Supervivencia de injerto graso en la lipotransferencia glútea / Survival of fat graft in gluteal lipotransfer

Introducción: El aumento de glúteos tiene como objetivo lograr una apariencia y contorno más joven; así como crear la proporción ideal entre cintura y cadera. Esto se puede lograr mediante la lipoinyección, aunque en este caso existen controversias en cuanto a la viabilidad del tejido injertado y la supervivencia de la grasa. Objetivo: Determinar el porcentaje de supervivencia del injerto de grasa autóloga y su relación con el volumen inyectado en pacientes sometidas a lipotransferencia glútea. Métodos: Se realizó un estudio observacional, descriptivo, de corte longitudinal y prospectivo con una muestra de 44 pacientes sometidas a lipotransferencia glútea en el Servicio de Cirugía Plástica del Hospital Docente Clínico Quirúrgico Dr. Miguel Enríquez en el período comprendido entre marzo de 2018 y junio de 2021. Resultados: El estudio evidencia que, mediante ultrasonido y fórmulas, el volumen promedio y la altura de la de grasa en los glúteos se duplica en el posoperatorio mediato y disminuye en el posoperatorio tardío sin llegar a los valores del preoperatorio. Además, se estableció que cerca de la media del volumen de grasa autóloga injertada en los glúteos sobrevive de manera definitiva en el posoperatorio tardío. Además, quedó establecido que la relación entre el volumen infiltrado y la supervivencia del injerto de grasa autóloga es inversamente proporcional: mientras mayor es el volumen, menor es su supervivencia. Conclusiones: Solo la mitad del volumen de grasa autóloga injertada en los glúteos sobrevive de manera definitiva, y la supervivencia de la grasa es inversamente proporcional al volumen infiltrado(AU)

Introduction: Buttock augmentation aims to achieve a more youthful appearance and contour; as well as creating the ideal proportion between waist and hips. This can be achieved by lipoinjection, although in this case there are controversies regarding the viability of the injected tissue and the survival of the fat. Objective: To determine the percentage of autologous fat graft survival and its relationship with the injected volume in patients undergoing gluteal fat transfer. Methods: An observational, descriptive, longitudinal and prospective study was carried out, with a sample of 44 patients undergoing gluteal lipotransfer, in the plastic surgery service of the Dr. Miguel Enriquez Clinical Surgical Teaching Hospital, in the intermediate period between March 2018 to June 2021. Results: The study shows that through ultrasound and formulas, the average volume and height of fat in the buttocks doubles in the immediate postoperative period, decreasing in the late postoperative period, without reaching preoperative values. Furthermore, it's established that about the mean volume of autologous fat grafted to the buttocks survives definitively in the late postoperative period. In addition, it was established that the relationship between the infiltrated volume and the survival of the autologous fat graft is inversely proportional, the greater the volume, the less its survival. Conclusions: Only half of the volume of autologous fat injected into the buttocks survives definitively, and the survival of the fat is inversely proportional to the volume injected(AU)

Reconstrucción mamaria diferida con expansor-implante y matriz dérmica autóloga. Una alternativa terapéutica aplicable en tejidos no irradiados. / Delayed breast reconstruction with expander-implant and autologous dermal matrix. An alternative applicable therapeutic in non irradiated tissues.

INTRODUCCIÓN Y OBJETIVO: la reconstrucción mamaria diferida o post mastectomía tiene una importancia trascendental en la vida de la mujer así también como parte del tratamiento integral y multidisciplinario del cáncer mamario, ya que tamaña agresión impacta en la autoestima y funcionalidad social en aquellas mujeres que por algún motivo no fueron sometidas a reconstrucción inmediata. El objetivo es describir a través de la técnica expansor-implante, matriz dérmica autóloga, injerto de grasa y reconstrucción del complejo areola pezón con tejidos autólogos, los resultados alcanzados en pacientes mastectomizadas y reconstruidas de manera diferida. MATERIAL Y MÉTODO: es un estudio retrospectivo, longitudinal, observacional y descriptivo de una serie pequeña de 5 pacientes privadas mastectomizadas no irradiadas que no fueron sometidas por algún motivo a reconstrucción inmediata en otros centros médicos y que acudieron al consultorio privado derivadas por médicos cirujanos mastólogos-oncólogos para ser sometidas en forma diferida a reconstrucción con expansor implante en una secuencia técnica de 3 tiempos quirúrgicos en un periodo comprendido entre abril del 2015 y octubre del 2020. RESULTADOS: la reconstrucción diferida habitualmente la realizamos con expansor-implante y optamos por la utilización de colgajos autólogos siempre cuando se hubiera irradiado la mama enferma. En 4 de 5 pacientes realizamos la reconstrucción del complejo areola pezón (CAP), 3 pacientes fueron de reconstrucción unilateral y 2 de bilateral, en 2 mujeres ocupamos prótesis de doble lumen tipo anatómicos y en 3 mujeres expansor con puerto a distancia, utilizando en 2 pacientes, prótesis de forma redonda y en un implante expansor anatómico. Presentamos un caso de deflación del implante a los 3 años post reconstrucción no reportamos casos de necrosis grasa, ni cuadros infecciosos, no presentamos casos de contractura capsular y reportamos un solo caso de seroma tardío de origen traumático en una paciente de reconstrucción unilateral a los 7 meses post implante. CONCLUSIÓN: la técnica reconstructiva diferida de expansor-implante, matriz dérmica autóloga, y tejidos propios para la reconstrucción del CAP, representan una buena opción terapéutica de baja morbilidad en pacientes que no han sido sometidas a irradiación post mastectomía. Creemos que a nivel nacional aún faltan políticas en salud y conductas que beneficien a las mujeres con cáncer mamario en el camino largo del tratamiento integral de la enfermedad hasta la reconstrucción mamaria y su re inserción con funcionalidad social, laboral y emocional, para unificar criterios y protocolos entre servicios públicos, privados, ministerio de salud, secretarias regionales de salud y sociedades científicas de Mastologia y Cirugía Plástica apoyando a los pocos equipos en reconstrucción mamaria , optimizando protocolos médicos que beneficien a las pacientes enfermos.

INTRODUCTION AND OBJECTIVE: delayed breast reconstruction or post mastectomy has a transcendental importance in women ́s life as well as part of the comprehensive and multidisciplinary treatment of breast cancer. Such aggression impacts on self-esteem and social functionality in women who for some reason were not undergoing immediate reconstruction. The objective is to describe the results achieved in mastectomized patients, through the expander-implant technique, autologous dermal matrix, fat graft and reconstruction of the nipple areola complex (NAC) with autologous tissues MATERIAL AND METHOD: it is a retrospective, longitudinal, observational and descriptive study of a small group of 5 non-irradiated mastectomized private patients who were not subjected to an immediate reconstruction at other medical centers. They came to the private practice referred by other mastologists-oncologists medical surgeons to be submitted to a delayed breast reconstruction with expander prosthesis in a 3 surgical times technique between April 2015 and October 2018. RESULTS: the delayed breast reconstruction is usually performed with expander prosthesis and for those injured breasts that had been irradiated, we use autologous flaps. In 4 out of 5 patients we performed the reconstruction of the NAC, 3 were submitted to unilateral reconstruction and 2 were bilateral, 2 women had anatomical double lumen prosthesis, 3 had expander implant with remote port at which 2 were round and one anatomical. We presented only one case of deflation 3 years later after reconstruction. We didn ́t report cases of fat necrosis nor infectious symptoms. We didn ́t have any case of capsular contracture but only a single case of late seroma after 7 months' post implant in a patient with unilateral reconstruction due to a traumatic incident. CONCLUSION: the delayed breast reconstructive technique with expander-implant, uses of autologous dermal matrix or own tissues for reconstructing the NAC, represents a good therapeutic option of low morbidity to patients who have not undergone post-mastectomy irradiation. We briefly believe that at a National level there is a lack of health policies and therapeutic behaviors that could benefit women with breast cancer on this long path from a complete treatment of this disease to breast reconstruction and its social, labor and emotional reintegration, to unify criteria and protocols between public services, private services, ministry of health, regional secretaries of health and scientific societies such as Mastology and Plastic Surgery to support the few teams in breast reconstruction and optimize medical protocols to benefits the sick patient.

Clinical application of autologous fat grafting in hand rejuvenation / 中华医学美学美容杂志

Objective:To investigate the effect of autologous fat grafting in hand rejuvenation and to provide effective clinical treatment for the aging hand.Methods:A total of 52 patients received autologous fat grafting in hand. Fat was collected by liposuction from the abdomen or thigh regions utilizing the superwet technique. The harvested fat was washed and injected to the dorsal hand. Standardized photographs were taken before and after the operation, and the patients＇ satisfaction was evaluated.Results:Picture scores between preoperative and postoperative had statistically significant differences ( P<0.01). The majority of patients (75%) were satisfied with their results. All patients were followed up for 6 months with no infection, fat liquefaction, cysts and other complications occurred. Conclusions:This study provides the clinical basis for fat grafting in hand rejuvenation with high satisfactory rates.

Utilização de corpo adiposo bucal em comunicação oroantral / Use of body adiposo body in oroantral communication

Introdução: A comunicação oroantral tem como principais causas etiológicas os processos patológicos, traumatismos e cirurgias, sendo comum sua ocorrência durante exodontias de elementos dentários superiores posteriores devido ao íntimo contato dos ápices radiculares com o assoalho do seio maxilar. Relato de caso: Paciente do sexo feminino, com 51 anos de idade, apresentando comunicação oroantral há 6 anos após exodontia do elemento dental 16. Realizado fechamento da comunicação oroantral sob anestesia local, com tracionamento e sutura da bola de Bichat sobre a falha óssea. Após um ano de proservação, observamos a ausência de comunicação bucosinusal bem como de sintomatologia, resultando no sucesso do tratamento. Considerações Finais: A utilização do retalho pediculado do corpo adiposo bucal é uma alternativa útil para o fechamento e tratamento de comunicações bucosinusais, sendo que o deslizamento da bola de Bichat é um método seguro para fechamento de tais comunicações e que esta é uma técnica de simples execução, com poucas complicações e limitações... (AU)

Introduction: The oroantral communication has as main etiological causes the pathological processes, traumatisms and surgeries. Its occurrence during the exodontia of posterior superior dental elements is due to the intimate contact of the root apices with the floor of the maxillary sinus. Case report: A 51-year-old female patient, presenting oroantral communication 6 years ago after the dental element 16 was extubated. The oroantral communication was closed under local anesthesia with Bichat's ball traction and suture on the bone defect. After 1 year of proservation, we observed the absence of oral communication, as well as symptomatology, resulting in the success of the treatment. Final considerations: It is concluded that the use of the pedicle flap of the buccal adipose body is a useful alternative for the closure and treatment of buco sinusal communications, and the sliding of the bichat ball is a safe method for closing such communications and that this is a technique of simple execution, with few complications and limitations... (AU)

Modified penile augmentation by dermal-fat graft in post-operative hypospadias adults / 中华整形外科杂志

Objecive@#To assess the clinical outcomes of patients who received modified penile augmentation by free dermal-fat grafting.@*Methods@#From April 2012 to December 2014, a total of 15 male adults (18-24 years of age) after hypospadias repairs were included. They underwent modified penile augmentation, including girth enhancement using free dermal-fat grafting, and penile elongation (suprapubic skin advancement-ligamentolysis). Penile measurements were performed using ruler before operation and 6 months after operation. The outcome was evaluated by patients, based on the Male Genital Image Scale. SPSS 22.0 was used to analyze the data. In-paired t-test and Wilcoxon test were applied.@*Results@#In 6-84 months of follow-up, all patients achieved excellent cosmetic results, and satisfied with the appearance and diameter. In weak state, the penile length increased from (5.03±0.47) cm to (6.69±0.49) cm. The increased value was (1.67±0.24) cm (t=8.6, P<0.001). Under traction, the penile length increased from (7.29±0.74) cm to (9.21±0.73) cm. The increased value was (1.93±0.21) cm (t=7.8, P<0.001). In weak state, the diameter of the middle part of penis increased from (7.16±0.25) cm to (8.69±0.44) cm, with the increased value of (1.53±0.23) cm (t=8.2, P<0.001). The MGIS score grew from 31.73±4.86 to 40.20±4.54(Z=3.2, P=0.001).@*Conclusions@#This modified technique is safe and effective in enlarging penile size for patients who had underwent hypospadias repair. It is confirmed that physical dimensional enhancement does contribute to improving their self-estimation of penile size.

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.

Micronized Cross-Linked Human Acellular Dermal Matrices: An Effective Scaffold for Collagen Synthesis and Promising Material for Tissue Augmentation

Micronized cross-linked human acellular dermal matrices (ADMs) contain the extracellular components necessary for cell integration and tissue remodeling, and have high tensile strength and durability. We hypothesized that such material could serve as a scaffold to enhance the survival of adipocytes in grafted fat. Nude mice (n = 15) were randomly assigned to three groups, each receiving different subcutaneous injections into two dorsal paravertebral areas: fat and saline (control), fat and micronizedADM(E1), and fat and diluted micronizedADM(E2). Digital photographs were taken at 2-week intervals, and the grafted fat volumes and weights were examined after 10 weeks. A histological analysis of the grafted fat was performed, and the expression of vascular endothelial growth factor (VEGF) was examined. The grafted fat volumes decreased over time in all groups; however, at 10 weeks, the grafted fat was better preserved in both experimental groups, with significantly greater weights than in the group C (both, p<0.001). In the experimental groups, there was more regular arrangement of collagen in the graft tissue, whereas relatively thin, disorderly collagen deposition was observed in the control group. In addition, VEGF expression was significantly greater in the experimental groups than in the control group (p<0.001). These results are the first to show that micronized cross-linked human ADMs are an excellent scaffold for promoting adipocyte survival and may be an option for maintaining or promoting the in vivo survival of grafted fat.

Causes and Surgical Outcomes of Lower Eyelid Retraction

PURPOSE: To investigate the causes of lower eyelid retraction and evaluate the outcomes of various surgical procedures. METHODS: We conducted a retrospective medical record review of patients who underwent lower eyelid retraction surgery performed by a single surgeon at Kim's Eye Hospital between 2006 and 2013. We investigated the causes of lower eyelid retraction, clinical history, characteristics, treatment, and surgical outcomes. Preoperative and postoperative margin reflex distance 2 and inferior scleral show were measured for each eyelid. Success was defined as a positive eyelid elevation and a decrease in inferior scleral show. RESULTS: A total of 19 lower eyelids were treated in 14 patients with lower eyelid retraction. For cosmetic reasons, surgical correction for congenital lower eyelid retraction was performed on seven eyelids (36.8%). Ten eyelids (52.6%) exhibited secondary lower eyelid retraction after surgery. One eyelid (5.3%) was affected by facial palsy and one eyelid (5.3%) exhibited exophthalmos of an unknown origin. We adopted a selective approach based on lower eyelid retraction severity. Spacer grafting via a subconjunctival approach was the most commonly performed surgical technique (13 eyelids, 68.4%). The lateral tarsal strip procedure was used to horizontally tighten three eyelids (15.8%). At the time of the procedure, one of these eyelids (5.3%) also received an adjuvant suborbicularis oculi fat lift. Autogenous dermis fat grafting was performed on two lower eyelids (10.5%), whose retraction was caused by fat and soft tissue loss. Cosmetic outcomes were satisfactory in all cases. CONCLUSIONS: To achieve satisfactory surgical outcomes, surgeons should adopt an approach based on the severity of lower eyelid retraction. Mild lower eyelid retraction can be corrected without grafts. When retraction is severe and exceeds 2 mm, spacer grafts that push the lower eyelid margin upwards and support it from below are required.

Cutaneous Mixed Infection of Mycobacterium fortuitum and Mycobacterium intracellulare after a Fat Graft / 대한피부과학회지

Atypical mycobacteria, widely distributed in nature, are opportunistic infection strain, rare pathogen in immunocompetent patients. Recently, the increase of invasive cosmetic treatment and surgery has increased the infection of atypical mycobacteria. We report a case of cutaneous infection by Mycobacterium fortuitum and Mycobacterium intracellulare that occurred after a fat graft. A 62-year-old female patient presented painful, erythematous nodules and purulent discharge on her face after a fat graft. A skin biopsy and culture were performed. Polymerase chain reaction-hybridization to identify mycobacterium other than tuberculosis revealed M. fortuitum and M. intracellulare. The patient was treated with clarithromycin, rifampicin, and ethambutol for 1 month after excision and drainage of pus, after which the skin lesions improved. In cases of refractory cutaneous infection after an invasive cosmetic procedure, atypical mycobacterial infection should be suspected.

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.

Clinical Outcomes Following Simultaneous Orbital Implant Insertion Operation and Dermo-Fat Graft for Anophthalmos Patients

PURPOSE: To investigate the clinical results of patients who have undergone simultaneous dermo-fat graft and insertion of orbital implants in patients who are unable to put on an ocular prosthesis due to severe conjunctival sac contracture or large orbital implant exposure. METHODS: A retrospective analysis was performed of patients who underwent dermo-fat graft simultaneously with orbital implant insertion for replacement of the conjunctival sac from 2007 to 2012. Eight eyes were enrolled in this study and all patients were followed up for phthisis bulbi or implant exposure. RESULTS: Among the eight eyes, five eyes (62.5%) that were diagnosed with orbital implant exposure underwent orbital implant exchange and dermo-fat graft, and two eyes (25%) were anophthalmic enophthalmic patients and underwent secondary orbital implant insertion and dermo-fat graft. One patient (12.5%) underwent orbital implant insertion and dermo-fat graft simultaneously during the evisceration operation. We followed the progress for 46.3 months. For seven out of eight eyes, the results of the wound healing process were successful. One patient underwent removal and reinsertion of the orbital implant with dermo-fat graft, and the wound in this case healed well. However, after five months, dermo-fat re-graft was performed for orbital implant re-exposure and it was not exposed thereafter. Overall cosmetic appearance was satisfactory in each patient, and all patients were able to comfortably retain a prosthesis. CONCLUSIONS: We found that undergoing dermo-fat graft simultaneously when performing orbital implant insertion is effective for replacement of the conjunctival sac and orbital volume.

Comparative analysis of use of porous orbital implant with mucus membrane graft and dermis fat graft as a primary procedure in reconstruction of severely contracted socket.

Purpose: The purpose of our study is to present a surgical technique of primary porous orbital ball implantation with overlying mucus membrane graft (MMG) for reconstruction of severely contracted socket and to evaluate prosthesis retention and motility in comparison to dermis fat graft (DFG). Study Design: Prospective comparative study. Materials and Methods: A total of 24 patients of severe socket contracture (Grade 2‑4 Krishna’s classification) were subdivided into two groups, 12 patients in each group. In Group I, DFG have been used for reconstruction. In Group II, porous polyethylene implant with MMG has been used as a primary procedure for socket reconstruction. In Group I DFG was carried out in usual procedure. In case of Group II, vascularized scar tissues were separated 360° and were fashioned into four strips. A scleral capped porous polyethylene implant was placed in the intraconal space and four strips of scar tissue were secured to the scleral cap and extended part overlapped the implant to make a twofold barrier between the implant and MMG. Patients were followed‑up as per prefixed proforma. Prosthesis motility and retention between the two groups were measured. Results: In Group I, four patients had recurrence of contracture with fall out of prosthesis. In Group II stable reconstruction was achieved in all the patients. In terms of prosthesis motility, maximum in Group I was 39.2% and Group II, was 59.3%. The difference in prosthesis retention (P = 0.001) and motility (P = 0.004) between the two groups was significant. Conclusion: Primary socket reconstruction with porous orbital implant and MMG for severe socket contracture is an effective method in terms of prosthesis motility and prosthesis retention.

Recent Advancements in Autologous Fat Grafting

Autologous fat grafting has been performed for more than one hundred years and there had been a major refinement of fat grafting by Coleman in 1997. Since then, clinical practice using this natural filler is becoming more popular and the results are becoming more consistent. Nowadays autologous fat grafting is utilized broadly for both aesthetic and reconstructive purposes. With the beginning of the twenty first century, adipose stem cell (ASC) was discovered and regenerative medicine is facing a new era of evolution. ASC was applied to fat transfer and 'cell-assisted lipotransfer' technique could be developed. Eto et al. recently presented experimental results of fat graft survival. Their efforts disclosed the important role of ASCs in fat graft, and contributed the progress of fat transfer. Owing to the accumulation of knowledge related with fat graft survival, discovery of ASCs and advancements in surgical techniques, such as Coleman technique and cell-assisted lipotransfer, survival rate of the grafted fat increased and side effects such as fat necrosis decreased. Consequently, there is a new surgical trend of applying large volume fat grafting for augmentation mammoplasty and breast reconstruction with or without silicone implant. Recently, fat grafting is expanding it's limit to new field of treatment of burn, scar, and wound. This article reviews several significant advancements of fat grafting techniques in this century, furthermore intends to widen scientific understandings and contribute to be practiced as a feasible method.

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.

Congenital orbital teratoma.

revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid‑sparing exenteration for congenital orbital teratoma.

Effects of platelet rich plasma on free fat graft's survival in rats / 中华医学美学美容杂志

Objective To investigate the role of platelet rich plasma (PRP) on free fat graft's survival in a rat model.Methods Twenty-four rats were used in the experiment.For each rat,three groups of free fat grafts were injected into the subcutaneous layer of dorsum.Group A was the control group with 0.5 ml fat and 0.12 ml normal saline.Group B received 0.5 ml fat and 0.1 ml PRP with 0.02 ml normal saline.Group C was given combination of 0.5 ml fat and 0.1 ml PRP which was activated by 0.02 ml calcium chloride.Eight rats were euthanised using pentobarbital sodium each time,1,2 and 3 months after fat transplantation.Specimens were acquired and stained with haematoxylineeosin,and then the histological changes examined using light microscopy.All the data were statistically analysed using paired t test to determine if there were differences between the study groups.Results Compared the volume of the fat grafts at 1 month,there was no deference between the groups(P＞0.05).However,the diameter of group C was significantly higher than group A (P＜0.05).On histological examination,larger vascular density was observed in group C compared with group A at 1 month (P＜0.05).And reduced inflammatory reaction was also observed in group C at 3 months(P＜0.05).While other histological parameters were not statistically significant (P＞0.05).Conclusions PRP does not enhance the survival of fat graft in the Wistar rat model.

Outcomes of Autogenous Dermis Fat Grafting with Different Donor Sites in Exposed Porous Orbital Implants

PURPOSE: To compare the outcomes of autogenous dermis fat grafting with different donor sites in the treatment of exposed porous orbital implants. METHODS: The present study retrospectively evaluated the medical records of 17 patients (17 anophthalmic eyes) who had undergone autogenous dermis fat grafting based on the diagnosis of exposed porous orbital implants and were regularly followed up for at least 12 months since the surgery from January 2001 to December 2010. The patients were divided into 2 groups (thigh and abdomen) according to the site of the donor grafting. The treatment outcome and complications were compared between the 2 groups. RESULTS: The success rate of thigh dermis fat grafting was 88.9% (8/9) and 100.0% (8/8) in the abdominal dermis fat grafting, and there was no statistically significant difference between the 2 groups (p = 1.000). Regarding ocular complications, graft tissue infection (thigh 11.1%, abdomen 0%) and superior sulcus deformity (thigh 22.2%, abdomen 25.0%) were present. Regarding donor site complications, tenderness (thigh 55.6%, abdomen 25.0%), dehiscence (thigh 22.2%, abdomen 25.0%) and scar formation (thigh 33.3%, abdomen 25.0%) were observed. In the gait associated complications, pain (thigh 55.6%, abdomen 25.0%) and limping (thigh 22.2%, abdomen 12.5%) were observed. The rate of all complications showed no statistically significant difference between the thigh dermis fat grafting and the abdominal dermis fat grafting (all p > 0.05). CONCLUSIONS: Thigh and abdomen can both be considered as an effective donor site for the autogenous dermis fat grafting in the treatment of exposed porous orbital implants.

Correction of Sunken and/or Multiple Folded Upper Eyelid by Refined Structural Micro-Fat Graft: Technical Pearls

Structural micro-fat graft is one of the surgical techniques for facial rejuvenation, and it is reliable for correction of sunken upper eyelids especially. However, several factors may influence surgical outcomes substancially. The author introduces the modified micro-fat graft to correct sunken eyelids and multiple eyelid folds to make better results. A series of 162 patients who underwent the refined structural micro-fat graft were included in this study. The purified fat was injected into the subcutaneous and sub-orbicularis oculi muscle layer of the upper eyelids through the 19-gauge cannula with 1 ml syringe. After the operation, all patients were followed up on 2 weeks, 1 month, 3 months, 6months, and 1 year. Clinical photographs were taken every visit and the author evaluated the volume and symmetry of the eyelids and checked the satisfaction of each patient and any complications. Among the 162 patients, 156 patients were satisfied with the upper eyelid volume after primary fat graft and other 6 patients were performed secondary fat graft. Even though the volume of the fat was sufficient, 4 patients showed palpable fat nodule during the follow-up period. Modified micro-fat graft is a simple, safe, and alternative method to correct sunken eyelids and multiple eyelid folds.