Site selection for fat autotransplantation: some observations

The use of autologous fat for implantation has recently received renewed attention in the plastic surgery literature. Autologous fat reportedly has been used for the treatment of wrinkles and Romberg's disease, and for buttock and breast augmentation. While some measure of success has been achieved, many surgeons report that substantial resorption of fat tissue occurs at the site of implantation. There is lack of unanimity regarding the ideal site for extraction or injection in order to minimize fat resorption. Adipose tissue samples were taken from women undergoing surgical procedures on the abdomen, gluteal-femoral region, and breast. Facial adipose tissue samples from men and women were also analyzed. Adipocytes were isolated chemically and sized microscopically. Activity of the lipogenic enzyme adipose tissue lipoprotein lipase (ATLPL) was measured in frozen samples. Results suggest that femoral site samples are somewhat larger (NS) and have greater lipogenic activity (p less than 0.03) than other sites. In our study, small facial samples had very low or unmeasurable levels of ATLPL activity. Perhaps cell size and lipogenic activity should be considered when selecting tissues for autotransplantation.     

Clinical and Experimental Study of Autologous Fat Grafting After Processing by Centrifugation and Serum Lavage

Background  This clinical and experimental study compared adipose tissue transplant behavior after two different techniques of purifying: centrifugation at 3400 rpm for 3 min and serum lavage without centrifugation. Methods  Clinical evaluation was performed under standardized conditions for lipofilling on a series of 51 female patients, intentionally selected to have similar characteristics and assigned to two groups based on the method of processing. Experimentally, a culture system in diffusion chambers with vitaline membranes was designed to mimic the behavior and to study the morphology of the adipose tissue used for autografting. Survival, structure, and proliferation of the adipose cells in vitro were examined by classical histologic H&E staining and immunohistochemistry for leptin and cyclin D1. Results  The main differences encountered experimentally were the presence of a greater amount of preadipocytes in the noncentrifuged adipose tissue cultures and more distinctly expressed cell proliferation. The postoperative clinical results favored of the serum lavage purifying technique. Conclusion  Our data suggest that with transplantation of noncentrifuged adipose tissue more active preadipocytes are applied which could possibly lead to better potential chances of survival and even de novo development of fat.     

个性化自体脂肪移植在面部年轻化中的应用效果

目的 探讨自体脂肪移植在重塑面部轮廓,提升面部饱满度以及改善皮肤质地等方面的效果.方法 自2016年1月至2019年12月,大连瑞和医疗美容门诊部和大连大学附属新华医院对149例患者采用自体脂肪移植的方法,首选抽取腹部或大腿内外侧脂肪,将脂肪静置沉淀、漂洗、离心提纯后移植于额部、颞部、颧部、泪沟、面颊、鼻唇沟、颏部等面...     

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.     

应用旋转切削技术治疗体表脂肪瘤及局限性脂肪堆积

目的　探索一种治疗体表脂肪瘤及局部脂肪堆积的新方法。方法　自 1 998年 1 0月以来笔者对 1 2例患者在局麻下采用耳鼻咽喉科的鼻内窥镜系统及旋转切削刀具治疗体表脂肪瘤及局限性脂肪堆积。结果　随访 6个月至 2年所有病例均取得了满意的效果。结论　该手术方法操作简便、安全、疗效可靠 ,也符合美容外科的原则。是治疗体表脂肪瘤及局限性脂肪堆积值得推广的手术方法之一     

The use of autologous free fat tissue in prevention of calvarial bone regeneration: an experimental study

Autologous free fat grafts have been successfully used to limit ingrowth of postlaminectomy fibrous tissue and to prevent reossification after bone resection in long bones. This study was designed to test the effect of placing autologous adipose tissue in standardized craniotomy defects and also to determine the effect of the presence of periosteum and dura in the area of the fat augmented defects. In 18 immature rabbits, aged 18–21 days, two identical full-thickness defects were made bilaterally in the parietal bone. An autologous free fat graft was placed in one of the defects, the second being an internal control. The study groups were as follows: Group I: dura and periosteum left intact; Group II; periosteum removed; dura left intact; Group III; periosteum and dura removed. The animals were sacrificed after ten weeks. Histological examination of all groups demonstrated prevention of bone regeneration at the margins of the defect with some variations. In the first and second groups, new bone formation appeared over the dura, creating an incomplete plate of bone. On the periosteal side of the graft, a smaller amount of bone formation appeared close to the osteotomy line. The third group demonstrated a total prevention of bone regeneration. The use of free fat tissue graft can prevent calvarial bone regeneration and may be a useful adjunct for the treatment of craniosynostosis. Measures should be taken regarding the new bone formation over the dura, since this may cause reoccurrence of craniosynostosis.     

脂肪干细胞辅助的自体脂肪移植隆乳术临床疗效分析

目的：评价脂肪干细胞（ADSCs）辅助的自体脂肪移植隆乳术的临床效果。方法：选取2008年11月-2009年12月于韩国首尔TIARA整形外科医院接受ADSCs辅助的自体脂肪移植隆乳术的患者100例,对其临床效果进行研究和分析。所有患者均自下腹或大腿部抽取脂肪组织,从其中100mL脂肪组织中提取ADSCs约5mL,与填充用脂肪组织均匀混合后注射于患者乳房内,每侧乳房注射约200mL脂肪。术后测量患者直立位乳头根部至前胸壁平面的垂直距离即为乳房的隆起值。测量术后2周、1个月、3个月和6个月患者乳房的隆起值,与术前隆起值之差即为隆起增加值,并以2周时的隆起值（或隆起增加值）作为基准,评价乳房隆起的保持效果。结果：1OO例患者乳腺整形手术均顺利完成,未出现严重的并发症。绝大多数患者对隆乳效果表示满意,尤其对于自然的胸部曲线与触感非常满意。术后2周测量100例患者隆起的总值是1435mm,平均隆起14．35mm;术后1个月保持率为79．08％,术后3个月保持率为66．75％,术后6个月保持率为7057％。术后1、3和6个月的隆起值与术后2周相比,差异均有统计学意义（P〈O．001）;术后1个月隆起值与术后3、6个月比较,差异有统计学意义（P〈O．05）;而术后3个月和6个月之间差异无统计学意义（P〉O．05）。不同年龄组的患者术后隆乳效果除术后2周有差异外（P〈O．05）,其他时间段的差异无统计学意义（P〉O．05）。结论：ADSCs辅助的自体脂肪移植隆乳术临床效果确切可靠。术后3个月乳房内保存的移植脂肪基本成功存活,之后乳房的隆起效果不再发生变化。不同年龄组的患者均可以通过ADSCs辅助的自体脂肪移植隆乳术获得满意的临床效果。     

富血小板纤维蛋白联合自体脂肪颗粒移植在面部年轻化中的应用研究

目的 探讨富血小板纤维蛋白(platelet-rich fibrin,PRF)联合自体脂肪颗粒移植在面部年轻化中的应用效果.方法 回顾性分析自2017年12月至2019年12月宜宾市第一人民医院整形烧伤科诊治的82例面部皮肤松垂或局部软组织缺失凹陷求美者的临床资料,按治疗方法分为观察组、对照组.两组均为双侧填充,对照组...     

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。     

腹部切口脂肪液化的诊断与治疗

目的　探讨腹部切口脂肪液化的病因及防治措施。方法　回顾性分析我科自 1 996年6月～ 2 0 0 2年 6月施行大、中手术后发生切口脂肪液化的 95例病例。结果　肥胖、术中皮下脂肪层使用电刀、术后切口未予红外线照射理疗等因素各自与非肥胖、术中皮下脂肪层未用电刀、术后切口给予红外线理疗等比较 ,切口脂肪液化发生率均升高。结论　切口脂肪液化病因较多 ,肥胖、术中使用电刀、术后理疗等均为重要的影响因素     

自体脂肪颗粒及微粒皮混合移植修复烧伤患者深度创面

目的 了解自体脂肪颗粒及微粒皮混合移植修复大面积烧伤深度创面的效果. 方法选择20例重度烧伤患者,采用自身同体对照法,将患者双侧肢体或躯干对称部位创面分为脂肪颗粒+微粒皮组和微粒皮组,分别行自体脂肪颗粒+微粒皮(体积比1:1)混合移植和自体微粒皮移植.术后30、45、60 d计算2组创面愈合率;术后7、14、21、28 d取创面组织,行HE染色和增殖细胞核抗原(PCNA)免疫组织化学观察. 结果移植术后30、45、60 d,脂肪颗粒+微粒皮组创面愈合率分别为(56.3±3.1)%、(76.4±6.1)%、(96.2±1.5)%,均明显高于微粒皮组的(28.3±2.0)%、(47.3±4.8)%、(85.4±2.2)%(P<0.01).HE染色显示脂肪颗粒+微粒皮组创面上皮化早于微粒皮组,胶原纤维排列较整齐.脂肪颗粒+微粒皮组PCNA阳性细胞较微粒皮组多,主要分布于表皮基底层. 结论自体脂肪颗粒+微粒皮混合移植可促进创面愈合.     

活性维生素D3与脂肪组织的相关研究进展

活性维生素D3与脂肪组织的关系密切,参与了脂肪组织在生理、病理过程中诸多功能的调控。为了深入探究活性维生素D3在促进自体脂肪移植再生中应用的科学性,该文作者综述了活性维生素D3与脂肪组织之间的相关作用,特别是活性维生素D3对脂肪生成、细胞凋亡及炎性反应的调控,为临床应用实践拓展了新思路。     

The current status of autologous fat grafting

The opinion of the majority of surgeons is fat grafting does not work. The fat cells do not survive transfer. Many have attempted the techniques only to become discouraged and abandon it. This article describes certain principles necessary for successful fat grafting: for harvesting use of a large-diameter syringe and needles, an atraumatic method of cleaning the fat cells, and an anaerobic method of storage. A method of autologous fat cell transfer including harvesting, processing, and injection of the fat is described. Long-term results are shown and limitations of the procedure are presented.Presented at the 9th Annual Meeting of the Lipoplasty Society of North America, Seattle, Washington, September 1991     

脂肪组织来源干细胞提高游离脂肪移植存活率的研究

目的 探讨脂肪组织来源干细胞移植在体内促进游离移植脂肪组织的再血管化,提高移植脂肪组织存活率的可行性.方法 自人体吸脂术中脂质部分分离、培养AScs,行成脂、骨和软骨分化.将ASCs以DiI标记后与人体吸脂术获得的脂肪组织混合移植于18只裸鼠背部,裸鼠背部随机注入3组移植物:ASCs组(A组)、胰岛素组(B组)及培养基对照组(C组).术后6个月观察移植物情况,通过组织观察、HE染色和免疫组化进行分析.结果 抽脂术脂质部分能获取大量的ASCs,能分化成脂肪、成骨和软骨细胞.术后6个月3组移植脂肪的湿重分别为A组(165.97±5.51)mg,B组(93.42±5.12)mg,C组(67.64±5.09)lIIg.A组移植脂肪的存活率高于B、C组(P=0.000).纤维化程度的测定,"网格点计数"3组移植物的点个数分别为A组(152.2±9.8)个/10HF,B组(743.9±20.4)个/10HF,C组(892.2±16.5)个/10HF.A组移植脂肪的纤维化及坏死程度低于B、C组(P=0.000).免疫组化证实:ASCs散在分布于部分脂肪细胞及小叶间隔中,ASCs在体内能够部分转化为血管内皮细胞.结论 脂肪组织来源干细胞移植在体内可促进游离移植脂肪组织的再血管化,提高移植脂肪组织的存活率并改善了移植物的质地.AsCs辅助移植可能是一种较为理想的细胞疗法.     

自体富血小板血浆对自体脂肪颗粒组织移植存活率影响的研究

目的探讨混合注射富血小板血浆最佳浓度,并通过临床混合注射自体富血小板血浆及自体移植脂肪组织,观察自体富血小板血浆对移植脂肪颗粒组织存活率的影响。方法提取抽脂术中获取的脂肪颗粒组织中的脂肪来源干细胞,实验分为4组：A组（对照组）加入10％胎牛血清,B组添加5％富血小板血浆,C组添加10％富血小板血浆,D组添加15％富血小板血浆,传代培养,定时获取细胞行MTT实验,测试细胞生长曲线,并观察细胞形态变化。临床实验选取15例患者,抽取腹部脂肪组织颗粒后进行纯化;同时抽取静脉血,采用离心法提取自体富血小板血浆。纯化的脂肪颗粒与自体富血小板血浆按照10：1的质量比进行混合注射移植。术前、术后1周及术后3个月,患者在B超下行皮下组织厚度测定。结果第3代脂肪来源干细胞培养观察显示,C组有较好的细胞增殖性及活力;临床研究皮下组织厚度增加率为（158．4±83．1）％;术后3个月,皮下组织厚度增加率为（106．4±70．7）％。结论10％富血小板血浆混合浓度对细胞增殖较为适宜,且临床应用可以有效提高自体脂肪颗粒组织移植的存活率,移植后远期仍能达到较为满意的效果,可在临床上进一步推广应用。     

吸脂隆乳术常见并发症的处理及临床分析

目的探讨吸脂隆乳术常见并发症产生的原因以及相关的处理。方法通过总结处理吸脂隆乳术后并发症17例经验体会，分析该术式产生并发症的原因及预防措施。结果对于术后出现乳房内脂肪液化、硬结及钙化，给予手术清除，取得满意效果。随访3个月至3年，无复发。结论进行吸脂隆乳术时，应对抽吸的脂肪颗粒进行纯化，严格控制注射量，多层次分散注射，使脂肪颗粒在乳房内分布均匀，以减少术后并发症。     

吸脂隆乳术常见并发症的处理及临床分析

目的探讨吸脂隆乳术常见并发症产生的原因以及相关的处理。方法通过总结处理吸脂隆乳术后并发症17例经验体会,分析该术式产生并发症的原因及预防措施。结果对于术后出现乳房内脂肪液化、硬结及钙化,给予手术清除,取得满意效果。随访3个月至3年,无复发。结论进行吸脂隆乳术时,应对抽吸的脂肪颗粒进行纯化,严格控制注射量,多层次分散注射,使脂肪颗粒在乳房内分布均匀,以减少术后并发症。