Infected Skin Necrosis after Mesotherapy

Recently, mesotherapy is frequently used for body contouring. But, there is a many controversy on the effect of mesotherapy for fat reduction, as well as it's complication tends to look over. So, we let you know the complicated case of the mesotherapy which we experienced. A 28-year-old woman after mesotherapy on her right lateral thigh was admitted to the hospital because of cellulitis and skin necrosis. The patient had a local injection on the both her lateral thigh for body contouring at local hospital. 2 days before hospitalization, we could see infection on her right lateral thigh. The infection finding was swelling, reddish to purple color change and bullae formation. As time goes by, skin necrosis and eschar formation took a place. The size of eschar was estimated about 12 x 10 cm. MRI was accomplished, and the cellulitis on the right hip ant thigh was found on the MRI. The eschar was surgically removed and wound bed was exposed to subcutaneous fatty layer. And then, split thickness skin graft taken from left lateral thigh was done successfully. The grafted skin was well taken without complication, as well as donor site was well healed. The mesotherapy for body contouring is tried by various method, but, the definite mechanism is not established and safe way of drug combination is not clear. For more safer procedure, more study about the way of drug combination and mechanism is needed.

Experiences in Reduction of Height of Double Eyelid Fold

Most Koreans who do not have supratarsal fold are anatomically quite different from Caucasians, and double eyelid operation is one of the most common operations in Korea. However, it might cause various complications, and high fold might occur as a complication. The purpose of this study is to introduce an appropriate operation procedures to correct the high fold. From March 1999 to April 2008, 45 patients experienced secondary blepharoplasty due to high fold after double eyelid operation. We divided patients into four groups to correct the high fold. We operated the first group with lower flap dissection method because of mild high fold and bulky lower flap eyelid. We operated the second group them with upper orbital fat slide down anchoring method due to sufficient orbital fat. We operated the third group with the free fat graft method due to insufficient orbital fat. We operated the fourth group with ptosis correction method. The lower flap dissection method was applied to most of the forth cases because of thick lower flap. The upper orbital fat slide down anchoring method is to drag orbital septum-fat down to prevent readhesion and showed the best result without any complication. The case of insufficient fat could be corrected through the free fat graft to prevent readhesion. The case of ptosis which was corrected by the levator advancement-Muller Tucking method showed good result. The operation to correct the high fold could be very difficult and in order to get good result, one needs to exactly know anatomical structure of upper eyelid, and accurate understanding of how much orbital fat should be left by pushing eyelid skin and eyeball down. It is suggested that the best method to use is the upper orbital fat slide down anchoring method. It would be better to use the free fat graft for patients who suffer from insufficient fat. In cases of ptosis, the use of the levator advancement- Muller tucking method is recommended.

Allogenic Grafting of Cryopreserved Fat Cell

PURPOSE: The most effective methods of harvesting, preparing, and injecting autologous fat grafts have been inconsistent and conflicting. With its limitation as resorption in fat grafting, handling various techniques affect adipocyte survival, and is crucial to optimizing its long-term survival. To improve graft survival, re-implantation of cryopreserved adipocytes was developed. In addition, adipocytes do not induce immune rejection in response to non-self lymphocytes in a mixed lymphocyte reaction. The purpose of this study is to analyze the changes in cryopreserved adipocytes so as to determine the most efficient long-term storage period, and to analyze the changes in cryopreserved allografted adipocytes so as to determine the efficacy of cryopreserved adipocytes allografting. METHODS: Fat tissues were harvested from the inguinal and retroperitoneal fat pad of mice. After the centrifugation of the harvested fat tissues, they were disintegrated with collagenase. The adipocytes were obtained by centrifugation of the disintegrated fat tissues. The adipocytes were treated as follows: (1) They were examined for weight and then frozen at -20degrees C (n=25). For four months, each five frozen samples were taken and examined for weight and histologic changes in the 1st week, the 1st month, the 2nd month, the 3rd month, and the 4th month, respectively. (2) The adipocytes were immediately frozen at -20degrees C (n=125). For four months, five frozen samples were taken, and allografted in the same time period as above. Finally, for four months, five cryopreserved allografted adipocytes were taken and examined for histologic changes in the same time period as above. RESULTS: (1) Significant weight changes and histologic findings with inflammatory and destructive changes were observed in the cryopreserved adipocytes in three months. (2) Significant fat necrotic changes in the histologic changes with Hematoxylin and eosin stain were observed in the cryopreserved allografted adipocytes since the first week, independent of the freezing period. CONCLUSION: The study results show that the adipocytes that were cryopreserved for more than three months underwent obvious weight reductions and necrotic changes, and the adipocytes that were allografted without freezing were viable for four months, but the cryopreserved allografted adipocytes had obvious necrotic changes since the first week regardless of the freezing period.