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Fillers for Acne Scarring
Published in Antonella Tosti, Maria Pia De Padova, Gabriella Fabbrocini, Kenneth R. Beer, Acne Scars, 2018
Beginning in the early 1900s, autologous fat transfer to correct facial folds demonstrated some benefit; however, the long-term effects were unpredictable and variable [24,25]. According to Peer [26], there was a 45% reduction in the weight of the fat after 1 year, which demonstrates the importance of blood supply in the recipient tissue area [26]. Soon, with the advent of liposuction around the 1970s, more cases of fat transfer were performed for the cosmetic enhancement of facial features. Fat can be extracted from the adipose tissue of various parts of the body during a liposuction procedure using a blunt-tipped microcannula, which is then isolated from the rest of the infranatant. It is recommended to overcorrect by 30%–50% during injection of the face as there will be an expected amount of resorption [27]. Additionally, some authors recommend injecting the fat directly into the muscle for better vascularization [2]. The inflammatory reaction that ensues produces fibrotic tissue, which has been seen in biopsied samples and may explain the process of volume restoration [27]. Due to the excessive scarring in cases of severe acne, leading to the skin tethering down and volume loss of the midface, fat transfer can help to replete the significant areas of volume loss in the face. Thus, the role of fat transfer in acne scarring is for more deep volume augmentation, which then allows the practitioner to focus on the more superficial component of acne scarring [28].
Fat transfer: Applications in gynecology
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Deborah C.M. Boyle, Simon H. Wood
Fat transfer is a widely accepted technique in plastic surgery since its first description in 1893 by Gustav Neuber (Van de Graaf and Korteweg 2010), who transferred fat from the orbit to treat depressed scars resulting from osteomyelitis. It has since been shown to act as more than simply a “filler.” Animal and clinical studies have shown that fat transfer improves the quality of the skin, with changes in skin texture and mechanical properties, associated with stimulation of collagen synthesis (Foyatier JL et al. 2004, Mojallal and Foyatier 2007, Mojallal et al. 2009, von Heimburg et al. 2001). It is associated with low complication rates (Coleman 2006, Mojallal et al. 2009). In 1995, Sydney Coleman published his technique of fat grafting, which has been widely adopted (Coleman 1995). Although variations exist, the basic principles are the same and are described below.
Volumetric Approach to Midfacial Rejuvenation
Published in Neil S. Sadick, Illustrated Manual of Injectable Fillers, 2020
Robert A. Glasgold, Justin C. Cohen, Mark J. Glasgold, Sachin M. Shridharani, Jason D. Meier
Traditional volume rejuvenation of the midface relied on preformed alloplastic implants. The benefits of alloplastic implants are in their ability to provide long-term predictable volume changes. However, the placement of implants is limited by the facial anatomy, specifically the infraorbital nerve affecting the superior extent. Malar implants add cheek volume but do not address, and may even exaggerate, the volume deficit at the inferior orbital rim responsible for the shadowed demarcation between lower lid and cheek. Alloplastic implants are also limited in their ability to make precise surface contour changes. Their subperiosteal placement leaves the retaining ligaments, and their effect on surface contour, intact. Autologous fat transfer (AFT) has continued to gain popularity as an alternative to midface volume restoration. AFT has the advantage of creating a more tailored, natural augmentation as it can be placed more diffusely, and is not limited by the underlying anatomy. Despite these advantages, fat transfer is a surgical procedure requiring more downtime and, due to variable resorption (average retention rate is 30%), may need multiple treatments to achieve the ultimate result (2). The advent of an increasing array of injectable fillers opened the door to midface volume restoration with less downtime and the convenience of an office-based procedure. Several presently available injectable fillers are US Food and Drug Administration approved for facial augmentation of the midface. Generally, these fillers possess a larger particle size and a greater ability to lift. This grouping of fillers provides an attractive, less-invasive alternative to surgery. Durability is relatively predictable and, in the case of hyaluronic acid (HA) gel dermal fillers, the result can be reversed via simple injection of hyaluronidase.
Autologous fat grafting as a minimally invasive technique to avoid cochlear implant extrusion
Published in Cochlear Implants International, 2022
Mirko Aldè, Riccardo Francesco Mazzola, Umberto Ambrosetti, Federica Di Berardino, Giovanna Cantarella
The autologous fat transfer technique, performed to increase the volume and thickness of the area overlying the R/S and to promote tissue revascularization, involved three steps: fat harvesting, purification and placement. Fat was harvested from the lower abdomen after infiltration by a 10-cc solution of 2% mepivacaine with 1:200 000 epinephrine. A stab incision was performed at the iliac crest, and harvesting was by liposuction with a 3-mm-diameter blunt-tip cannula connected to a 10-ml Luer-Lok syringe. The plunger of the syringe was gently retracted to maintain a negative pressure. The lipoaspirate was centrifuged at 3000 rpm for 3 minutes to remove aqueous, hematic, oily components and debris. The refined fat (8.5 cc) was injected into the scalp overlying the CI R/S by a 21-gauge cannula, using a 3-ml Luer-Lok syringe for a better control of fat placement, taking care not to damage the CI electrode array. The overall duration of the procedure, performed under local anesthesia, was 20 minutes. Cefazolin 2 grams were administered intravenously during surgery to prevent infection.
Full-face augmentation using Tissuefill mixed with platelet-rich plasma: “Q.O.Fill”
Published in Journal of Cosmetic and Laser Therapy, 2019
Hyejeong Lee, Kichan Yoon, Munjae Lee
For patients who desire full-face augmentation, Q.O.Fill is expected to be an excellent alternative to autologous fat transfer. Autologous fat transfer needs complex manipulations for harvesting and preparation of fat. However, Q.O.Fill has the advantage of a simple preparatory process. Autologous fat transfer has definite long-term volume augmentation results. Jason et al. showed that approximately 32% of the injected volume remains after 16 months (20). Matthew et al. showed that long-term (>6 months) patient satisfaction was believed to be excellent for 13%, good for 40%, and fair for 41% (21). Our study showed that Q.O.Fill also has definite long-term durability that 90.7% of participants felt much better or a little better until 2 years after the injection. Furthermore, Q.O.Fill can be very suitable for very thin patients with little fat to harvest.
Aesthetic improvements of radial forearm flap donor site by autologous fat transplantation
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Benedetto Longo, Michail Sorotos, Rosaria Laporta, Fabio Santanelli di Pompeo
Ultrasound measurements were performed to evaluate soft tissue thickness using the B-mode ultrasound device and a high-frequency linear probe of 12 MHz (M-Turbo Ultrasound Machine, system 3.7; SonoSite Fujifilm, Tokyo, Japan). Measurements were collected with the probe held at a 90-degree angle to the donor site cutaneous plane and symmetrically on the contralateral forearm. All measurements were made preoperatively and at the end of the surgical treatment thrice, and the average value was used for analysis. Epicritic and proprioceptive sensitivity testing was also performed at the RF donor site area and at contralateral limb, assessing pressure thresholds of static and moving one and two-point discrimination with the Pressure-Specified Sensory Device (Sensory Management Services, LLC, Baltimore, MD), in order to measure and compare skin sensitivity on the reconstructed and healthy forearm. Tests were performed after fat transfer treatment at donor site’s midpoint and symmetrically at the contralateral side.