post-radiation rectal ulcers using autologous microfragmented adipose tissue. Material and methods. The study included 30 patients, of which 24 (80.0% were women and 6 (20.0%) were men. Manual lipoaspiration was used to obtain autologous adipose tissue. Then, microfragmentation was performed through transfers. The introduction of autologous concentrated adipose tissue was performed in edges of post-radiation ulcerative defect of the rectal wall under endoscopic control. Results and discussion. The duration of the manipulation from the moment of adipose tissue sampling to the end of the injection was a little more than an hour (Me = 75.0 min). No intraoperative complications were identified. One patient (3.3%) had a local recurrence of cervical cancer, and therefore the patient was excluded from the study. Control rectoscopy after 6 months in 28 (93.3%) patients showed complete epithelialization of post-radiation ulcerative defects of the rectum. Conclusion. The technique of using autologous microfragmented adipose tissue is affordable and effective in the treatment of patients with post-radiation ulcerative proctitis

To evaluate the safety and efficacy of autologous concentrated adipose tissue for the treatment of knee OA. Eighty-seven patients with knee arthritis from grade 1 to 3, according to Kellgren-Lawrence scale, have been treated with knee arthroscopy and successive intra-articular injection of concentrated adipose tissue. The efficacy of the treatment has been evaluated by the Knee Society Score, Lysholm Score, Forgotten Joint Score, Knee Injury and Osteoarthritis Outcome Score and Noise Reporting Scale. A total of 78/87 patients concluded the study. Overall, the patients were satisfied with the intervention and a significant reduction of the pain was observed in 67 patients, while the others did not report any change in pain severity or worsening. A statistically significant improvement was observed in the considered orthopaedic index, and no major adverse effects were described. The first week after the intervention, most patients reported knee swelling. Five patients failed because they underwent knee replacement surgery between five and ninemonths from treatment. In patients with knee OA, a single intra-articular injection of autologous adipose tissue reduced knee pain, stiffness, improved knee function and quality of life without severe complications.

Optimization of autologous adipose tissue transplantation: The impact of patient-specific and intraoperative factors on cellular viability before and after cryopreservation.

Objective: Vaginal atrophy, vulvovaginal dystrophy, and stress urinary incontinence (SUI), common conditions in women, have detrimental effects on quality of life. Current treatments require ongoing use and are associated with risks, complications, and incomplete resolution of symptoms. The aim of this observational case series was to evaluate the safety and feasibility of autologous micro-fragmented adipose tissue injections for the treatment of vaginal atrophy, vulvovaginal dystrophy, and SUI in women. Methods: Ten women affected by vaginal atrophy, vulvovaginal dystrophy, and/or SUI were injected into their affected areas with harvested and processed autologous micro-fragmented adipose tissue. Symptoms, diagnoses, previous treatments, and gynaecological surgeries were considered. Outcomes were measured using the Female Sexual Function Index (FSFI), the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), the Vulvovaginal Symptoms Questionnaire (VSQ), and the Short-Form 12 (SF-12) health survey. Information gained from discussion and clinical examination at consultations was also used to measure outcomes. Results: No adverse events or complications were reported during the intraoperative, recovery, postoperative, or follow-up periods. No signs of infection, pain, dysuria, skin irregularities, skin discolouration, discharge, or worsening of symptoms were reported. All 10 women reported an improvement of symptoms within 6–16 months of the planned follow-up period. Conclusions: Autologous micro-fragmented adipose tissue injections appeared to be safe and feasible and may have a positive role in the treatment of the physical signs and symptoms of vaginal atrophy, vulvovaginal dystrophy, and SUI.

The objective of this study was to evaluate the safety and the efficacy of intra-articular injections of autologous micro-fragmented adipose tissue in patients affected by early or moderate ankle osteoarthritis (AOA). A total of 31 symptomatic patients, aged 28-71years, affected by AOA, were treated with 5ml of autologous micro-fragmented adipose tissue. Clinical evaluations before the treatment and after six, 12, and 24months were performed through American Orthopaedic Foot and Ankle Society (AOFAS) scale, the Foot and Ankle Disability Index (FADI), and Visual Analogue Scale (VAS) scores. Adverse events were recorded. No severe complications were noted during the treatment and the follow-up period. A statistically significant improvement from basal evaluation to the six, 12-, and 24-month follow-up visit was observed, whereas a statistically significant worsening from the 12-month to the 24-month follow-up visit was showed. The autologous micro-fragmented adipose tissue for the treatment of pain in ankle osteoarthritis seems safe and able to provide positive clinical outcomes, potentially offering a new minimally invasive therapeutic option for patients who are not eligible for more invasive approaches. Further high-quality studies are needed to confirm these findings.

Mature outbred male Wistar rats have been used in the study. The animals were divided into 7 experimental groups with complete transection of the sciatic nerve on the right side at the mid-third level of the thigh. The ends of the transected nerve were pulled apart, inserted into a silicon conduit, and secured to the epineurium. The conduit of group 1 (control) was filled with a saline solution; in group 2, it was filled with an autologous omental adipose tissue with saline solution. Intravital labeling of the omental adipose tissue with the lipophilic PKH 26 dye (in group 3) was used for the first time to find out whether the omental cells were involved in formation of the regenerating nerve. Diastasis in groups 1-3 was 5 mm, the postoperative period was 14 weeks. The dynamics of the omental adipose tissue changes in groups 4-7 was assessed by placing the omental tissues into the conduit covering 2 mm of diastasis. The postoperative period was 4, 14, 21, and 42 weeks. In group 2 (omental adipose tissue + saline), the clinical condition of the damaged limb after 14 weeks may be evaluated as satisfactory and approximating to the intact parameters as compared to group 1 where the conduit was filled with a saline solution only. The sum of large and medium-sized nerve fibers in group 2 was 2.7 times greater than that in group 2. The milled omental adipose tissue inside the conduit changed its volume and structure in nerve diastasis and was constantly utilized up to complete elimination over time. The omental cells integrated into the newly formed nerve in the graft area. As a graft, the adipose tissue of the autologous omentum produces a stimulating effect on the post-traumatic regeneration of the sciatic nerve.