Effectiveness of Autologous Fat Graft in Treating Fecal Incontinence

PURPOSE: The most common risk factor for fecal incontinence (FI) is obstetric injury. FI affects 1.4%–18% of adults. Most patients are unaware when they are young, when symptoms appear suddenly and worsen with aging. Autologous fat graft is widely used in cosmetic surgical field and may substitute for injectable bulky agents in treating FI. Authors have done fat graft for past several years. This article reports the effectiveness of the fat graft in treating FI and discusses satisfaction with the procedure. METHODS: Fat was harvested from both lateral thighs using 10-mL Luer-loc syringe. Pure fat was extracted from harvests and mixed with fat, oil, and tumescent through refinement. Fats were injected into upper border of posterior ano-rectal ring, submucosa of anal canal and intersphincteric space. Thirty-five patients with FI were treated with this method from July 2016 to February 2017 in Busan Hangun Hospital. They were 13 male (mean age, 60.8 years) and 22 female patients (mean age, 63.3 years). The Wexner score was checked before procedure. We evaluated outcome in outpatients by asking the patients. For 19 patients we checked the Wexner score after procedure. RESULTS: Symptom improved in 29 (82.9%), and not improved in 6 (17.1%). In 2 of 6 patients, they felt better than before procedure, although not satisfied. No improvement in 4. Mean Wexner score was 9.7 before procedure. There were no serious complications such as inflammation or fat embolism. CONCLUSION: Autologous fat graft can be an effective alternative treatment for FI. It is safe and easy to perform, and cost effective.

The current state of autologous fat graft / 中华整形外科杂志

Autologous fat grafting has been widely used in plastic and cosmetic surgery, however, the unpredictable survival rate has plagued many surgeons.The fat grafting includes the harvesting, purification and injection, different methods have a certain impacton the survival of the fat.The following review provides a brief summary on the current status of autologous fat grafting.

Cryptogenic Temporal Hollowing

Temporal hollowing is a common complication that occurs after coronal approach surgeries. However, temporal hollowing without previous nerve damage or trauma history is rare. Herein, we present a patient with cryptogenic temporal hollowing. A 22-year-old man without any history of craniofacial interventions or trauma presented with temporal hallowing. Magnetic resonance imaging revealed fatty degeneration of the left temporalis muscle. Electromyography and nerve conduction study showed no signs of neurologic abnormalities. The patient received autologous fat injection of 30 mL harvested from the left thigh using the modified Coleman technique. Temporal hollowing is commonly caused by atrophy of the superficial temporal fat pad. Its incidence is reported to be as high as 6% after coronal approach operation. Augmentation using porous hydroxyapatite or titanium mesh is a treatment option. Autologous fat graft can also be an option for mild to moderate temporal hollowing. In this case, a patient with no history of trauma, surgery, or myogenic disease developed temporal hollowing. Further study of the littleknown cryptogenic form of temporal hollowing is warranted.

Correction of the Sunken Upper Eyelid Depending on the Dermatochalasis or Blepharoptosis Using the Autologous Fat Grafting

BACKGROUND: To date, many methods have been proposed to resolve the sunken eyelid. We treated our clinical cases of sunken upper eyelid based on whether there is a concurrent presence of the dermatochalasis or blepharoptosis and then performed the autologous fat grafting using either closed or open technique. METHODS: According to the classification of the patients, we used the following injection techniques: First, we solely performed the autologous fat grafting using the closed technique in the sunken upper eyelid only group, for which we did the injection using a micro-injector cannula on the suborbicularis plane. Second, we performed such procedures as skin excision, orbicularis oculi muscle strip excision and levator aponeurosis advancement to manage each symptom in the sunken upper eyelid with dermatochalasis or blepharoptosis group. Simultaneously, we also made a small window in the lateral portion of the orbital septum using the open technique with metzenbaum scissors. Thus, we performed the intraseptal injection of the autologous fat. RESULTS: During a period ranging from January of 2012 to April of 2014, we treated a total of 53 patients. The patients were followed up during a mean period of four months. Thus, we obtained satisfactory treatment outcomes without notable complications. CONCLUSIONS: In conclusion, our results indicate not only that surgeons should consider the fat grafting as one of eyelid-surgery procedures but also that they should perform it concurrently with blepharoplasty or blepharoptosis correction for the purposes of obtaining good treatment outcomes.

Complications of Augmentation Mammaplasty with Autologous Fat Grafts / 한국유방암학회지

PURPOSE: Autolougous fat grafting to the breast for cosmetic enlargement remains controversial because the efficacy and the complications due to fat necrosis are unclear. METHODS: Ten cases who underwent autologous fat grafting to the breast for enlargement and visited author's clinic from October 2006 to March 2008 were evaluated retrospectively. Mammography, ultrosonography, culture, cytology, operative findings and results were reviewed for each cases. RESULTS: The study group consisted of 7 cases for additional augmentation mammaplasty, 1 case for breast abscess, 2 cases for breast examination. Two of 7 augmentation cases had multiple palpable masses. One of 2 cases for breast examination had fat grafts 20 months ago and have suffered from painful huge masses especially on exercise. One case with abscess had fat graft 4 months ago and have suffered from painful reddish swelling. On mammography of 9 cases except 1 breast abscess, malignancy could not be excluded in 2 cases because of bizarre forms of multiple microcalcifications. On ultrasonography of 8 cases, there were ill defined hypoechoic masses in 2 cases which needed additional cytology for rule out malignancy. There were implant puncture in all 2 cases with silicone implants, and in case with abscess, there were S. epidermidis in culture. Among 7 augmentation mammaplasty cases, removal of fat necrosis was performed simultaneously in 1 case with severely palpable masses but postoperative seroma formation and capsular contracture occurred. CONCLUSION: Autologous fat grafting for breast augmentation can make masses, abscess and microcalcifications on mammography due to fat necrosis which compromise breast cancer detection. Additional study is necessary to evaluate the efficacy of fat stem cell grafts as an alternative to traditional method.

Use of autologous-fat graft in postenucleation-socket syndrome

Objective@#To describe the use of autologous-fat grafting in postenucleation-socket syndrome.@*Methods@#This is a case report.@*Results@#There was marked improvement in the gross appearance of the treated orbit of the patient. There was relief in enophthalmos and superior-sulcus deformity. Bilateral orbital symmetry was achieved. Postoperatively, only minimal bruising and swelling both in the orbit and source site were observed, which resolved in 4 weeks.@*Conclusion@#The use of autologous-fat graft is a novel but highly effective technique and a good alternative in treating patients with postenucleation-socket syndrome.