Fat Grafting In Patients Research Articles

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.

Evaluation of autologous fat grafting in the treatment of juvenile localized scleroderma with facial involvement

Objectives: The objective of this study was to evaluate the effect of autologous fat grafting in patients with juvenile localized scleroderma with facial involvement. Methods: We retrospectively studied patients with juvenile localized scleroderma who were followed at the Hamburg Center for Pediatric and Adolescent Rheumatology at least 6 months post-operative follow-up and received at least one autologous fat transplantation for a facial lesion. Autologous fat grafting was conducted independent of disease-modifying treatment and/or disease activity. The effectiveness of the intervention was evaluated by assessing the immediate volume enhancement after injection of fat tissue compared with volume retained after 6 months. The volume enhancement was calculated from three-dimensional photo images analyzed in Mirror Medical Imaging Software, Canfield Scientific (New Jersey, USA). Results: Data of 22 juvenile patients were assessed from March 2006 to September 2021. In six patients, the photos could not be evaluated for the study. The median age of the remaining 16 patients at the beginning of the first fat graft was 8 years (range = 2.5–22 years). Patients underwent mean three interventions (range = 1–9). Evaluation of three-dimensional images showed that the volume retention at 6 months post autologous fat grafting is approximately 50%. The Modified Localized Scleroderma Skin Severity Index value did not correlate to volume changes at 6 months. In 4 of 16 patients, a decrease of the Localized Scleroderma Damage Index occurred. In all seven patients with cheek involvement, mean tragus-nose distance difference decreased (mean decrease 1.09 cm). We did not observe any significant clinical side effects. Conclusion: In this first bigger pediatric case series, the mean facial lesion volume increased around 50% after a mean of three interventions at 25 months of follow-up. No flares of the underlying disease were noted. Autologous fat grafting is a promising method to improve the cosmetic appearance of those patients.

Conversion to Autologous Breast Reconstruction with Latissimus Dorsi and Immediate Fat Grafting in Patients with Previous Implant Failure: An Efficient, Reproducible, and Safe Technique.

Introduction Implant-based breast reconstructions (IBBRs) increased last years despite the growing indications for radiotherapy in the treatment of breast cancer. As a result, complications and reconstructive failures associated to IBBR have increased. Autologous breast reconstruction (ABR) using fat-augmented latissimus dorsi (FALD) has become popular in recent years. Methods We aimed to evaluate conversion to ABR using latissimus dorsi and immediate fat grafting in 61 cases with IBBR failure. Results Immediate reconstruction was found significatively related with an increased number of surgeries resulting from IBBR complications ( p < 0.001). Note that 41% of the cases presented a grade III/IV Baker and Palmer capsular contracture, 29% implant extrusion, and 21% implant infection. Mean survival of the first implant was 16.95 months. ABR process was completed in 47% of cases with a single surgery. Statistically significant differences were observed between this fact and previous IBBR failure due to infection ( p = 0.03) or extrusion ( p = 0.01). Mean volume of fat graft was 429.61 mL, mean length of the surgical procedure was 3.17 hours, and the average length of hospital stay after surgery was 2.67 days. Only 3.3% of the cases developed some major complication. None of the cases presented reconstructive failure. Conclusion FALD is a very safe total ABR technique, an important fact in patients with previous reconstructive failures. The large volume of fat that can be grafted in a single surgery allows the reconstruction of breast in a reasonable size. The reduced length of surgery and hospital stay make the FALD technique an option to consider when an autologous but efficient and safe reconstruction is desired.

Outcomes Following Autologous Fat Grafting in Patients with Sequelae of Head and Neck Cancer Treatment.

A single-center retrospective study was designed to assess the outcomes of autologous fat grafting for improving surgery- and radiotherapy-related sequelae in 40 patients with head and neck cancer. All patients underwent surgical resection of primary tumors and radiotherapy (50-70 Gy) and were followed over 12 months after fat grafting. Eligibility for fat grafting procedures included complete remission after at least 3 years of oncological treatment. The cervical and paramandibular regions were the most frequently treated areas. Injected fat volumes ranged between 7.5 and 120 mL (mean: 23 mL). Esthetic improvement was obtained in 77.5% of patients, being significant in 17.5%, and functional improvement in 89.2%, being significant in 29.7% of patients. Minor complications occurred in three patients. There was a high degree of satisfaction regarding esthetic improvement, global satisfaction, and 92.5% of patients would recommend the procedure. This study confirms the benefits of fat grafting as a volumetric correction reconstructive strategy with successful cosmetic and functional outcomes in patients suffering from sequelae after head and neck cancer treatment.

Autologous fat grafting in patients with volume restoration, soft tissues and skin defects correction

Objective. To analyze the results of fat grafting in volume restoration, soft tissues and skin defects correction.&#x0D; Materials and methods. Autologous fat grafting was performed for aesthetic soft tissues correction in 30 women, as well as in 3 patients with long-term non-healing trophic ulcers to obtain a regenerative effect. Subcutaneous fat aspiration was implemented using standard liposuction techniques, water jet, mechanical and syringe.&#x0D; Results. The volume of fat graft varied depending on the area requiring correction, and averaged 90 (33195) ml. The areas, most often subjected to fat grafting, were the mammary glands 10 (33 %), shins 8 (27 %), buttocks 5 (17 %), hands 2 (7 %), lips and nasolabial region 2 (7 %), the outer surface of the thigh 1 (3 %). Despite partial decrease of fat graft volume in the postoperative period, all patients were satisfied with the results; no complications of the procedure were noted. The preparation of fat graft for the correction of trophic defects included its washing with saline and filtering with 1.4 and 1.2 mm anaerobic fat transfers; the fat was grafted through a 2 mm cannula into the subcutaneous tissue directly under and around the ulcerative defects. It improved the regeneration of the epithelium around the trophic ulcers and reduced their size.&#x0D; Conclusions. Thus, the efficiency and safety of using the technique of autologous fat grafting for volumizing and regenerative purposes has been clinically confirmed.

Preliminary results of alternative treatment for postmastectomy pain syndrome: stromal vascular fraction-enriched fat grafting

Postmastectomy pain syndrome (PMPS) is defined as chronic pain lasting more than 3 months after surgery. PMPS reduces the quality of life for patients and affects their daily life. Although the pathogenesis of PMPS has not been clearly elucidated, it is strongly suggestive of neuropathic pain caused by damage to the intercostobrachial nerve. While previous studies have used stromal vascular fraction (SVF)-enriched fat grafts in patients with neuralgia, few studies have used it for PMPS. Therefore, the present study evaluated the use of SVF-enriched fat, which includes adipose-derived stem cells with good differentiation capacity, in patients with PMPS to improve quality of life and reduce neuropathic pain. In three patients, the fat was mixed with concentrated SVF using a centrifuge and injected into the primary pain sites. After surgery, in all three cases, the subjective pain scale score decreased significantly over time.

Effects of radiation and chemotherapy on adipose stem cells: Implications for use in fat grafting in cancer patients.

Autologous fat transplantation is a versatile tool in reconstructive surgery. Adipose-derived stem cells (ASCs) increase survival of fat grafts and thus are increasingly used for breast reconstruction in breast cancer patients. However, radiation and/or chemotherapy have been proposed to inhibit soft tissue regeneration in wound healing thus suggesting alteration in stem cell pathways. Therefore, elucidating effects of radiation and chemotherapy on ASCs is critical if one desires to enhance the survival of fat grafts in patients. This review outlines our work evaluating the function and recoverability of ASCs from radiation or chemotherapy patients, focusing specifically on their availability as a source of autologous stem cells for fat grafting and breast reconstruction in cancer patients. Even though evidence suggests radiation and chemotherapy negatively influence ASCs at the cellular level, the efficiency of the isolation and differentiation capacity did not appear influenced in patients after receiving chemotherapy treatment, although fat from radiated patients exhibited significantly altered ASC differentiation into endothelial-like cells. Further, the in vitro growth rates of patient’s ASCs do not differ significantly before or after treatment. Taken together, these studies suggest ASCs as an important new tool for grafting and reconstruction even when radiation and chemotherapy treatment are involved.

Commentary on: Evidence of Browning of White Adipocytes in Poorly Survived Fat Graft in Patients and Browning of White Adipocytes in Fat Grafts Associated With Higher Level of Necrosis and Type 2 Macrophage Recruitment.

Commentary on: Evidence of Browning of White Adipocytes in Poorly Survived Fat Graft in Patients and Browning of White Adipocytes in Fat Grafts Associated With Higher Level of Necrosis and Type 2 Macrophage Recruitment.

Evidence of Browning of White Adipocytes in Poorly Survived Fat Grafts in Patients.

Browning adipocytes induced by burn and cancer were assumed less viable and more prone to necrosis for their hypermetabolic properties. Recent studies have shown browning of white adipose after fat engraftment in mice. The authors sought to evaluate whether fat transfer could induce browning biogenesis in fat grafts in humans and if it is associated with graft necrosis. Necrotic adipose grafts were excised from 11 patients diagnosed with fat necrosis after fat grafting or flap transfer. Non-necrotic fat grafts were from 5 patients who underwent revisionary surgeries after flap transfer. Histology and electronic microscopy as well as protein and gene expression of browning-related marker analyses were performed. Fat grafts with necrosis demonstrated a higher gene expression level of uncoupling protein-1 (greater than fivefold increase, **P < 0.01), a master beige adipocyte marker, than non-necrotic fat grafts. Electronic microscopy and histology showed that browning adipocytes were presented in necrotic adipose in patients. Fat transfer induced browning adipocytes in patients and was evident in patients with postgrafting necrosis.

Long Term Volume Survival after Autologous Fat Transplantation to the Breast: A Review

Importance Autologous fat transplantation for breast augmentation has become a standard technique and is widely applied. The major weak point is that long time results, especially sudies about long term volumetric survival of the fat grafts have not been available yet. Observations We compared the available literature about volume survival after fat transplantation, including recent findings six years after fat transfer to the breast, showing stable results and even volume gain of transplanted fat grafts in patients that gained weight. Conclusions Fat transplantation to the breast for cosmetic breast augmentation offers stable long term results in terms of volume survival of the transplanted fat grafts. The available long term studies do not show any late complications of fat transfer.

Surgical Experience in Prevention of Postoperative CSF Leaks Using Abdominal Fat Grafts in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Adenomas

Objective Cerebrospinal fluid (CSF) leaks are the most common complication during endonasal endoscopic transsphenoidal approach (EETSA) and prevention of postoperative CSF leaks is critical. In this study, we report a single surgeon's experience of sellar floor reconstruction using abdominal fat grafts for prevention of postoperative CSF leaks in EETSA for pituitary adenomas. Study Design This study is presented as case series with retrospective chart review. Setting Present study was conducted at tertiary referral center. Participants A total of 216 patients who underwent surgery via EETSA for pituitary adenomas between 2008 and 2018 at our institution were evaluated. When an intraoperative CSF leak occurred, sellar floor reconstruction was performed using a fat graft harvested from the abdomen via a 2-cm skin incision. Main Outcome Measures Primary outcome and measures of this study was postoperative CSF leaks. Results A total of 53 patients showed intraoperative CSF leaks (24.5%) and 2 patients showed postoperative CSF leaks (0.93%). There were no postoperative CSF leaks in any patients who showed intraoperative CSF leaks and received sellar floor reconstruction using fat grafts. There were also no postoperative CSF leaks in 12 patients who received preventative sellar floor reconstruction using fat grafts due to extensive arachnoid herniation without intraoperative CSF leaks. However, there were two postoperative CSF leaks in patients who did not show intraoperative CSF leaks and did not receive sellar floor reconstruction. Conclusion The effectiveness of sellar floor reconstruction using abdominal fat grafts in patients receiving EETSA for pituitary adenoma was reported. We suggest that identification of intraoperative CSF leaks is important and preventive sellar floor reconstruction without evidence of intraoperative CSF leaks can also be beneficial.

RANDOMIZED CONTROLLED TRIAL OF LIMITED FASCIOTOMY WITH INJECTION OF ADIPOSE GRAFT FOR DUPUYTREN'S DISEASE.

ABSTRACTObjective: Dupuytren’s disease is a genetic disorder related to the proliferation of myofibroblasts. The pluripotent property of stem cells present in adipose tissue inhibits myofibroblast proliferation. Our study sought to evaluate the effect of stem cell-rich fat grafts in patients that underwent limited fasciotomy.Methods: We studied 45 patients, in a single-blind, prospective, randomized clinical trial. All patients underwent limited fasciotomy. In one group, fat graft was injected.Results: The total passive extension deficit results did not exhibit a significant difference. Fat group exhibited worse functional score at 6 months and 1 year postoperatively, such as higher complication rates (43%), when compared with control group (8%), and more pain at 6 weeks follow-up.Conclusion: Fat grafting associated with limited fasciotomy promotes worse functional results compared to conventional limited fasciotomy in the short term. However, long-term results and recurrence rates should be further assessed. Level of Evidence II, Prospective comparative study.

Fat Grafting in Patients With Extensive Unilateral Facial Deficiency: Three-Dimensional Computer-Assisted Planning, Implementation, and Outcome Assessment.

Autologous fat injection is a widely used, simple, and less invasive technique to correct volume deficiency. This study developed a treatment method by using a 3-dimensional (3D) simulation to plan and implement fat injection in patients with an extensive facial deficiency and then validated the accuracy of the method and treatment outcomes. Seven patients with a large unilateral facial deficiency receiving autologous fat grafts between 2015 and 2017 were recruited. One patient received repeated treatment. Furthermore, 3D surgical simulation was used to measure the difference between the mirrored image and lesion side. An extra 20% to 30% of fat graft was added. A color map was provided, and contour lines 2 mm deep marked the location of the fat injection. Outcome assessments were then performed, and a 3D symmetry index was defined using the contour lines on the facial surface. No significant difference was noted between the predicted volume and postoperative fat graft retention (35.7 ± 7.4 and 31.6 ± 9.7 mL, respectively; P = 0.176). A comparison of preoperative (79.5% ± 4.3%) and postoperative (89.0% ± 3.3%) 3D symmetry indexes indicated significantly improved facial symmetry (P = 0.018). Patient-reported outcomes of satisfaction on FACE-Q questionnaires yielded an average score of 62.73, higher than the control score (59.83). By using the proposed method, we could predict the required fat graft volume; moreover, the contoured map aided accurate surgical implementation. Thus, this method is useful for planning and guiding fat grafting treatment in patients with major unilateral facial deficiency.

Autologous Fat Grafting in Cleft Lip and Palate.

Structural fat grafting is a technically simple procedure that has revolutionized the field of plastic surgery, with applications ranging from tissue regeneration to scar modulation to volume restoration. This technique has found applications in the treatment of cleft lip and palate, where it can be used to fill deficient midfacial volume and treat velopharyngeal insufficiency. In this article, the authors summarize the current literature supporting the use of fat grafting in patients with clefts. Evidence as to the safety, efficacy, longevity, and potential complications of the technique are discussed.

Fat Grafting into Younger Recipients Improves Volume Retention in an Animal Model.

Soft-tissue deficits associated with various craniofacial anomalies can be addressed by fat grafting, although outcomes remain unpredictable. Furthermore, consensus does not exist for timing of these procedures. Whereas some advocate approaching soft-tissue reconstruction after the underlying skeletal foundation has been corrected, other studies have suggested that earlier grafting may exploit a younger recipient niche that is more conducive to fat graft survival. As there is a dearth of research investigating effects of recipient age on fat graft volume retention, this study compared the effectiveness of fat grafting in younger versus older animals through a longitudinal, in vivo analysis. Human lipoaspirate from three healthy female donors was grafted subcutaneously over the calvaria of immunocompromised mice. Volume retention over 8 weeks was evaluated using micro-computed tomography at three experimental ages: 3 weeks, 6 months, and 1 year. Histologic examination was performed on explanted grafts to evaluate graft health and vascularity. Recipient-site vascularity was also evaluated by confocal microscopy. The greatest retention of fat graft volume was noted in the youngest group compared with both older groups (p < 0.05) at 6 and 8 weeks after grafting. Histologic and immunohistochemical analyses revealed that improved retention in younger groups was associated with greater fat graft integrity and more robust vascularization. The authors' study provides evidence that grafting fat into a younger recipient site correlates with improved volume retention over time, suggesting that beginning soft-tissue reconstruction with fat grafting in patients at an earlier age may be preferable to late correction.

Abstract P5-16-14: Outcome of lipofilling in patients with a history of breast cancer: A retrospective cohort study

Abstract Background:Autologous fat grafting [AFG] is a surgical technique used to correct breast deformities or to reconstruct partial breast deformities after breast conservative treatment [BCT] or mastectomy for breast cancer. However, a strong debate remains upon the topic of safety and the oncological risk after lipofilling. There is a need for more studies assigned with a higher level of evidence. Objective:This retrospective cohort study aimed to provide a strong evidence-based argument concerning the safety of fat grafting in patients who underwent breast cancer surgery in comparison to a group with similar characteristics who did not receive lipofilling. Methods: Two cohorts consisting of women with a history of breast cancer were retrospectively assembled. All patients underwent BCT and/or a mastectomy as breast cancer treatment. An intervention population of patients that had received primary or secondary lipofilling was statistically compared to a control population of patients that had received a breast reconstruction without lipofilling. Results: Fifty patients with a mean age of 53.6 ± 9.3 years at the time of lipofilling were included in the intervention cohort. The control group included 67 patients with a mean age of 52.8 ± 8.5 years at the time of breast reconstruction. Both cohorts showed no significant differences for demographic or oncological data. Mean follow-up time was 15.0 ± 15.6 months in the intervention group and 45.4 ± 35.1 months in the control group. The prevalence of the complications are shown in the table. No complications were seen in 35 patients [70%] after lipofilling. Fat necrosis was mostly observed [n=15] but no infections or local oncological recurrences were reported. In the control group a complication-free follow-up occurred in 38 patients [56.7%] after breast reconstruction. One control patient demonstrated a local oncological recurrence. A higher prevalence of infections was observed in the control population [p = 0.048] and the prevalence of fat necrosis was higher after lipofilling [p = 0.028]. Prevalence of complications Study populationStudy populationControl populationControl populationp-valueLocal oncological recurrence0 1(1.5%)0.386Infection0 5(7.5%)0.048Fet necrosis15(30.0%)9(13.4%)0.028Microcalcifications3(6.0%)3(4.5%)0.712Other1(2.0%)17(25.4%)0.086- hematoma1(2.0%)5(7.5%) - seroma0 2(3.0%) - capsular contracture0 1(1.5%) -implant leak0 1(1.5%) - implant/flap loss0 6(9.0%) - implant redo0 1(1.5%) - rash0 1(1.5%) None35(70%)38(56.7%)0.142 Conclusion: Lipofilling is a safe technique for breast reconstruction in patients with a history of breast cancer. There is no increase in local oncological recurrence. A side effect is an increase in fat necrosis which can potentially lead to more investigations. Citation Format: Thiessen F, De Schrijver L, De Decker M, Tondu T, Van Goethem M, Tjalma WA. Outcome of lipofilling in patients with a history of breast cancer: A retrospective cohort study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-16-14.

Assessment of outcomes and complications of posterior pharyngeal wall augmentation with dermal fat graft in patients with Velopharyngeal Insufficiency (VPI) after primary cleft palate repair: A pilot study

IntroductionMaterials used for posterior pharyngeal wall augmentation have been associated with important complications (exogenous materials) or variable and unpredictable durability (exogenous and endogenous materials); therefore, introducing a different material for augmenting the posterior pharyngeal wall seems necessary for reviving this relatively forgotten technique.The purpose of this study was to emphasize on the use of a material associated with minimal complications and maximum recovery and durability in correcting VPI and the use of evaluative adjuncts such as nasoendoscopy and videofluoroscopy to assess surgical outcomes. MethodsIn a pilot study, 24 patients underwent posterior pharyngeal wall augmentation with dermal fat graft harvested from the low crease abdominal region. Early and late complications, autologous graft durability in posterior pharynx, and speech improvement were assessed. ResultsThere was a significant improvement in hypernasality, nasal emission, and nasal grimace after posterior pharyngeal wall augmentation with dermal fat graft (p<0.0001). The authors observed no significant life-threatening complication. The most evident short-term complication was snoring, which occurred in five patients, and all relieved uneventfully. ConclusionThe authors believe that augmenting the posterior pharyngeal wall with dermal fat graft is effective in improving hypernasality in patients with moderate velopharyngeal gap size and relatively adequate velar motion. This method has minimal complication profile because of autologous tissue application.

Autologous fat grafting after sarcoma surgery: Evaluation of oncological safety

The regenerative effectiveness of lipoaspirate procedures relies on the presence of mesenchymal stem cells, but the stromal microenvironment and hormonal secretions of the adipose tissue may be involved in cancer growth. Only few oncological outcome studies of fat grafting at the surgical site of malignant neoplasms of mesenchymal origin are available; none of these studies examined a series of sarcoma cases. We analyzed outcome in terms of local or distant spread and overall survival to investigate the oncological safety of fat grafting in patients with sarcoma. Sixty consecutive patients who had undergone 143 fat grafting procedures after surgical resection of bone and soft tissue sarcomas of the head, trunk, and limbs with clear resection margins were enrolled from 2004 to 2015 in our tertiary care center. A multidisciplinary sarcoma team administered adjuvant therapies. Patients were recurrence free at fat grafting. The overall median follow-up was 7.5 years. At follow-up after fat grafting (2.4 years), one patient had distant metastasis and two had local relapse. Kaplan-Meier analysis showed disease-free survival rate of 95.4% (CI: 89.1-100.0) at 24 months. The risk of local recurrence (LR) within 24 months was 4.6% (CI: 0.0-20.9). The probability of not having LR after fat grafting was ≥ 89.1%. We found no evidence of an increased cancer risk after fat grafting procedures in patients with sarcoma, but a stimulatory role of fat cannot be excluded for bone sarcomas based on the cases reported here, and further studies are therefore needed.

Abstract QS32: Autologous Fat Transfer for Scar Prevention and Remodeling (AFT-SPAR): Could Saline be as Efficacious as Fat?

PURPOSE: Despite a lack of high-level evidence to support improved skin and scar quality, interest in autologous fat grafting for such continues to grow. This multi-center, double-blinded, randomized, placebo-controlled trial aimed to evaluate the effect of autologous fat grafting in patients with cutaneous scars. METHODS: 17 patients with cutaneous scars affecting quality of life underwent Coleman-type fat grafting, completed with autologous fat/saline at a density of 1mL/cm2. Outcomes were measured at baseline, and 6/12 months. Scars were subjectively and objectively evaluated using POSAS, durometer (hardness), cutometer (elasticity), colorimeter (wavelength absorbance), and single-observer histological analyses. RESULTS: POSAS score totals, cutometer and durometer analyses were not significantly different between grafted (fat) and control (saline) scar appearance, elasticity or hardness at 0, 6, or 12 months, respectively. A single significant colorimetric difference in the a* color coordinate at 6 months (p = 0.037) was demonstrated, but was not durable at 12 months (p = 0.49). Single-observer histological 5-point scale ranking revealed no significant differences between AFT-treated and control scar vascularity or inflammation, nor epidermal thickness at baseline, six or twelve months. There was no statistically reliable difference of categorical evaluations, including vascular orientation, collagen organization and remodeling, and inflammation chronicity at the 0.05 level. CONCLUSION: In conclusion, these results suggest that autologous fat transfer can improve the qualitative profile of scar from a patient and observer perspective, consistent with a large body of level-III and -IV scientific work. These qualitative improvements, however, are not corroborated by measurable differences in skin hardness, elasticity, color, or histology. Further rigorous, large volume, randomized-controlled trials are required to elucidate the quantitative effects of autologous fat transfer. Insight into these effects may yield the clinical treatment requisites, and subsequently, the realization autologous fat transfer’s potential for scar prevention and remodeling. J.C. Brown: None. H. Shang: None. N. Yang: None. A.J. Katz:; The GID Group, Ltd..

Camouflaging Cleft Lip Scar Using Follicular Unit Extraction Hair Transplantation Combined with Autologous Fat Grafting.

The scar that occurs after cleft lip surgery poses a serious cosmetic problem. One of the methods used to solve this problem in adult male patients is hair transplantation. However, satisfactory results with this method cannot always be achieved because of possible graft loss. The corrective feature of fat grafting has been reported in many studies. The authors' aim with this report is to share their results with hair transplantation combined with fat grafting in patients with cleft lip. This study included 20 patients who had both a scar and alopecia in the cleft lip area. The patients underwent fat grafting from the periumbilical region by means of miniature liposuction harvesting cannulas. Three months after fat injection, hair transplantation was performed with hair from the submental area and scalp using the folliculate unit extraction technique. Patients were followed for 12 months. Survival rate of transplanted hair and patient satisfaction were analyzed after the procedures. After this camouflaging technique with fat grafting and hair transplantation, the scar was hidden quite well. The graft survival rate was also better compared with results from similar studies. Patient and observer satisfaction results with the scar tissue were significantly improved, which was confirmed statistically. This study demonstrates that this combined camouflaging technique is a very effective treatment in male patients with cleft lip who have serious secondary upper lip scars. The authors present a series of patients treated with this technique, which resulted in a high level of patient satisfaction. Therapeutic, IV.