Autologous Fat Grafting Research Articles

Cell-supplemented autologous fat grafting: a review from bench to bedside

Autologous fat grafting is routinely used in plastic and reconstructive surgery to improve contour deformities and appearance. However, retention of fat over time is inconsistent and unpredictable. Cell-assisted lipostransfer (CAL), the practice of using stem cell-containing portions of adipose to enrich fat grafts, has been found to be a promising area of research to increase not only the retention of volume but also increase collagen production, enhance angiogenesis, and direct the overall repair, remodeling, and regeneration of the recipient site. CAL, therefore, has a multitude of clinical applications, ranging from oncologic reconstruction following radiation to facial rejuvenation, among others. In this paper, we provide a comprehensive review of the current state of cell-supplemented fat transfer and discuss our understanding of cellular interactions in enriched fat grafts, techniques to improve the viability of fat, clinical translation of CAL, regulatory oversight, and future directions.

Donor variability in adipose tissue-derived stem cells: implications for the clinical efficacy of autologous fat grafting

Donor variability in adipose tissue-derived stem cells: implications for the clinical efficacy of autologous fat grafting

8550 Processing Technique Affects Aromatase Expression in Fat Grafts for Breast Reconstruction

Abstract Disclosure: S. Arbuiso: None. Y. Chen: None. N.A. Vernice: None. A. Zhang: None. I.J. Rhodes: None. C.C. Alston: None. S. Hanif: None. S. Liu: None. P. Bhardwaj: None. D. Janhofer: None. G.G. Black: None. D.M. Otterburn: None. K.A. Brown: None. Introduction: Autologous fat grafting is commonly used in breast reconstruction as it is associated with good cosmetic outcomes, high patient satisfaction, and minimal risks. Adipose tissue is known to support cancer growth via the secretion of adipokines and the modulation of estrogen levels due to aromatase expressed in adipose stromal cells. A higher body mass index (BMI) and postmenopausal status are associated with higher levels of aromatase. With novel processing techniques being developed to increase fat graft retention, there is a need to better understand how these will affect the biology of lipoaspirates for women who have previously had breast cancer. This study aims to assess how different processing techniques used in fat grafting (1) impact aromatase gene expression, (2) affect breast cancer cell proliferation, and (3) affect the cellular composition of the engrafted lipoaspirate. Methods: Patients who underwent breast reconstruction for breast cancer treatment or for prophylactic measures, and were receiving autologous fat grafting, were enrolled in a prospective randomized controlled trial (NCT04891510). Patients were randomized to one of three processing techniques: standard decantation, active filtration, and low-pressure decantation. Conditioned media (CM) was created from each sample. Aromatase mRNA was measured in the lipoaspirate using qRT-PCR for aromatase (CYP19A1) and related to patient BMI or menopausal status. The effect of CM on the proliferation of MCF7 cells (estrogen receptor positive (ER+) breast cancer cell line) was measured using CyQUANT. Formalin-fixed lipoaspirate samples were embedded in HistoGel and paraffin. Adipocyte diameter was measured in hematoxylin and eosin (H&E) stained sections using ImageJ. Results: Aromatase mRNA levels were correlated with BMI and were higher in postmenopausal women (p≤0.05), with the standard decantation group demonstrating a stronger correlation with BMI. Samples processed via active filtration were associated with weaker correlations between aromatase gene expression and BMI and menopausal status. CM induced MCF7 cell proliferation to a similar extent to cells plated in fetal bovine serum-containing media. There was no difference in proliferation patterns between treatment groups. Upon histological assessment, adipocytes were intact, and adipocyte diameter was significantly correlated with patient BMI. Conclusion: Lipoaspirate may contain factors that promote breast cancer cell proliferation, unaffected by processing technique. Caution should be used to ensure local control of the cancer has been achieved prior to reconstruction. Our data suggest that active filtration selects for a lower percentage of adipose stromal cells, which may be beneficial for patients who previously had ER+ breast cancer. Presentation: 6/1/2024

Sciatic Nerve Transection Following Prosthetic Buttock Augmentation: First Reported Case and Review of the Literature

Abstract Gluteal augmentation is typically carried out by implant placement or autologous fat grafting. Over recent years, there has been a significant increase in the number of gluteal augmentations being performed. However, as the number of procedures has increased, so too have the number of complications. We present a case of a 33-year-old female with an implant infection with concomitant sciatic nerve transection following bilateral gluteal augmentation with implants leading to a permanent foot-drop. While transient sciatica due to compression has been described as a complication of gluteal augmentation, this is the first reported case, to our knowledge, of transection. The many unusual management decisions that had to be made when faced with this rare and devastating complication are highlighted and the relevant literature on gluteal augmentation is discussed. Patients and surgeons alike need to take particular care when considering this procedure.

Therapeutic Efficacy of Adipose Tissue-Derived Components in Neuropathic Pain: A Systematic Review.

Neuropathic pain results from a defect in the somatosensory nervous system caused by a diversity of etiologies. The effect of current treat-ment with analgesics and surgery is limited. Studies report the therapeutic use of adipose tissue-derived components to treat neuropathic pain as a new treatment modality. The aim of this systematic review was to investigate the therapeutic clinical efficacy of adipose tissue-derived components on neuro-pathic pain. PubMed, Medline, Cochrane and Embase databases were searched until August 2023. Clinical studies assessing neuropathic pain after autologous fat grafting or the therapeutic use of adipose tissue-derived com-ponents were included. The outcomes of interest were neuropathic pain and quality of life. In total, 433 studies were identified, of which 109 dupli-cates were removed, 324 abstracts were screened and 314 articles were excluded. In total, ten studies were included for comparison. Fat grafting and cellular stromal vascular fraction were used as treatments. Fat grafting indications were post-mastectomy pain syndrome, neuromas, post-herpetic neuropathy, neuro-pathic scar pain and trigeminal neuropathic pain. In seven studies, neuropathic pain levels decreased, and overall, quality of life did not improve. The therapeutic efficacy of adipose tissue-derived components in the treatment of neuropathic pain remains unclear due to the few performed clinical trials with small sample sizes for various indications. Larger and properly designed (randomized) controlled trials are required.

A Novel Laboratory-Based Strategy for Single Adipocyte and Adipose-Derived Stem Cells Extraction for Transplantation: An Experimental Research.

Autologous fat grafting is widely used in plastic surgery. However, its main limitation is the low survival rate of fat grafts after transplantation. Transplantation of single adipocytes in combination with adipose-derived stem cells (ADSCs) could largely preserve the activity of the fat and improve graft survival. To verify the long-term survival rate of single adipocyte graft in vivo and its viable fat morphology for future fat grafting. Healthy adipose tissue was harvested and disassociated using fat dissociation solution, the Single-cell Suspension Preparation System (SSPS) was used to obtain a mixture of single adipocytes, ADSCs and stromal vascular fraction (SVF), and the structure of single adipocytes was verified by cell mask red and DAPI double staining. Nine male Balb/c nude mice were used, and three different graft volumes were established (0.05, 0.1 and 0.2ml). For each mouse, four sites were selected for transplantation, one for macrofat and the other three for single adipocytes, and different transplant volumes 30, 60 and 90days after transplantation. In each period, 3mice were selected to measure the volume of fat graft. Double staining with cell mask red and DAPI confirmed that the nucleus was identified intracellularly, which also indicated that the adipocytes in the single-cell suspension were structurally complete. When evaluating the transplantation, the groups with a volume of 0.05 ml and 0.2ml performed better in the single-cell fat group in all transplantation periods, the group with a volume of 0.1ml performed better in the single-cell group in the 30- and 60-day transplantation, and the differences were significant (P<0.05). In this study, the SSPS was used to obtain a new transplant material containing single adipocytes and ADSCs by enzymatic hydrolysis of adipose tissue and converted into single cells. It effectively improved the survival rate of fat grafting and the long-term effect of transplantation. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

A full-face contouring using micro-autologous fat transplantation (MAFT)-gun technique in Vietnamese population

IntroductionMicro-autologous fat transplantation (MAFT)-gun technique is applied to accurately deliver small fat parcels to multiple fat layers in varied facial sites. Our study presented surgical and clinical outcomes of the MAFT-gun technique for full face contouring. MethodsFrom 01/2021 to 06/2023, 31 healthy participants undergoing fat grafting by MAFT-gun technique for volumization of their full face at our hospital were included. Data on fat volume grafted in different facial sites, complications, and satisfaction rate (%) were collected and analyzed. ResultsThe fat volumes grafted over the left and right cheek were 10.3 ± 0.31ml and 10.2 ± 0.30ml. The forehead and temples demanded lower fat volume by 9.8 ± 0.23ml and 4.5 ± 0.21ml. A small fat volume was required for the nasolabial fold, the tear trough, and the infraorbital areas, by 2.2 ± 0.11ml, 1.9 ± 0.10ml, and 1.4 ± 0.11ml. The fat volumes for the nasolabial fold and the tear trough were significantly different between young and old people. No complications including infection, necrosis, or vascular injury were noted. At the end of the follow-up, 26 patients (83.9%) expressed their satisfaction after the procedure. ConclusionThe MAFT-gun technique is safe and effective for full-face autologous fat grafting. Commercial closed-system processors could be an effective alternative to centrifugation for fat processing. The procedure contributed to the improvement of facial hollowness and brought a more attractive and satisfied appearance to people even after 12 months postoperatively.

Effect of cephalosporin injection postoperative after cell assisted lipografting in fat survival and improving post burn scar quality

Scars have always been an issue, and the majority of treatments have failed to address them adequately. The biggest obstacle that plastic surgeons still face is finding an effective procedure that works for all skin types in the long run. In a non-invasive way, external volume expansion (EVE) devices use suction to mechanically stretch and stimulate tissues. Different studies have proposed various mechanisms for how stretch releases the skin, including mechanical action on individual cells, inflammation, ischemia, and soluble mediators that promote cell proliferation, adipogenesis, and most crucially, vascular remodeling. Platelet-rich plasma (PRP) is a product made from autologous blood that is concentrated in plasma volume and contains an abundance of platelets, growth factors, and chemo/cytokines. The contents of the alpha and dense granules in PRP have the ability to provide a high concentration of growth factors to the tissues that need them. Autologous fat grafting, initially described by Neuber in 1893 and subsequently improved by Coleman, is a relatively new alternative to scar tissue removal. It is believed that autologous fat grafting improves skin quality by increasing dermal thickness and volume via stimulating the neosynthesis of collagen fibers. It is still unclear what impact autologous fat grafting has on scar tissue, despite its growing popularity in the medical field, and the use of postoperative cephalosporin is very essential for guarding against infection and losing of fat. Critics have cast doubt on its usefulness due to the fact that survival rates can range from 30% to 80% , the infection rate and loss of fat

Advantages and Disadvantages of Breast Augmentation: Surgical Techniques, Outcomes and Future Directions.

Breast augmentation remains a highly sought-after cosmetic surgery, with various techniques available to enhance breast size using implants or fat transfer. This systematic review, spanning studies from 2003 to 2024 and adhering to PRISMA guidelines, evaluates the outcomes of different surgical approaches concerning scar quality, postoperative pain, patient satisfaction, and complications. The periareolar technique emerges as a favorable option, offering minimal postoperative pain, high patient satisfaction, and precise surgical control with subtle scarring. Transumbilical breast augmentation (TUBA) is noted for its scar-free approach, resulting in low pain and high satisfaction, though it requires specialized training and cannot use prefilled implants. The review highlights the varying complication rates across techniques: modern silicone implants, while safer than earlier injectable materials, still face risks such as rupture and capsular contracture. Autologous fat grafting is generally safer but can lead to issues like erythema and abscesses. The use of effective acellular dermal matrix (ADM) is linked to higher rates of seroma and infection compared to non-ADM procedures, although sterile human ADM shows a lower risk profile. The study underscores the importance of personalized surgical planning to optimize outcomes, as each technique offers distinct benefits and challenges. The findings suggest that future research should aim to refine these techniques and address their associated complications to further enhance patient satisfaction and surgical outcomes in breast augmentation.

The Landscape of Research on Autologous Fat Grafting for Breast Reconstruction

The Landscape of Research on Autologous Fat Grafting for Breast Reconstruction

Improving the Retention Rate of Fat Grafting by Botulinum Toxin A: A Randomized, Self-controlled, Clinical Trial.

Botulinum toxin A (BTX-A) can enhance the efficacy of fat grafting. However, most studies conducted animal experiments, lacked objective clinical data, or were non-randomized controlled trials. Thus, objective evaluation of the clinical effectiveness of BTX-A is still elusive. A randomized, self-controlled trial (2020-2022) on 16 patients who underwent bilateral autogenous fat breast augmentation was performed with each patient receiving autologous fat graft and BTX-A on one side and fat graft and equal volume of saline on the other side. All patients were followed. The effects of BTX-A were evaluated objectively by comparing the remaining bilateral fat graft volumes obtained through digital three-dimensional reconstruction. The improvement of each breast appearance and complication were assessed by the physician and patients who were blinded to the treatment. The outcome of fat breast augmentation was evident for both sides at follow-up with no evidence of fat embolism, vascular/nervous injury, infection, and prolonged bruising. The analysis of the three-dimensional reconstruction data and assessments from both physicians and patients showed significant differences in the fat graft retention volume between the BTX-A side and the control side. No significant difference was found in the incidence of complications between the two sides. Autogenous fat breast augmentation is safe and effective. This study shows that BTX-A can significantly improve the retention rate of fat transplantation, but cannot reduce complications. Trial registration This study was registered prior to patient enrollment (ClinicalTrials.gov identifier:ChiCTR2100054878). This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

SP6.6 - Examining the Immunomodulatory Effects of Fibrosis Induced by Radiation Using Adipose-derived Stem Cells

Abstract Background and Introduction Radiation-induced fibrosis (RIF) is a complication of radiotherapy in the treatment of head and neck cancer. RIF is characterised by the formation of fibrous tissue and is associated with significant morbidity. Autologous fat grafting (AFG) is a promising approach for treating RIF, and adipose-derived stem cells (ADSC) have been identified as key contributors to this therapeutic effect. Method The experimental group included subjecting human-derived fibroblasts (iHDF) to radiation, whereas the control group remained radiation-free. Both groups were then treated with ADSC-controlled medium and co-cultured with ADSC. The amounts of important immunomodulators produced by iHDF cells were then collected and evaluated using enzyme-linked immunosorbent assays (ELISA) and real-time reverse transcription-polymerase chain reaction (RT-PCR). Results Co-cultured iHDF samples demonstrated a slight reduction in CCL2 concentrations compared to untreated iHDF samples (p = 0.0006). The iHDF co-culture samples exhibit a marginal elevation in CCL3 levels compared to the untreated iHDF samples (p = 0.0247). The co-culture samples of iHDF demonstrate a substantial and measurable elevation in IL-8 levels compared to the untreated iHDF samples (p = 0.027). The expression of Col1A1 is decreased in iHDF samples in comparison to control groups. Discussion CCL2 is implicated in the recruitment of ADSCs to specific locations. The elevated production of IL-8 in ADSC samples is associated with the pro-angiogenic characteristics of ADSC secretions, which promote healing in fibrotic tissue. Conclusion ADSCs were shown to possess anti-fibrotic properties via stimulating pro-angiogenic factors. However, experimental data indicates a concomitant elevation in pro-inflammatory factors. Further research is needed to explore the in-vivo effects of ADSC.

SP6.7 - Exploring the Mechanistic Basis of the Adipose Derived Stem Cell Secretome on Extracellular Matrix Remodelling in Radiation Induced Fibrosis

Abstract Background Radiation-induced fibrosis (RIF) is a debilitating complication following radiotherapy, characterised by fibroblast proliferation and excessive extracellular matrix (ECM) deposition, leading to functional and aesthetic impairments. Although autologous fat grafting (AFG) has shown promise in reversing RIF, the mechanisms, largely attributed to adipose-derived stem cells (ADSCs), remain elusive. This study aimed to investigate ADSCs’ and their secretome on ECM remodelling in RIF management. Methods The anti-fibrotic potential of the ADSC secretome on HDFs subjected to ionising radiation was assessed via a series of in vitro experiments. Control HDFs were compared with irradiated HDFs to assess any phenotypical changes. Irradiated HDFs were treated with ADSC pre-conditioned media (CM) or ADSC co-culture (CC). Gene expression (COL1A1, TGF-β1, CCN-2, MMP-1, MMP-3, TIMP-1, ACTA2, TNC) was assessed via real-time quantitative PCR (RT-qPCR). ProCollagen1a1 and CCN2 protein concentrations were assessed by ELISA. Results Irradiated HDFs demonstrated changes in fibrotic gene expression. ADSC-CM treatment significantly reduced COL1A1 expression, although protein levels remained unchanged. TGF-β1, CCN2, MMP-3, TIMP-1 and ACTA-2 exhibited reduced expression post-ADSC-CM treatment whereas TNC expression was found to be significantly increased. Co-culture with ADSCs led to a general, but not statistically significant, decrease in pro-fibrotic gene expression. Notably, CCN-2 protein expression significantly increased. Conclusion This study demonstrates that ionising radiation results in a pathological pro-fibrotic phenotype in HDFs. The ADSC secretome potentially mitigates this, reducing pro-fibrotic gene expression. Unexpectedly, co-culture experiments highlighted a complex interaction with upregulation of fibrosis-associated genes. Further research is needed to clarify these interactions to improve therapeutic interventions for RIF.

Fatty Menace: A case report of superior ophthalmic vein fat embolism due to autologous fat grafting

Autologous fat grafting is among the many procedures used for facial rejuvenation and reconstruction, and its popularity has been increasing in Asia and worldwide. This procedure carries a risk of arterial or venous occlusion, which can lead to serious consequences. Venous embolism following autologous fat grafting is rarely reported. Here, we present a case of superior ophthalmic vein fat embolism and orbital compartment syndrome in a patient who underwent autologous fat grafting. Timely diagnosis, appropriate referral, and comprehensive multidisciplinary assessment are crucial for achieving favorable clinical outcomes.

What Patient-related Factors Most Strongly Influence Autologous Fat Grafting Volume Retention in Breast Augmentation?

Background: Regarding autologous fat grafting for breast augmentation, the factors influencing volume retention are unclear. Few studies have assessed which factors, particularly patient-related variables, could affect volume retention and to what extent, without performing multivariate analysis. In this study, we performed three-dimensional breast volume measurements before and after autologous fat grafting, calculated the volume and volume retention, and investigated factors that may affect volume retention. Methods: A total of 204 breasts that underwent autologous fat grafting by the same surgeon at our hospital between May 25 and December 25, 2021 were included. Volumetric measurements were taken preoperatively and at 1, 3, and 6 months postoperatively using a three-dimensional camera; volume retention was calculated. Linear mixed model analysis was performed to examine the effects of age, body mass index, number of total autologous fat grafting procedures, pregnancy and lactation history, smoking status, fat processing techniques (sedimentation versus centrifugation), preoperative volume, and weight change at the 3- and 6-month postoperative volume retention analyses. Results: Using multivariate analysis, the preoperative volume was found to be a significant factor at 3 and 6 months. The preoperative volume affected fat volume retention rate by 0.004 (P = 0.001) and 0.008 (P = 0.011) per 10 mL at 3 and 6 months, respectively. Conclusions: The preoperative volume likely affected fat volume retention. Specifically, a 100-mL increase in the preoperative breast volume might increase the volume retention by 4%–8%. Preoperative volume is an important confounding factor for future studies.

Single-cell RNA sequencing identifies inherent abnormalities of adipose-derived stem cells from nonlesional sites of patients with localized scleroderma

BackgroundLocalized scleroderma (LoS) is an autoimmune disorder that primarily affects the skin, and is often treated with autologous fat grafting (AFG). Nevertheless, the retention rate of AFG in patients with LoS is typically low. We hypothesize that the low retention rate may be partially attributed to the inherent abnormalities of adipose-derived stem cells (ASCs) from nonlesional sites of patients with LoS.MethodsWe performed a comparative analysis of the single-cell transcriptome of the SVF from nonlesional sites of patients with LoS and healthy donors, including cellular compositional analysis, differential expression analysis, and high-dimensional weighted gene coexpression network analysis. Experimental validation with fluorescence-activated cell sorting and bleomycin-induced skin fibrosis mice models were conducted.ResultsWe found a significant reduction in the relative proportion of CD55high interstitial progenitors in ASCs under the condition of LoS. Differential expression analysis revealed inherent abnormalities of ASCs from patients with LoS, including enhanced fibrogenesis, reduced anti-inflammatory properties, and increased oxidative stress. Compared with CD55low ASCs, CD55high ASCs expressed significantly higher levels of secreted protein genes that had functions related to anti-inflammation and tissue regeneration (such as CD55, MFAP5, and METRNL). Meanwhile, CD55high ASCs expressed significantly lower levels of secreted protein genes that promote inflammation, such as chemokine and complement protein genes. Furthermore, we provided in vivo experimental evidence that CD55high ASCs had superior treatment efficacy compared with CD55low ASCs in bleomycin-induced skin fibrosis mice models.ConclusionsWe found that the low retention rate of AFG may be partially ascribed to the reduced pool of interstitial progenitor cells (CD55high) present within the ASC population in patients with LoS. We demonstrated the potential for improving the efficacy of AFG in the treatment of LoS by restoring the pool of interstitial progenitors within ASCs. Our study has significant implications for the field of translational regenerative medicine.

Fat Grafting and Prepectoral Prosthetic Reconstruction with Polyurethane-Covered Implants: Protective Role against Adjuvant Radiotherapy.

Background/Objectives: Breast cancer treatment increasingly incorporates immediate prepectoral prosthetic reconstruction after conservative mastectomy, including nipple-sparing (NSMs) and skin-sparing mastectomies (SSMs). Although recent data from the literature show that postmastectomy radiotherapy (PMRT) after prepectoral reconstruction presents good clinical results, with reduction in capsular contracture and implant migration, compared to the traditional submuscular technique, these patients have higher rates of long-term complications when compared with nonradiated patients. This study evaluates the protective effects of autologous fat grafting to reduce long-term radiotherapy-induced complications in breast cancer patients submitted for prepectoral reconstruction with polyurethane-covered (PU) implants. Methods: A pilot study with two parallel cohorts of patients undergoing an NSM or SSM followed by PMRT was conducted. Patients were randomly assigned to either of the two groups to ensure homogeneity. One cohort underwent autologous fat grafting sessions, individually tailored based on periodic evaluations by the principal investigator (PI), M. Salgarello, at least six months after PMRT. The control group received standard clinical follow-ups without fat grafting. Inclusion criteria ensured participants were disease-free, non-smokers, and had a LENT-SOMA score within 2. Results: Preliminary findings indicate significant differences between the groups, with improved outcomes observed in patients undergoing tailored lipofilling. Specifically, these patients experienced a notable reduction in capsular contracture severity and reported higher satisfaction with the aesthetic results compared to the control group. Conclusions: Autologous fat grafting, customized per patient by the PI based on ongoing evaluations, appears to mitigate some adverse effects of radiotherapy in prepectoral breast reconstruction, suggesting a viable option for enhancing surgical outcomes in irradiated patients. Further research is needed to substantiate these findings and evaluate long-term benefits.

Correction of Post-Surgical Temporal Hollowing with Adipo-Dermal Grafts: A Case Series.

Background: Surgical dissection and partial detachment of the temporalis muscle during neurosurgical procedures might result in a temporal depression known as "temporal hollowing". Reconstructive procedures to correct this condition include the implantation of synthetic materials (e.g., hydroxyapatite, methacrylate or polyethylene), injection of autologous fat or fillers as well as the use of flaps (e.g., temporo-parietal local flap and latissimus dorsi free flap). However, none of these techniques proved to be an ideal option due to a high complication rate or need for invasive and complex surgery. Adipo-dermal grafts are autologous; the resorption rate seems to be limited and the complexity of the procedure is minor. Moreover, autologous fat grafting can be performed to enhance the final outcome by correcting residual contour deformities. Methods: In this series of five patients, an institutional experience is presented using multi-layered adipo-dermal grafts harvested from the supra-pubic area for the restoration of volume and contour in post-surgical temporal hollowing. During the last follow-up, patients were asked to express their satisfaction, which was assessed by a survey. Results: this approach demonstrates a marked improvement in temporal hollowing associated with a low complication rate and good patient satisfaction. Conclusions: the aim of this consecutive case series is to emphasize the effectiveness of this surgical technique as one of the options to address temporal hollowing.

Autologous Fat Grafting-A Panacea for Scar Tissue Therapy?

Scars may represent more than a cosmetic concern for patients; they may impose functional limitations and are frequently associated with the sensation of itching or pain, thus impacting both psychological and physical well-being. From an aesthetic perspective, scars display variances in color, thickness, texture, contour, and their homogeneity, while the functional aspect encompasses considerations of functionality, pliability, and sensory perception. Scars located in critical anatomic areas have the potential to induce profound impairments, including contracture-related mobility restrictions, thereby significantly impacting daily functioning and the quality of life. Conventional approaches to scar management may suffice to a certain extent, yet there are cases where tailored interventions are warranted. Autologous fat grafting emerges as a promising therapeutic avenue in such instances. Fundamental mechanisms underlying scar formation include chronic inflammation, fibrogenesis and dysregulated wound healing, among other contributing factors. These mechanisms can potentially be alleviated through the application of adipose-derived stem cells, which represent the principal cellular component utilized in the process of lipofilling. Adipose-derived stem cells possess the capacity to secrete proangiogenic factors such as fibroblast growth factor, vascular endothelial growth factor and hepatocyte growth factor, as well as neurotrophic factors, such as brain-derived neurotrophic factors. Moreover, they exhibit multipotency, remodel the extracellular matrix, act in a paracrine manner, and exert immunomodulatory effects through cytokine secretion. These molecular processes contribute to neoangiogenesis, the alleviation of chronic inflammation, and the promotion of a conducive milieu for wound healing. Beyond the obvious benefit in restoring volume, the adipose-derived stem cells and their regenerative capacities facilitate a reduction in pain, pruritus, and fibrosis. This review elucidates the regenerative potential of autologous fat grafting and its beneficial and promising effects on both functional and aesthetic outcomes when applied to scar tissue.

Clinical effect of botulinum toxin type A combined with autologous fat grafting in patients with nasolabial fold depression.

Nasolabial fold (NLF) depression can affect the facial appearance of patients to some extent and increase their psychological burdens. In recent years, autologous fat grafting (AFG) combined with botulinum toxin A (BTX-A) injection (AFG + BTX-A injection) has been gradually applied in the treatment of patients with NLF depression. Although studies have been conducted on the efficacy and safety of AFG + BTX-A injection in treating NLF depression, the experimental design, observational indicators, and sample enrollment criteria vary remarkably, making it difficult to draw convincing and consistent conclusions. Thus, further relevant research is warranted. To assess the esthetic improvement, efficacy, and safety of AFG + BTX-A injections in patients with NLF depression. This study included 60 patients with NLF depression who were treated in our hospital from February 2019 to April 2021. These patients were categorized into control (n = 30) and observation (n = 30) groups. The observation group received AFG + BTX-A injection, whereas the control group underwent AFG only. All patients were evaluated using the wrinkle severity rating scale (WSRS) and global aesthetic improvement scale. The compactness of facial contours, skin evaluation indexes, adverse reactions, and satisfaction of the two groups were evaluated 3 months postoperatively. The WSRS scores of the observation group at 1, 3, and 6 months postoperatively were lower than those of the control group (P < 0.05). Three months postoperatively, facial fine lines and pores showed obvious improvement and the skin index score was higher in the observation group than in the control group (P < 0.05). The compactness of facial contours was better in the observation group than in the control group (P < 0.05). In addition, no remarkable differences were noted in the incidence of postoperative adverse reactions such as facial stiffness, facial asymmetry, facial bruising, and facial concavity inequality (P > 0.05). AFG + BTX-A injection is a highly safe, cost-effective, effective, and long-lasting treatment for NLF depression with high esthetic value, which should be promoted in the future.