Clinical Efficacy of Mechanical Micronized Fat-Assisted Fat Grafting on Temporal Depression.

BACKGROUND: Temporal concavities result from reduced subcutaneous fat and bone structure variations, impacting facial aesthetics. Filling treatments, including autologous fat grafts, synthetic fillers, and biological materials, are used for enhancement. Autologous fat grafting is promising but limited by unpredictable fat absorption and nonstandardized procedures. This study aims to assess the clinical effectiveness of mechanical micronized fat in combination with autologous granular fat grafting for lipofilling in the correction of temporal deformities. METHODS: Patients (n = 37, mean age = 37.48) with temporal concavity caused by aging and Inherently inadequate capacity were enrolled and divided into control group (n = 10) and study group (n = 9) according to different fat grafts. Control group received pure autologous granular fat, with an average volume of approximately 19.30 mL. In contrast, the study group used mechanical micronized fat along with autologous granular fat co-injection through an 18G needle with an average injection volume of about 18.89 mL. All autologous fat collected from patients' abdominal and thighs. Information, including postoperative clinical efficacy scored by various plastic surgeons for the comparison of preoperative and postoperative photos of patients, patient satisfaction, and complications between the two groups, was documented. Additionally, changes in patients' quality of life were evaluated using the FACE-Q scale. RESULTS: Six months after surgery, the efficacy of temporal filling in the study group (6.69 ± 0.64) was higher than the control group (6.37 ± 0.67) (P = 0.0048). The patient satisfaction was more prominent in the study group (6.28 ± 0.87) than in the control group (5.80 ± 0.71) (P = 0.0449). Differences between above two observation indicators were statistically significant (P < 0.05). The FACE-Q scale items, which assess psychological health, social functioning, and early life impact, showed higher scores in the study group both before the surgery (psychological health: 59.22 ± 3.53, social functioning: 64.75 ± 3.15) and 6 months after the surgery (psychological health: 69.44 ± 4.50, social functioning: 75.33 ± 3.81, early life impact: 74.21 ± 0.70) (P > 0.05). Notably, only one micronodule formation was detected among all patients. CONCLUSION: Mechanical micronized fat combined with autologous granular fat improve the clinical effect of treating concavity in temporal region, which is worthy of further promotion and application.

Clinical results in patients affected by moderate-severe knee osteoarthritis and treated with micro-fragmented adipose tissue: the therapeutic effects on symptomatology.

Osteoarthrosis is a degenerative musculoskeletal disease that presents a major public health problem, due to the increasing average age of the active population, as well as the increasing percentage of obesity or overweight of the general population. New therapeutic approaches have been developed, such as regenerative medicine that uses mesenchymal stromal cells taken from adipose tissue. This study analyzed the clinical potential benefits of using autologous adipose tissue to treat patients with moderate-severe knee osteoarthritis.In 2021, a total of 50 knees, affected by moderate-severe knee osteoarthritis, were treated with an intra-articular injection of micro-fragmented subcutaneous adipose tissue. Patients were submitted to the KOOS questionnaire before the operation and one year after the operation and VAS pain score at time 0, 3, 6, 12 months.Of the 50 patients treated, 2 patients were excluded from the study. Of the remaining 48 patients, improvements have been achieved in all subclasses of KOOS. In particular, VAS score proves that improvements are more considerable starting from the 3rd month after surgery.The results obtained in this study show the safety and potential benefit of the use of autologous micro-fragmented adipose on people who are affected by moderate-severe knee osteoarthritis.

Transplantation of Cold-Stimulated Subcutaneous Adipose Tissue Improves Fat Retention and Recipient Metabolism.

BACKGROUND: Induction of beige fat for grafting is an emerging transplantation strategy. However, safety concerns associated with pharmaceutical interventions limit its wider application. Moreover, because beige fat is a special type of fat with strong metabolic functions, its effect on the metabolism of recipients after grafting has not been explored in the plastic surgery domain. OBJECTIVES: The aim of this study was to explore whether cold-induced inguinal white adipose tissue (iWAT) transplantation has a higher retention rate and beneficial effects on recipient metabolism. METHODS: C57/BL6 mice were subjected to cold stimulation for 48 hours to induce the browning of iWAT and harvested immediately. Subsequently, each mouse received a transplant of 0.2 mL cold-induced iWAT or normal iWAT. Fat grafts and recipients' iWAT, epididymal adipose tissue, and brown adipose tissue were harvested at 8 weeks after operation. Immunofluorescence staining, real-time polymerase chain reaction, and western blot were used for histological and molecular analysis. RESULTS: Cold-induced iWAT grafting had a higher mean [standard error of the mean] retention rate (67.33% [1.74%] vs 55.83% [2.94%], P < .01) and more satisfactory structural integrity than normal iWAT. Histological changes identified improved adipose tissue homeostasis after cold challenge, including abundant smaller adipocytes, higher levels of adipogenesis, angiogenesis, and proliferation, but lower levels of fibrosis. More importantly, cold-induced iWAT grafting suppressed the inflammation of epididymal adipose tissue caused by conventional fat grafting, and activated the glucose metabolism and thermogenic activity of recipients' adipose tissues. CONCLUSIONS: Cold-induced iWAT grafting is an effective nonpharmacological intervention strategy to improve the retention rate and homeostasis of grafts. Furthermore, it improves the adverse effects caused by traditional fat grafting, while also conferring metabolic benefits.

Implantation of autologous fat globules in localized scleroderma and idiopathic lipoatrophy - report of five patients / Implante de fragmentos de lobulos de gordura autologa na esclerodermia localizada e lipoatrofia idiopatica, relato de cinco pacientes

A large number of diseases may cause Atrophic skin disorders are caused by a large number of diseases, some of them idiopathic and others inflammatory, in which there is loss of volume of body segments. Localized scleroderma is a rare inflammatory dermatosis, manifested by atrophic skin and subcutaneous tissue alterations. Lipoatrophy may be genetically inherited or acquired as a result of panniculitis, HIV infections or aging. Many treatments have been proposed. Results vary in the acute inflammatory phase and are scarce when sclerosis and atrophy have already been established. This article describes four cases of localized facial scleroderma and one of facial idiopathic lipoatrophy treated with implantation of autologous fat globules extracted from the infragluteal groove, without utilization of cannula aspiration, with lasting results.

Os distúrbios atróficos da pele abrangem inúmeras doenças, algumas idiopáticas e outras, inflamatórias, em que há perda do volume de segmentos do corpo. A esclerodermia localizada é uma dermatose inflamatória, rara, que pode manifestar-se com alterações atróficas da pele e tecido subcutâneo. A lipoatrofia pode ser herdada geneticamente ou adquirida relacionada a paniculites, infeccção pelo HIV, ou envelhecimento. Muitos tratamentos são propostos. Os resultados são variáveis na fase inflamatória aguda e apresentam pouca resposta quando a esclerose e atrofia já estão instaladas. Descreve-se o tratamento de quatro casos de esclerodermia localizada e um de lipoatrofia idiopática, na face, tratados com enxerto de fragmentos de lóbulos de gordura autóloga extraídos sem a utilização da cânula aspirativa, com resultados duradouros.

Osteocalcin Immunohistochemical Expression During Repair of Critical-Sized Bone Defects Treated with Subcutaneous Adipose Tissue in Rat and Rabbit Animal Model

The aim of this study was to evaluate the osteocalcin immunoexpression during the bone repair treated with subcutaneous adipose tissue in rats and rabbits. Fourteen rats and 14 rabbits were used in the study. A critical-sized calvarial defect was created in each animal. The animals were divided into 4 experimental groups: RC (rat control), RbC (rabbit control), RAT (rat adipose tissue), RbAT (rabbit adipose tissue). In the groups RC and RbC the defect was filled with a blood clot. In groups RAT and RbAT, the defect was filled with macerated subcutaneous adipose tissue. The euthanasia was performed at 30 days (RC and RAT) and 40 days (RbC and RbAT). Histological analysis and immunohistochemical analysis of osteocalcin protein expression were performed. Data were submitted to descriptive statistical analysis (mode). Osteocalcin immunoexpression was detected in the experimental models. Notwithstanding, RbAT showed higher positivity, especially in the adipocytes, than the group RAT group. In groups RC and RbC, the surgical wound was filled by collagen fibers. In Group RAT, the defect was composed by collagen fibers and adipocytes in the reparative sites. Similarly, in RbAT, the defect also was partially filled by collagen fibers and presence of adipocytes dispersed among the fibers. Additionally, chronic inflammatory process and areas of bone matrix deposition were observed. It may be concluded that in both animal models the adipose tissue demonstrated low osteogenic capacity. However, the rabbit animal model exhibited a more evident osteocalcin immunoexpression and a greater amount of newly formed bone matrix.

Este estudo avaliou a imunoexpressão da osteocalcina no reparo ósseo de defeitos críticos tratados com tecido adiposo subcutâneo em rato e coelho. Foram utilizados 14 ratos e 14 coelhos. Um defeito crítico foi realizado na calvária de cada animal. Os animais foram divididos em 4 grupos experimentais: CR (controle rato), CC (controle coelho), TAR (tecido adiposo do rato), TAC (tecido adiposo do coelho). Nos grupos CR e CC, o defeito foi preenchido com coágulo. Nos grupos TAR e TAC, o defeito foi preenchido com tecido adiposo subcutâneo macerado. A eutanásia dos grupos CR e TAR ocorreu com 30 dias e dos grupos CC e TAC com 40 dias. Foram realizadas análise histológica e imunoistoquímica com a proteína osteocalcina. Os dados foram submetidos à análise estatística descritiva (moda). Nos modelos experimentais foi observada a imunoexpressão de osteocalcina. Contudo, o TAC apresentou maior imunoexpressão entre os adipócitos quando comparado ao TAR. Nos grupos CR e CC a ferida cirúrgica foi preenchida por fibras colágenas. No grupo TAR foi observado o preenchimento por fibras colágenas e presença de adipócitos no interior deste tecido. No grupo TAC o defeito foi preenchido parcialmente por fibras colágenas, com presença de adipócitos dispersos entre as fibras. Além disso, foi observado processo inflamatório crônico e sinais de neoformação óssea. Conclui-se que em ambos os modelos animais o enxerto de tecido adiposo apresentou baixa capacidade osteogênica. Contudo, o modelo animal coelho apresentou uma imunoexpressão da osteocalcina mais evidente e maior quantidade de matriz óssea neoformada.

Impacto da mitomicina-C tópica na deposição de colágeno em torno de enxerto de gordura na prega vogal de coelhos: estudo histológico e morfométrico / Impact of topical mitomycin-C in the deposition of collagen around fat grafts in vocal folds of rabbits: histologic and morphometric study

Desde o início de 1990, a enxertia de gordura na prega vocal é descrita como um método para reparar a insuficiência glótica. O objetivo deste estudo é avaliar os efeitos da aplicação tópica de mitomicina-C no processo cicatricial de enxertos autólogos de gorduras inseridos em pregas vocais de coelhos através da medida da deposição de colágeno. Vinte e oito coelhos foram submetidos a enxertia de gordura em ambas pregas vocais. As pregas vocais direitas recebeu previamente a aplicação tópica de mitomicina-C (0,4mg/ml) durante cinco minutos enquanto que as pregas vocais esquerdas formavam o grupo controle (sem mitomicina-C). Quatro grupos com 6 coelhos cada foram sacrificados com 7, 14, 30 e 90 dias após a cirurgia de enxertia. As pregas vocais foram removidas para estudo histológico com a intenção de quantificar a deposição de colágeno através da coloração por Picrossírius Red sob microscopia polarizada. A deposição de colágeno foi menor em todos os grupos de pregas vocais que receberam aplicação tópica de mitomicina-C quando comparada com as pregas vocais do grupo controle. No presente estudo, a aplicação tópica de mitomicina-C antes da enxertia de gordura reduziu significativamente a deposição de colágeno (p = 0,05).

Since the early 1990s, fat implantation in the vocal fold is described as a method of repairing glottal insufficiency. The aim of this study was to evaluate the effect of topical application of mitomycin in the healing process with collagen deposition measurement around of autologous fat implants inserted in rabbits vocal folds. Twenty-eight rabbits were submitted to a fat implant in the both vocal folds. The right vocal folds received previously topical application of mitomycin (0,4mg/ml) for five minutes and the left vocal folds were the control group (without mitomycin). Four groups of 6 rabbits each were sacrificed 7, 14, 30 and 90 days after the implantation. The samples of the vocal folds were collected for histological analysis with the purpose of quantifying the collagen deposition by Picrosirius Red stain under polarization microscopy. The collagen deposition was lower in all groups of vocal folds with topical application of mitomycin than in control groups. In the present study, the topical application of mitomycin before the fat grafts reduced significantly the collagen deposition (p = 0,05).

Gordura centrifugada nas deformidades craniofaciais

Objetivo: Relatar experiência com gordura centrifugada para correção de deformidades craniofaciais por deformidade óssea ou defeitos de partes moles. Método: Trinta e dois pacientes com deformidades craniofaciais realizaram enxertia de gordura em face nos anos de 2006 e 2007, utilizando-se o método da centrifugação como coleta. Os resultados foram avaliados por meio de foto pré e pós-procedimento cirúrgico e os resultados classificados como satisfatório e insatisfatório. Os pacientes classificados como resultado satisfatório foram aqueles que não necessitaram de novo procedimento e insatisfatórios aqueles que necessitaram de novo procedimento. O seguimento dos pacientes variou de 6 meses a 30 meses e o trabalho foi enviado para apreciação de comissão de ética do hospital. Resultados: Trinta e dois pacientes submetidos a procedimento cirúrgico para correção de deformidades faciais, 8 (25%) pacientes com depressões em face pós-trauma, 6 (18,7%) pacientes com síndrome de Parry-Rombeg, 7 (21,9%) com fissura labial, 2 (6,2%) fissuras raras de face, 3 (9,4%) com síndrome de Treacher-Collins, 2 (6,2%) com assimetria facial congênita, 2 (6,2%) com esclerodermia e 2 (6,2%) com seqüela de tumor em face. Quatorze (43,75%) pacientes tiveram resultado satisfatório no primeiro procedimento cirúrgico e 18 (56,25%) necessitaram de novo procedimento...