Adipocyte microinfiltration in the face or tissue restructuration with fat tissue graft

The author presents his experience of the autologous fatty tissue transplantation. He calls his method microinfiltration of adipocytes (MIA). The fat of the body is harvested with the technique of syringe liposuccion without trauma and is refined and placed in an intricate layering of autologous fatty tissue with anatomic patented microcanulaes. This procedure named Lipostructure by Coleman is not a lipofilling or "liposculpture" as described by P. Fournier in 1989. By focusing on the procedure as autotransplantation fat grafting technique and fully respecting the delicate nature of the fat cell, the author has been able to document a high rate of success with 3 years follow-up.     

下睑缘切口组织瓣联合自体脂肪转移修复颧部凹陷畸形

目的:探讨下睑缘切口入路组织瓣联合自体脂肪转移修复颧部软组织凹陷畸形的方法。方法:根据凹陷部位可采用两种修复方法:①凹陷部位在颧脂垫以上:采用下睑缘切口入路,松解瘢痕挛缩的眼轮匝肌;褥式缝合两断端,释放眶隔内脂肪;填充在凹陷区皮下眼轮匝肌与眶隔之间,缝合固定;②凹陷部位在颧脂垫区域时:采用下睑缘切口入路,剥离到凹陷区域皮下;充分松解深层的瘢痕粘连组织,拉拢周围脂肪组织、筋膜等形成软组织瓣,褥式缝合。结果:术后随访6月~2年,11例患者对外形和功能满意。颧部软组织凹陷畸形基本消失。结论:下睑缘切口入路组织瓣联合自体脂肪转移是修复颧部小面积软组织凹陷畸形的有效方法之一。     

自体脂肪移植技术现状及在面部整形中的应用

面部畸形在临床中较为常见，其发生原因与先天发育障碍、外伤及衰老等相关，凹陷畸形、软 组织量丢失等情况影响患者的面部美观。面部自体脂肪移植技术是指将患者自身的脂肪组织移植到面部区 域的微创手术。近年来，自体脂肪移植技术在面部整形中已经取得了阶段性的进展，本文从自体脂肪移植 技术现状及在面部整形中的应用作一综述，以期为临床诊疗提供参考。     

Extensive traumatic soft tissue loss: reconstruction in severely injured patients using cultured hyaluronan-based three-dimensional dermal and epidermal autografts.

BACKGROUND: This report demonstrates the potential of two-stage autologous keratodermal grafting as a starting point for noninvasive reconstruction of extensive traumatic soft tissue defects. METHODS: In three severely injured patients, skin biopsies for cell cultivation were taken. Cultured "neodermis" consisting of cultured autologous fibroblasts grown on biocompatible three-dimensional scaffolds made up of benzyl ester of hyaluronan was grafted on conditioned defect areas. After ingrowth of dermal substitutes, transplantation of cultured autologous keratinocytes on hyaluronan-based laser-perforated membranes was performed. Ten days later, a 0.2-mm thin, 1:6 meshed autograft was overlaid. Clinical follow-up, histologic, and immunohistochemical findings were documented. RESULTS: Grafting with cultured autologous fibroblasts revealed a suitable dermal tissue replacement. Epithelialization was evident after transplantation of keratinocytes. Final closure of the defects with "normoelastic" tissue properties was achieved after thin mesh-grafting. CONCLUSION: Preliminary findings with the described method seem to be very promising. As in all fields of tissue engineering, long-term studies and further follow-up are required.     

自体脂肪颗粒注射移植治疗面部软组织凹陷

目的 评价自体脂肪颗粒注射移植治疗面部软组织凹陷的效果。方法 利用吸脂术从身体其它部位皮下吸取脂肪颗粒，注射植入面部软组织凹陷部位。结果 1996年～2002年，共治疗36例(56个部位)面部软组织凹陷，其中45个部位接受1次脂肪颗粒注射，11个部位接受2次注射，每次注射量为1．5m1～24m1，平均8．9m1。在随访超过6个月的28例(43个部位)中，8个部位(18．6％)注射2次，术后6个月38个部位外形得到明显隆起的改善效果，优良率88．4％(38／43)。未见严重并发症。结论 对于较为单纯的面部软组织凹陷的患，自体脂肪颗粒注射移植是一种微创、简便、安全、有效的治疗方法，必要时需重复注射。     

Future of fat as raw material for tissue regeneration

Tissue replacement traditionally requires use of autologous tissue and is associated with the attendant morbidity of donor site harvest. In the case of allograft transplantation, there are concerns, similar to those associated with organ transplantation, of rejection and immunosuppression. For these reasons, emphasis has been placed on the development of tissue-engineered substitutes that incorporate autologous stem cells into tissue-engineered scaffolds. The authors' laboratory has characterized a population of cells obtained from processed lipoaspirate (PLA), which have the capacity in vitro to differentiate into osteoblasts, chondrocytes, myocytes, adipocytes, and neuron-like cells. Adipose tissue is an abundant, expendable, and easily obtained tissue that may prove to be an ideal source of autologous stem cells for engineering tissues.     

Autologous fat transplantation employing liposuction techniques

Patients with minor to extensive contour defects continue to present a challenge to plastic surgeons. Surgical techniques that were previously used are often associated with a high degree of morbidity and complications. Past experience with fat transplantation has been combined with the latest advances in fat harvesting methods. The patient described in this article had a breast augmentation for symmetry and soft-tissue correction after breast reconstruction following mastectomy. Using fat removed by liposuction, autologous tissue was transplanted by transcutaneous injection. To date, our follow-up on this patient is almost 3 years. Excellent aesthetic results and volume augmentation have been maintained.     

Correction of hemifacial atrophy with autologous fat transplantation

BACKGROUND: Autologous fat transplantation has frequently been used by many surgeons for facial recontouring in esthetic patients, with good long-term results. However, this technique has not been used primarily in treating patients with hemifacial atrophy, and its efficacy and long-term outcome remain unknown. METHODS: In a 7-year period, 31 patients with hemifacial atrophy were treated with autologous fat transplantation in our institution. All patients had been in their stable phase of the disease for at least 1 year. Autologous fat grafts were harvested from the lower abdomen or thigh with our preferred low-pressure syringe technique and then spun at the lower speed. The fat grafts were injected into multiple areas in multiple tissue planes and tunnels to the diseased side of the face. The same procedure was repeated once or twice as necessary after each injection in at least 3 months. All patients were followed up to 5 years, and their outcomes were evaluated by the patients, plastic surgeons, and laypersons separately. RESULTS: Obviously improved facial contour was evident in most patients after autologous fat transplantations. More than 65% of the patients in this series were assessed as satisfactory by all 3 groups. Between 10% and 30% of the patients were mostly satisfactory. Only less than 7% of the patients were unsatisfactory. No complications were seen in either donor sites or recipient sites in this series. CONCLUSIONS: Autologous fat transplantation can be a good treatment of choice for patients with hemifacial atrophy.     

面中下部年轻化的综合治疗

目的:总结对面中下部衰老应用多部位联合手术进行综合性治疗的效果和经验。方法:于2008年6月～2013年4月,对于32例鼻唇沟加深患者采用颧袋脂肪抽吸术、自体浅表颗粒脂肪移植、联合眶隔脂肪释放的睑颊沟填充术的综合手术方法。结果:本组共32例患者,术后均随访3～24个月,鼻唇沟变浅,睑颊沟不明显,面中下部老化得到明显改善,效果满意。结论:针对以鼻唇沟加深为主要表现的面中下部衰老患者,应用多部位联合治疗,通过周围脂肪组织异位,局部脂肪容量变化,合理提升下垂组织,达到面中下部年轻化的美容目的。     

Periostin对自体脂肪移植成活率的影响

目的 探索Periostin复合自体脂肪颗粒移植后,对移植脂肪血管化及成活率的影响,以明确Periostin在自体脂肪移植中的作用。方法 体外实验验证低氧条件下Periostin对脂肪干细胞成血管的影响,RT-PCR检测CD133及CD144的基因表达情况;将Periostin复合自体脂肪组织移植到裸鼠体内,观察移植脂肪的成活情况。结果在低氧条件下,Periostin组细胞成血管能力明显优于空白对照组;RT-PCR检测结果显示,Periostin组的CD133和CD144表达量明显高于空白对照组;Periostin复合自体脂肪移植后1、3、6个月,移植脂肪成活率分别为79.50%±3.70%、67.71%±4.08%和64.78%±5.78%,明显高于对照组(51.83%±5.97%、39.45%±10.32%和34.20%±10.61%)。结论 Periostin能够改善脂肪移植早期组织对缺氧的耐受性,促进自体脂肪颗粒移植后的早期血管化,有利于移植脂肪颗粒的存活,可有效改善脂肪移植的成活率。     

自体脂肪移植联合A型肉毒毒素在面部吸脂后凹陷患者中的应用效果

目的 探究自体脂肪移植与A型肉毒毒素治疗面部吸脂后凹陷的效果。方法 选取2020年4月-2022年 4月本院整形科收治的64例面部吸脂后凹陷患者为研究对象,随机分为对照组和观察组,各32例。对照组 给予自体脂肪移植治疗,观察组给予自体脂肪移植联合A型肉毒毒素治疗,比较两组临床疗效、并发症发 生情况及脂肪组织坏死情况。结果 观察组治疗总有效率为96.88%,高于对照组的81.25%（P＜0.05）;观察 组并发症总发生率为0,低于对照组的18.75%（P＜0.05）;观察组自体脂肪组织坏死率为3.13%,低于对照 组的18.75%,但差异无统计学意义（P＞0.05）。结论 自体脂肪移植联合A型肉毒毒素在面部吸脂后凹陷患 者中的应用效果确切,可有效改善患者面部凹陷问题,提高其面部流畅度及美观度,同时能够促进移植脂 肪成活,降低不良反应发生几率,应用安全性较高。     

Fibrin tissue adhesive sealant for the prevention of CSF leakage following transsphenoidal microsurgery

Summary Fibrin glue (Beriplast, Behring or Tissucol, Immuno) was used for 126 sublabial transseptal transsphenoidal operations in 119 patients from April 1981 to March 1987 in a variety of sellar pathologies together with septal bone and spongycel to seal the sellar floor and the anterior wall of the sphenoid sinus.The incidence of postoperative rhinorrhea was 1.6%. A review of the literature revealed an incidence of 1.5%–9.6% with the use of autologous tissue for sellar packing such as fat or muscle; fibrin glue combined with autologous grafts led to postoperative rhinorrhea in 1%–4.4%. The present results support the view that sellar and sphenoidal sealing with fibrin glue instead of muscle or fat tissue does not raise the incidence of postoperative rhinorrhea.     

自体脂肪颗粒移植在面部年轻化的应用

目的探讨通过自体颗粒脂肪移植矫正面部老化的方法和临床效果。方法对178例,采用肿胀吸脂技术抽吸皮下脂肪,将抽吸出的自体颗粒脂肪经过离心、提纯后均匀注射于面部老化的标记区域,多层次多隧道注射,以补充面部丢失的软组织容量,改善老化面容。结果所有受术者随访3个月至3年,面部老化改善满意,无脂肪液化、感染、破溃等严重并发症发生,效果明显、持久。结论自体颗粒脂肪注射移植是一种安全有效的面部软组织填充手术技术,可以有效地取得改善面部老化、除皱的效果,值得临床推广应用。     

自体脂肪颗粒注射移植治疗半面萎缩及面部凹陷

目的：使用人工材料及皮瓣、肌瓣移植方法治疗半面萎缩和面部凹陷，存在人工材料引起的排异、异物感和不适、供区畸形等问题，自体脂肪颗粒移植能较好的克服上述治疗所存在的问题。本丈拟探讨自体脂肪颗粒注射移植治疗面部凹陷特别是半面萎缩病例的临床效果。方法：选择11例半面萎缩患者，l9例外伤性凹陷或面部消瘦患者。于腹部或大腿部抽取脂肪，并通过修剪、洗涤、静置等步骤筛选出中层纯脂肪颗粒，在凹陷区分皮下浅层、皮下深层或肌肉层等进行多层次、多隧道注射移植。移植受区轻度加压包扎两天，制动一周。术后一个月、三个月、六个月来院随访，拍照片与术前照片对比。三个月后对移植量不足的病例进行再次移植。结果：有5例半面萎缩患者经过3次注射充填：6例半面萎缩患者及7例面部凹陷患者经过2次注射充填；12例面部凹陷患者经过1次注射充填。30例患者基本达到形态对称。最长随访期3年，未发现并发症。结论：对半面萎缩及其他面部凹陷采用自体脂肪颗粒注射移植治疗，创伤小、并发症低、手术效果明显，相对现有其他治疗方法，是一种较为理想的治疗方法。此外，受区组织“生理同源性环境”十分有利于提高脂肪移植的成功率。     

Repair of left main coronary ostial stenosis using autologous aortic tissue

Abstract Background: Patch angioplasty is one of the several surgical options for patients with left main coronary ostial stenosis. It restores native antegrade blood flow in the left main coronary artery (LMCA) and does not leave the patient with graft‐dependent retrograde perfusion. Various direct techniques have been described for left coronary ostioplasty. Herein, we described the use of autologous aortic tissue in the surgical treatment of left main coronary ostioplasty, and reported the short‐ and long‐term outcomes of the patients. Methods: Between January 2003 and December 2010, 11 patients (nine males and two females) underwent surgical patch angioplasty for LMCA ostial stenosis using autologous aortic tissue as the patch material. Results: All patients survived the operation, and there were no significant postoperative complications. The follow‐up period was 44.09 ± 30.26 months (range, 1–94 months), and no deaths or restenoses were observed during follow‐up. Conclusions: The use of autologous aortic tissue as an onlay patch for reconstruction of left main coronary ostial stenosis is safe and free of major complications. This tissue is a reasonable material for treating selected types of LCMA patients. (J Card Surg 2011;26:586‐590)     

Reliable soft tissue augmentation: a clinical comparison of injectable soft-tissue fillers for facial-volume augmentation

While injectable fillers for facial-volume augmentation have been extensively marketed, there are few published reports comparing the clinical efficacy and cost-effectiveness of multiple injectable agents for soft-tissue augmentation in the face. We present our experience in 976 patients with the use of 4 common injectable agents: autologous fat, Hylaform, Restylane, and Radiesse. We analyzed the injection characteristics of each filler, including injection volume, complication rate, revision rate, and longevity, across 3 commonly treated anatomic regions: the nasolabial fold, glabella, and lips. We subsequently performed a detailed cost-effectiveness analysis of each filler in each anatomic region.Our results demonstrate that autologous fat transplantation is ideally suited for the treatment of the nasolabial fold and glabella, particularly in combination with other procedures. Fat grafting to the lips is limited to use as an adjunct to other facial surgery due to the prolonged recovery time required. We prefer Radiesse for the isolated treatment of the nasolabial folds and glabella. However, Radiesse is not recommended in the lips due to the increased incidence of complications. Last, the hyaluronic fillers Restylane and Hylaform have an excellent safety profile and are our first choice for isolated lip augmentation procedures.     

Autologous Fat Transplantation to the Breast: A Personal Technique with 25 Years of Experience

Background  

Over the last 30 years there has been interest in the use of autologous fat transplantation for breast reconstructive and cosmetic purposes. Up until now injection of adipose tissue into the breast has been subject to two limiting factors. First, fat injection into the breast could result in fat necrosis, cyst formation, and indurations that could be mistaken as cancerous calcifications. Second, the degree of reabsorption of the injected adipose tissue is unpredictable.     

自体脂肪移植矫正凹陷性瘢痕的技巧

目的探讨采用自体脂肪移植矫正凹陷性瘢痕的效果与注射移植技巧。方法自2009年7月至2014年3月,共接诊21例（24处）凹陷性瘢痕患者。移植前1d以生理盐水注射法评估注射量。用注射针头往返穿刺松解受区瘢痕粘连,然后行多层面、多隧道自体脂肪注射移植。结果21例（24处）患者注射盐酸肾上腺素生理盐水5～40ml,自体脂肪注射移植量为6～48ml,注射后凹陷畸形得到矫正,局部稍隆起;1个月后有部分吸收,隆起消退,注射处与周围皮面相平;6个月后,局部基本平坦,患者均满意。所有患者均未出现硬结、囊肿、感染等并发症。结论只要患者病情适合,注射方法得当,自体脂肪移植是矫正凹陷性瘢痕的良好方法。     

组织外扩张自体脂肪颗粒注射移植隆乳术

目的 探讨采用组织外扩张技术进行自体脂肪颗粒注射移植隆乳术的疗效及安全性.方法 进行自体脂肪颗粒注射隆乳术前,佩戴组织外Brava扩张器1个月,每天佩戴8 h,以增加乳房组织容积并改善血供.重复扩张与脂肪注射移植2～3次.结果 自2010年l～10月,采用组织外扩张自体脂肪颗粒移植隆乳术26例,获得良好隆乳效果,术后随访1个月至1年,未发现结节、硬块及囊肿等并发症.结论 以组织外扩张进行自体脂肪颗粒移植隆乳术,可以有效地增大乳房受区的容积及血管化程度,因而可以增加乳房内注射的脂肪量并提高脂肪的存活率,是一项提高自体脂肪颗粒注射隆乳效果的理想方法.     

Long-term clinical and radiologic results with autologous fat transplantation for breast augmentation: case reports and review of the literature

Autologous fat transplantation was initially performed by plastic surgeons for improving facial and body contour depressions and scars. There has been long-standing interest in breast augmentation for cosmetic purposes and for the filling of defects from partial breast resection for breast cancer. In the 1980s, autologous fat transplantation for breast augmentation and symmetry gained popularity. We present two cases of autologous fat transplantation into the breast parenchyma that demonstrate the long-term clinical and radiologic results of this approach and to illustrate the potential caveats regarding breast cancer diagnosis in these patients. We also review the existing literature on the subject as it relates to long-term effects and complications.