Prominent Fat Pads Research Articles

Age-Related Changes in the Regenerative Potential of Adipose-Derived Stem Cells Isolated from the Prominent Fat Pads in Human Lower Eyelids.

The existence of multipotent adipose-derived stem cells isolated from human orbital fat (OF) tissue has shown great therapeutic potential in tissue engineering and regenerative medicine. But the use of stem cells for therapeutic applications is influenced by their proliferative and differentiation potentials, which may be affected by the age of the donor. So far there is little knowledge about the effects of donor age on the biological properties of human orbital adipose-derived stem cells (OASCs). The intraorbital fat protrusion in the lower eyelids occurs as an aging process, and the protruded fat is routinely removed during aesthetic surgeries. Based on the ease of OF harvest and the availability of OASCs, we investigated in this study the relationship between age and the differentiation and proliferation potentials of human OASCs. Human orbital adipose samples were harvested from young (with normal lower eyelid appearance) and old donors (having protruded fat pads in the lower eyelids). The morphological properties of orbital adipocytes were assessed and the fat cell size displayed a decreasing trend with advancing age. OASCs were isolated from the fat samples, expanded in vitro and cultured under appropriate inducive conditions. Compared to the young cells, although no difference was found in the cell yield and phenotype expression, aged OASCs showed fewer progenitor cell numbers, reduced proliferative rates, increased senescent features and decreased differentiation potentials towards adipogenic, osteogenic and chondrogenic lineages. Our data suggested that using autologous OASCs from elderly patients for potential therapeutic purposes might be restricted.

Fat pad entrapment at the hip: a new diagnosis.

PurposeTo establish if a positive impingement sign in femoroacetabular impingement (FAI) may result from entrapment of the fat pad located at the anterior head-neck junction of the upper femur. This fat pad is routinely removed before any cam lesion excision.MethodsWe report a prospective study of 142 consecutive hip arthroscopies for symptomatic FAI where the aim was to remove the arthroscopically identified area of impingement, not necessarily to create a spherical femoral head. Patients were divided into two groups. Group 1 (n = 92; 34 females, 58 males), where a cam-type bony FAI lesion was identified and excised in addition to the fat pad which overlay it, and Group 2 (n = 50; 29 females, 21 males) where the only identified point of impingement was a prominent fat pad. In this situation the fat pad was excised in isolation and the underlying bone preserved. Patients were assessed preoperatively, at six weeks, six months, one year and two years with a modified Harris hip score (mHHS).ResultsBoth groups were comparable preoperatively for mean age, mean alpha angle and mean anterior offset ratio. Both groups improved significantly after surgery at all time points. However, Group 1 (fat pad and bone resection) demonstrated 16.0% improvement in mHHS by two years while for Group 2 (fat pad resection only) the improvement was 18.9% (p = 0.628).ConclusionsThe fat pad found at the anterior head/neck junction of the hip joint can be a source of pain and we propose fat pad entrapment as a new, previously undescribed diagnosis. Our findings also suggest that a large number of cam lesions are being excised unnecessarily and that further efforts should be made to understand the role of the fat pad as a source of groin discomfort.Level of EvidenceLevel IV, case series.

Pericardial Fat Masquerading as Tumor

A 65-year-old woman was evaluated for fatigue, malaise, and atypical chest pain. One year prior she had undergone subtotal gastrectomy and jejunostomy in treatment of a large gastrointestinal stromal tumor. Two-dimensional echocardiography was performed, which showed a small circumferential pericardial effusion with a soft tissue echo density attached to the right atrial/right ventricular junction that extended over the right ventricle. Because of concern about possible malignant disease, thoracoscopy and biopsy of the pericardial mass were recommended. Normal fibro-adipose tissue was found with no evidence of neoplasm. Pericardial fat deposition is common in multiple conditions. It can be found in any location but is most common over the anterior portion of the heart. In this case, the concomitant presence of a small pericardial effusion and prominent fat pad at the right atrial/right ventricular junction gave the appearance of pericardial tumor.

Is Intraorbital Fat Extraorbital? Results of Cross-Sectional Anatomy of the Lower Eyelid Fat Pads

Prominent fat pads of the lower eyelids are a frequent complaint prompting patients to seek cosmetic surgery. Previous studies have stated that these fat pads exist as three compartments in the lower eyelids. An accepted anatomic concept is that these lower eyelid fat pads are intraorbital. This study evaluates the possibility of distinct compartments of lower eyelid fat pads not being different from each other, but rather being separate from posterior intraorbital fat. This study used eight hemifacial cadaver dissections. Methylene blue injections were used to stain the middle and medial fat pads on each side. Sagittal cross-sections were obtained to visualize the area of fat staining. An axial cross-section of one additional specimen was obtained as confirmatory evidence. Each specimen showed that lower eyelid fat pads stain as discrete fat compartments that are not in continuity with the posterior intraorbital fat. Their anterior boundary is the orbital retaining ligament at the anterior aspect of the inferior orbital rim. Their posterior boundary is an insertion point on the floor of the orbit in line with the midpoint of the globe, called the circumferential intraorbital retaining ligament. Lower eyelid fat pads are not in continuity with posterior intraorbital fat. They can accurately be described as partially intraorbital and partially extraorbital in location. This information augments our previous understanding of the anatomy of the lower eyelid fat pads and is important for studies that attempt to determine their etiology.

Use of phosphatidylcholine for the correction of lower lid bulging due to prominent fat pads

Background: Orbital fat tissue, while important in protecting the eye, can protrude during aging, making a patient look ‘tired’. Surgical correction, although traditionally the treatment of choice, can lead to scarring. Phosphatidylcholine (PPT) has been shown to reduce the size of these fat pads after direct injection. The compound, licensed in Europe for intravenous treatment of fat embolism, has recently gained interest for reducing localized fat by subcutaneous injection. However, there is a dearth of clinical data relating to efficacy and side effects. Objective: An open‐label study was conducted in 21 subjects with the goal of reducing the infraorbital fat pad size. The objective of this study was to evaluate the efficacy and safety of PPT after injection into infraorbital fat pads. Methods: Twenty‐one subjects were injected with 0.4 ml of PPT every 6 weeks to reduce prominent infraorbital fat pads. Pre‐ and post‐treatment digital photographs were taken to document efficacy. In addition, side effects were recorded on a follow‐up questionnaire. Results: In all, 74% of the subjects showed significant improvement after two to three treatments. Five of the enrolled subjects (23%) were non‐responsive after two or more procedures and their treatment was discontinued. None of the patients had adverse side effects other than mild burning, erythema and swelling at the injection site. Nearly every patient maintained the results with no evidence of tissue damage after 6 months. Conclusion: PPT injection into infraorbital fat pads resulted in a satisfactory cosmetic effect in most treated subjects. Most subjects required more than one treatment. This simple, office‐based treatment provides a non‐surgical alternative to patients with prominent infraorbital fat pads. More clinical data are required to fully assess the long‐term safety and efficacy of this procedure.

The use of phosphatidylcholine for correction of lower lid bulging due to prominent fat pads.

Patients with prominent periorbital fat pads often complain of having a persistent "tired" look and seek treatment from their dermatologist. A non-surgical treatment of fat pads. Thirty patients were treated for prominent lower eyelid fat pads with phosphatidylcholine injection. Pre- and posttreatment photographs were taken for long-term analysis. A marked reduction of the lower eyelid fat pads was noted over the 2-year follow-up period. There were no recurrences. The injection of phosphatidylcholine (250 mg/5 ml) into the fat pads is a simple office procedure that may postpone or even substitute for lower eyelid blepharoplasty.

The Use of Phosphatidylcholine for Correction of Lower Lid Bulging Due to Prominent Fat Pads

The Use of Phosphatidylcholine for Correction of Lower Lid Bulging Due to Prominent Fat Pads