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Objective:To explore the mechanism of fat formation induced by PLA-adipose derived stem cells (ADSC) and LAF-ADSC cells, and to provide a new direction and idea for cell-assisted granular fat transplantation.Methods:The liposuction operation of normal human body was performed in the plastic surgery operating room of Chengdu Badachu Medical Cosmetic Hospital. The liposuction obtained through the operation was placed still, and the upper granular adipose tissue was digested, isolated, cultured and identified by PLA-ADSC; the obtained lower liquid tissue was centrifuged, and the precipitate was digested, isolated, cultured and identified by LAF-ADSC; the differentiation characteristics and growth ability of PLA-ADSC and LAF-ADSC were compared. Then animal experiments were carried out: PLA-ADSC and LAF-ADSC were mixed with matrix glue Matrigel and transplanted into nude mice as experimental group 1 and experimental group 2. Matrix glue Matrigel was transplanted into nude mice as control group. The lipogenic ability of the three groups in nude mice was compared.Results:The cell experiment showed that the cells extracted from the static granular fat and the lower filtrate sediment could adhere to the wall and grew and subcultured smoothly. The cells from the above two different sources expressed CD44, CD73 and CD105, with positive rates of 99.5%, 99.99% and 99.7% respectively, while CD19, CD31 and CD45 were negative. The results of lipogenic induction and differentiation showed that there were lipid droplets in the cytoplasm, and the lipid droplets were orange red after cell oil red O staining. The results of animal experiment showed that three months after transplantation, the average graft volume of experimental group 1 was (0.070±0.009) cm 3, that of experimental group 2 was (0.067±0.007) cm 3, and that of the control group was (0.009±0.005) cm 3. The difference between the graft volume of experimental group 1 and experimental group 2 and the control group was statistically significant ( t=26.522 and t=37.183, all P<0.01), There was no significant difference in graft volume ( t=1.250, P>0.05). The wet weight of grafts in experimental group 1 was (0.200±0.021) g, that in experimental group 2 was (0.175±0.019) g, and that in the control group was (0.129±0.012) g, there was significant difference between experimental groups 1 and 2 and the control group ( t=11.601 and t=9.978, P<0.05), but there was no significant difference between experimental group 1 and experimental group 2 ( t=3.650, P>0.05). After oil red O staining, the grafts in experimental groups 1 and 2 were generally orange yellow, and the control group was scattered light yellow. The expression of CD31 in the experimental groups 1 and 2 was positive, and the expression of CD31 in control group was negative. Conclusions:Active ADSCs can be extracted from the granular fat layer and the lower filtrate of the static fat aspirate, and the ADSCs from both sources have good lipogenic ability in nude mice.
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Objective:To investigate the clinical effect and safety of mid-face lifting combined with compound fat transplantation in facial rejuvenation.Methods:From October 2016 to May 2020, 26 patients with mid-facial aging were enrolled, including 10 males and 16 females, with an average age of (47±6) years (38-65 years). The facial superficial musculoaponeurotic system was stripped, folded and suspended through the temporal hairline incision to lift the middle of the face. Liposuction was performed and compound fat was prepared, in which structural fat was injected into the area marked with loss of facial volume before operation, and extravascular matrix component gel was injected into the static wrinkle dermis. Six and 12 months after operation, the global aesthetic improvement scale of the observer and the global aesthetic improvement scale of the patient were scored, and the postoperative complications and patients＇ satisfaction were counted.Results:At the end of 6 months, improvements in mid face were reported in all patients by blinded reviewers. 12 months after operation, 53.8% (14 cases) of patients had significant improvement in facial aging, 30.8% (8 cases) had moderate improvement, and 15.4% (4 cases) had slight improvement; 25 patients (96%) were satisfied with the postoperative results. Postoperative hemorrhage occurred in one patient, scar hyperplasia occurred in one patient, and no obvious complications occurred in the other patients.Conclusions:The method of midface lifting combined with compound fat transplantation can improve the facial soft tissue and supplement the facial missing capacity, improve the static wrinkles of the face, and comprehensively solve the aging problem of midface. It has a definite clinical effect, fewer complications, and is safe and reliable. It has definite clinical effect with less complications.
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Objective:To evaluate the effectiveness of correction of sunken upper eyelid with central orbital fat transposition during upper blepharoplasty.Methods:We performed 58 cases of upper blepharoplasty with sunken upper eyelids during January 2016 and June 2020. The lateral portion of the central orbital fat was dissected and reversed 180 degrees, and then fixed to the medial fat pad. Photographs before and 6 months post-operatively were measured to determine the degree of the upper eyelid depression. The results were compared statistically. At the consultation 6 months postoperatively, the patients were asked to evaluate the results of the operation using the Clients Satisfying Questionnaire, with the grade between 4 (very satisfactory) and 0 (very dissatisfactory).Results:Sunken eyelids were effectively corrected in 41 of the 52 patients, but 11 patients had minimal effect because of the lack of sufficient central fat volume mostly due to the prior blepharoplasty. At 6 months post-operatively, 52 of the 58 patients finished the satisfaction questionnaire. Forty one of the 52 patients were satisfying with the results. The mean score was 3.3+ 0.73. The degree of the upper eyelid depression was (4.9+ 1.1) mm preoperatively and (2.4+ 0.7) mm postoperatively. There was a statistically significant difference ( P<0.05). Conclusions:The central orbital fat transposition is an effective way to correct the sunken upper eyelids during the upper blepharoplasty. The results are satisfactory with full upper eyelids and smooth double eyelids.
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@#Autologous fat transplantation in the treatment of velopharyngeal insufficiency has the advantages of good histocompatibility, small local trauma, few complications, reversible operation and simple postoperative nursing, which can effectively increase the velopharyngeal closure area. If the clinical effect is poor, other surgical methods can be used at any time for replacement. Although there are many advantages in the treatment of velopharyngeal insufficiency with autologous fat transplantation, there are still some problems in the selection of indication, donor site, injection dose, recipient site, follow-up evaluation, complications and prevention and treatment. Current research shows that autologous fat transplantation is mainly used in patients with mild or moderate velopharyngeal insufficiency, but with the improvement of fat acquisition and treatment techniques, the indications for autologous fat transplantation continue to expand, and autologous fat transplantation combined with palatoplasty or pharyngoplasty has been proposed for the treatment of severe velopharyngeal insufficiency. However, there are complications, such as fat absorption and obstructive sleep apnea syndrome. In addition, the application of autologous fat transplantation in severe VPI patients and how to improve the long-term stability of autologous fat transplantation need further study.
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Objective:To identify the influence of age factors on biological characteristics of human adipose-derived stem cells (ADSCs), and to compare the differences in morphology, aging characteristics, differentiation potential, surface marker expression, and proliferation ability of human ADSCs with different ages and the effect of human ADSCs of different ages on proliferation and migration of fibroblasts.Methods:Adipose tissues from 27 individuals of healthy beauty treatments, aged 0-59 years, were collected from Department of Burns and Plastic Surgery, the 940th Hospital of Joint Logistics Support Force from January 2020 to December 2020. According to the age of the donor, they were divided into 6 groups. 0-9 years old group (4 cases), 10-19 years old group (4 cases), 20-29 years old group (5 cases), 30- 39 years old group (5 cases), 40-49 years old group (5 cases), and 50-59 years old group (4 cases). We obtained and cultured the ADSCs of each group, subcultured to obtain the ADSCs, and observed the morphological characteristics of each group; the proliferation ability of each group of ADSCs was detected by CCK-8 method; the differentiation potential of each group of ADSCs was detected by in vitro adipogenesis and osteogenic induction. Flow cytometry was used to detect the surface marker expression levels of each group of ADSCs, and qPCR was used to detect the expression levels of HGF, PPAR-γ, type Ⅲ collagen and DbX2 in each group. We also collected the skin tissues of a healthy person from Department of Burns and Plastic Surgery of the 940th Hospital of Joint Logistics Support Force in 2020, obtained and cultured fibroblasts, subcultured to obtain the second generation of fibroblasts, and prepared each group of ADSCs conditioned medium (ADSCs-CM); the proliferation ability of fibroblasts cultured in each group of ADSCs-CM was detected by CCK-8 method, and the migration ability of fibroblasts cultured in each group of ADSCs-CM was detected by cell scratch method. SPSS 21.0 software was used for data analysis and P<0.05 was considered statistically significant. Results:The cells of all age groups were in a typical spindle shape. The cells of the younger age group showed small nuclei and the cell morphology were uniform and similar; the cells of the older age group had larger nuclei and uneven morphology. With aging, the proliferation ability of ADSCs gradually decreased. In vitro adipogenic differentiation induction results showed that with the increase in age, the ability of ADSCs to differentiate into adipocytes gradually decreased. In vitro osteogenic differentiation induction results also demonstrated that with the increase in age, the ability of ADSCs to differentiate into osteoblasts gradually decreased. The expression rates of positive surface markers of ADSCs in each group of ADSCs were all above 93%. With aging, the expression levels of PPAR-γ, HGF, and type Ⅲ collagen decreased, and the expression levels of DbX2 showed an upward trend with age. The number of β-galactosidase staining positive cells increased with age, while the difference between groups A, B and C was not statistically significant, and the difference between groups A and D, E, and F was statistically significant ( P<0.05). The ADSCs conditioned medium of each group was able to promote the proliferation of fibroblasts, but the difference between the groups was not statistically significant. With aging, the ability of ADSCs conditioned medium to promote the migration of fibroblasts gradually decreased. Conclusions:The proliferation ability and multidirectional differentiation ability of human ADSCs and the ability to secrete a variety of cytokines that promote the proliferation and migration of fibroblasts show a downward trend, but the adipogenic differentiation ability of ADSCs declines significantly after the age of 40 years. ADSCs in all age groups could promote the proliferation and migration of fibroblasts.
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Objective:To observe the application and clinical effect of stromal vascular fraction gel (SVF-gel) in local rhinoplasty.Methods:A total of 84 patients with mild nasal root and low bridge were divided into observation group and control group. In the observation group, liposuction with SVF gel extraction plus injection rhinoplasty was carried out; in the control group, liposuction plus injection rhinoplasty was carried out according to the height change of nasal root and bridge, the change of nasal frontal angle, the occurrence of complications and the satisfaction of patients after operation.Results:The 84 patients were followed up for 2 weeks to 24 months. The height of nasal root and bridge increased significantly and the lines were more harmonious. The absorption of the observation group was much lower than that of control group. Except 3 patients in the observation group and 8 patients in the control group, there were different degrees of absorption within 6 months after operation. All patients did not have complications such as fat liquefaction, necrosis, induration and infection in the injection area. Three patients in the observation group were satisfied with the results after reinjection, and one patient in the control group was satisfied with the results after reinjection, three patients were not satisfied with the results, and four patients were satisfied with the prosthesis augmentation rhinoplasty. In the observation group, there were 37 cases of excellent satisfaction, 5 cases of good satisfaction, and the overall satisfaction was 100%; in the control group, there were 20 cases of excellent satisfaction, 15 cases of good satisfaction, 7 cases of bad satisfaction, and the satisfaction was 83.3%. The former was better than the latter.Conclusions:In view of superiorities such as lower complications with long-lasting effect, high fat survival rate and high satisfaction in local augmentation rhinoplasty, SVF-gel injection is especially suitable for patients who cannot accept autologous bone, prosthesis and allograft tissue filler for augmentation rhinoplasty.
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Stromal vascular fraction(SVF)are the remaining cells after removing mature fat cells in the adipose tissue. Containing a certain amount of adipose derived stem cells(ADSCs), SVF also includes many other cells, which may have the potential of promoting angiogenesis. In this review, the role of SVF in angiogenesis after fat transplantation was summarized by intensive reading relative literature in recent years. The result is that angiogenesis and fat graft revascularization are regulated by various factors: SVF promotes secretion of a diverse array of cytokines and growth which are capable of stabilizing endothelium vascular network. ADSCs have the potential of differentiating into smooth muscle cells and endothelial cells which can coroperate to form new blood vessels.
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Objective@#To discuss and analyze the respective clinical effects of autologous fat filling for facial rejuvenation in the same period of three months after incisions.@*Methods@#From June 2015 to January 2018, 117 patients with facial rejuvenation admitted to the Plastic Surgery Hospital of Weifang Medical College were randomly divided into A, B and C groups. Group A (39 cases, male 3 cases, female 36 cases, age 44-67 years old) received simple rhytidectomy. Group B (39 cases, male 4 cases, female 35 cases, age 45-67 years old) underwent rhytidectomy and autologous fat filling at the same time. Group C (39 cases, male 3 cases, female 36 cases, age 45-65 years old) received autologous fat filling 3 months after rhytidectomy. We compared the improvement of facial depression (nasolabial groove and mouth angle), the effect of facial rejuvenation after fat filling in three groups and the incidence of complications in group B and C.@*Results@#15 cases in group A, 12 cases in group B and 2 cases in group C had no obvious improvement in facial atrophy, the remaining 88 cases had obvious improvement compared with before operation, and achieved the effect of facial rejuvenation. The incidence of complications in group C (7.69%) was significantly lower than that in group B (35.90%), the excellent or good rate of facial improvement and the nasolabial groove and peri-oral depression improvement in group C (87.18%, 92.31%) was significantly higher than that in group B (64.10%, 64.10%) and group A (33.33%, 17.95%) (P<0.05).@*Conclusions@#Comparative analysis of fat filling after 3 months of wrinkle removal to improve facial soft tissue atrophy and collapse is more obvious and more permanent in effect than fat filling, which is worthy of clinical promotion.
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Autologous adipose tissue is the most common filling material for repairing soft tissue defects at present. There are many studies on the efficacy and safety of autologous fat transplantation, and the results highly varies. For helping the doctors select the best practices for patients and beauty-seekers, the following aspects of the research progress of autologous fat grafting in recent years are discussed: functional anatomy of the superficial fat compartments of the face, nano-fat injected in dermis by micro-needle, SVF-gel and matching the donor fat site and the recipient environment of autologous fat grafts for better postoperative outcomes and safety.
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Since the autologous fat transplantation was reported by a German surgeon, Gustav Neuber, in 1893, the technical method of autologous fat transplantation, the transplantation concepts and application range have undergone tremendous changes and progress. In recent years, with the advanced research on adipose derived stem cells (ADSCs), the application field of autologous fat has been widespread. From initially used for soft tissue filling, it gradually expanded to orthopedic surgery, reconstructive surgery and cosmetic surgery, such as treatment of scar, skin and tendon adhesion, Renault syndrome, breast enhancement, facial rejuvenation and body shaping. The Nanofat transplantation technology originated from autologous fat transplantation, and it is not an exact nanotechnology for the technology itself. However, due to its remarkable effect on local skin rejuvenation, the Nanofat transplantation has become one of the hot issues in orthopedics in recent years.
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Objective@#To explore the clinical application of subpectoral silicone implant associated with autologous fat grafting after tissue expansion, for breast reconstructions.@*Methods@#From Jan 2013 to Dec 2016, a total of 15 female patients were admitted to the plastic surgery department of the First Affiliated hospital of Fujian Medical University. They were after or were prepared to unilateral modified radical mastectomy. Patients were aged 18-50 years old, with the average of 33.5 years. There were 8 cases of T1N0MO (T1micN0MO, n=1), 3 cases of T2N0MO, 1 case of T2N1MO, 1 case of T1N2MO, 1 case of T2N2MO and 1 case of T3N3MO. A tissue expander was inserted beneath the posterior pectoralis major in first surgery. The cavity stripped range is greater than the expander around 1cm. The lowest position of the expander was determined according to the IMF of the other breast. The tissue expander was gradually filled intraoperatively and postoperatively periodically, until the expander exceeds 30%-50% of the volume of the other breast. Three months later, as the soft tissue over the breast area has stretched enough, the expander was removed in a second operation and a permanent implant was inserted. Meanwhile, the autologous fat particles, harvested from thigh or abdomen, was centrifuged at 800×g for 3 minutes. Then it was injected into the subcutaneous and posterior pectoralis major space. And the other breast may be adjusted if necessary for symmetry.@*Results@#Fifteen patients was included in this study (immediately tissue expander implanted, n=8; delayed tissue expander implanted, n=7). All the expanders are round in shape. The interval between the two operations was 6-12 months, with an average of 7.4 months. The total salt-water solution injected was 310-450 ml per patient, with an average of 365 ml. The volume of breast implants was 180-280 ml. The injection volume of autologous fat was 65-230 ml, 122.7 ml on average. All incisions healed well. The follow-up period was 1-3 years, with an average of 2 years. The reconstructed breasts were in a natural shape, with a slight drop and bilateral symmetry. According to Harris breast shape evaluation criteria, all reconstructed breasts were graded as excellent.@*Conclusions@#The permanent implant associated with autologous fat grafting after tissue expansion is alternative for breast reconstruction.
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Platelet-rich fibrin(PRF) was first reported in 2001 by Choukroun. PRF is rich in growth factors, which can promote collagen deposition, angiogenesis, and reduce the incidence of postoperative pain, inflammatory reaction and infection. It is often used in stomatology and other wound repair. Recently, some researchers try to use PRF in fat grafting. The aim of this review is to summarize PRF and its application in fat grafting.
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Background@#Autologous fat grafting has gained popularity in breast augmentation. Various methods can be used to estimate the volume retention rate. This systematic review aimed to establish whether the type of method used for measuring breast volume is a factor that influences the reported volume retention rate.@*Methods@#Studies were identified using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from inception of the database up to February 2019. Articles describing autologous fat grafting for breast augmentation were selected based on pre-determined inclusion and exclusion criteria. The characteristics of the included studies were summarized, and the reported volume retention rate from the studies was compared. A quality assessment of all included articles was performed using the methodological index for non-randomized studies criteria.@*Results@#A total of 618 articles were identified, of which 12 studies, with a total of 1337 cases, were eligible. The retention rate of injected adipose tissue varied when the method of fat grafting and volume analysis used were both the same, as well as when the method of fat grafting was the same but the method of volumetric evaluation used was different.@*Conclusions@#Currently, the tools available for estimating the volume retention rate come with limitations. In order to objectively evaluate the percentage of graft retention, a standard protocol that applies to the different methods should be established in the future.
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Platelet-rich plasma (PRP), the concentration of platelet and plasma, is rich of a variety of growth factors.It plays an important role in anti-inflammatory and tissue regeneration, and has gradually been used in cosmetology in the recent years.This paper introduces the application of PRP in facial rejuvenation, acne and alopecia treatment, as well as improving the survival rate of autologous fat transplantation. The side effects and prospectives of PRP application in cosmetology were also summarized.
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Autologous granule fat transplantation has been widely used in clinical and scientific research in recent years because of its adequate sources and good histocompatibility. There are many scholars made a lot of research to enhance the survival rate of autologous fat transplantation, not only focus on the survival of fat transplantation theory, the process steps, evaluation index and postoperative treatment etc, also involves the various related fields, such as tissue engineering, gene engineering, slow release technology, etc. The relevant factors affecting the survival rate of autologous fat transplantation are summarized as follows.
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Objective To investigate the feasibility and clinical effect of transaxillary dual-plane breast augmentation under endoscope combined with autologous fat transplantation.Methods From January 2015 to December 2015,88 patients who accepted augmentation mammoplasty were divided into control group (from January to June) and observation group (from July to December).Patients in control group only accepted transaxillary dual-plane breast augmentation and transaxillary dual-plane breast augmentation combined with autologous fat transplantation was used for patients in observation group.Patients' basic information,surgery-related indicators,recovery situations,complications and patients' satisfactory data were collected.34 patients in control group and 38 patients in observation group were followed up.Results For surgery-related indicators and recovery situations,statistically significant difference was not found in the blood lost,duration of drainage tube and postoperative stay (P＞0.05),but was found in operation time (P＜0.05).And there was no significant difference in terms of surgical effects between two groups (P＞0.05).There were no complications such as hematoma,infection,capsular contracture in two groups.25 patients in observation group were performed B ultrasonic examination 6 months after operation.Multiple cysts were found at the cleavage in only 1 patient and were cured by suction.And the rest B ultrasonic results were negative for pathologic findings such as calcifications,cysts and masses.Conclusions Autologous fat transplantation is useful in minimizing the unaesthetic appearance of the cleavage and the bad feeling of the inframammary fold and thus a proper solution for the patient's breasts with thin soft tissue.
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Methods: Two groups of fats were obtained from the left and right sides of a female patient during the abdomen liposuction surgery, respectively. And the fats in experimental group and control group were harvested by the new front opening liposuction cannula and the side hole liposuction cannula, respectively. The differences of adipocyte activity in vitro between 2 groups were compared by observation under the electron scanning microscopy and the glucose transportation test. Then, the fats in 2 groups ( n=20) were injected subcutaneously into the back of 20 nude mice (400 mg fats per injection zone). The differences of the injection area reactions, remaining weight, histological characteristics, and microvessel density (MVD) between 2 groups were compared after 4 weeks and 12 weeks.
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With the increasing application of autologous fat grafting and adipose-derived stem cells (ASC) in regenerative medicine, more researchers pay attention to its effects on scar, which may provide a promising alternative for scar treatment. In this article, a systemic review of available literature was undertaken, regarding the current progress in repairing scars with autologous granule fat, the introduction of nanofat grafting and its effects on scar, and the mechanism of ASCs in the treatment of scar. This review provides a reference for the clinical application and basic research of fat transplantation in scar treatment.
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Objective This study was intended to determine the role of microautologous fat transplantation (MAFT) in dealing with severe sunken upper eyelids.Methods The authors performed microautologous fat transplantation (MAFT) procedure,particularly in accurately delivering small fat parcels,to treat 238 patients with sunken upper eyelids with multiple folds.Results The average total injection volume of fat were 1.8 ml in right upper lid (from 1.1 to 2.4 ml) and 1.7 ml in left upper lid (from 1.1 to 2.4 ml) separately.Only 3 cases encountered prolonged swelling more than 2 weeks.There were no severe complications.All patients were satisfied with the final results and 2 patients asked for secondary enhancement procedure.Conclusions The therapeutic effects of MAFT and the long-term clinical results of patients with sunken upper eyelids with multiple folds indicate satisfactory outcomes.
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Objective To investigate how to improve the survival rate,and to avoid the serious complications in fat grafting.Methods Under comprehensive design of facial filling area,the fat was harvested by concentration in mesh;under the micro autologous fat transplantation gun with blunt needle injection technique,the fat was filled into the face to achieve the effect of improving the facial contour and the rejuvenation.From June 2014 to July 2015,78 patients with facial contour and facial soft tissue relaxation depression were treatment by the technique.Results The follow-up of 2 months to 1 year showed that 64 patients had the soft,young,significantly enhanced facial contour;7 patients had second times grafts and the remaining were satisfied.7 patients gave up the second times grafts because the other reasons.The surgical complications such as facial nerve injury and infection and embolism were not seen.Conclusions This technique by comprehensive design and purification of autogenous fat granules achieves a better effect on facial rejuvenation with fewer complications.