Enhancing Fat Transplantation Efficiency in a Mouse Model through Pretreatment of Adipose-Derived Stem Cells with RIP3 Inhibitors.

BACKGROUND: Autologous fat transplantation, widely used in cosmetic and reparative surgery for volumetric enhancements, faces challenges with its inconsistent long-term survival rates. The technique's efficacy, crucial for its development, is hindered by unpredictable outcomes. Enriching fat grafts with adipose-derived stem cells (ADSCs) shows promise in improving survival efficiency. OBJECTIVES: This study aimed to explore the potential of receptor-interacting protein kinase 3 (RIP3) kinase inhibitors as a pretreatment for ADSCs in enhancing autologous fat graft retention over a long term. METHODS: ADSCs were isolated, cultured under normal or oxygen-glucose deprivation conditions, and mixed with particulate fat grafts to form distinct experimental groups in female nude mice. Fat graft mass and volume, along with underlying mechanisms, were evaluated using quantitative reverse transcription polymerase chain reaction (RT-qPCR), immunohistochemistry, and Western blot analysis. RESULTS: The experimental group, pretreated with RIP3 kinase inhibitors, had higher graft mass and volume, greater adipocyte integrity, and increased peroxisome proliferator-activated receptor gamma (PPARγ) mRNA levels than control groups. Furthermore, the experimental group demonstrated lower expression of necroptosis pathway proteins in the short term and an ameliorated inflammatory response as indicated by interleukin-1 beta (IL-1ß), interleukin-10 (IL-10) mRNA levels, and histological analyses. Notably, enhanced neovascularization was evident in the experimental group. CONCLUSIONS: These findings suggest that RIP3 kinase inhibitor pretreatment of ADSCs can improve fat graft survival, promote adipocyte integrity, potentially decrease inflammation, and enhance neovascularization. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Cross-Sectional Survey on Pain Management in Dermal Filler Injections from Physicians' and Patients' Perspectives.

BACKGROUND: Hyaluronic acid (HA) dermal fillers injection is a common procedure in patients with cosmetic needs. Concomitant pain is a major complaint among patients undergoing HA filler injections. Relevant research is limited and there is no consensus on pain management of dermal filler injection. OBJECTIVES: To assist physicians in determining a more appropriate treatment approach, and to better provide treatment suggestions. METHODS: A nationwide (China) cross-sectional survey was conducted using questionnaires designed for physicians and patients, respectively. A total of 62 semi-structured questionnaires were administered to aesthetic physicians via face-to-face interview, whereas 123 online-based questionnaires were collected from patients who have ever undergone HA treatment. The collected questionnaire information was analyzed using descriptive statistics and content analysis. RESULTS: 42 (67.74%) physicians observed that over 50% of their patients were concerned about pain during injection. 101 (82.11%) of patients were concerned about impending pain ≥5 points (a total score is 10) before injection. For preferred pain relief modalities, 48 (77.42%) physicians would choose a hyaluronic acid dermal filler with lidocaine, and 82 (66.67%) patients would choose anesthetic-containing products. 59 (95.16%) physicians who injected lidocaine-containing hyaluronic acid found patients had a comfortable treatment experience. CONCLUSIONS: Pain management during hyaluronic acid dermal fillers injection is important from both perspectives of physicians and patients. This survey showed that compared with other analgesic methods, lidocaine-containing hyaluronic acid has offered a more satisfying experience. It also provides insights to physicians and patients in pain management. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Minimally Invasive 980 nm Laser-Assisted Lipolysis and Skin Tightening on Lower Eyelids of Asian Patients.

OBJECTIVE: The present study aimed to evaluate the effectiveness of minimally invasive 980 nm laser-assisted lipolysis and skin tightening in lower eyelid blepharoplasty of Asian patients. METHODS: Patients with mild and moderate degree of eyebags underwent 980 nm laser-assisted lipolysis via lower eyelid stab incision between December 2017 and December 2019. Evaluation criteria was reviewed by photographs taken preoperatively and 6 months postoperatively in accordance with guidelines of Global Aesthetic Improvement Scale, the patient's perspective from the questionnaire with the perception of reduction in eyebags size, the average perception of improvement in skin tightening, and the patient overall satisfaction, all with a score of 1 to 5 (5 being the most noticeable and very satisfied) and complications such as dyspigmentation, hematoma, prolonged edema, skin bump and thermal burn were documented as well. RESULTS: A total of 178 cases with 137 women and 41 men (age range from 23 to 50 years) were included. Total energy of 1200 J to 2000 J was delivered to both eyebags at 6 to 10 W. They were followed up for at least 6 months. A total of 166 patients (93.26%) revealed an improvement in Global Aesthetic Improvement Scale, with the 12 patients (6.74%) complaint no change 6 month postoperatively. Perception of improvement in eye bag protrusion scored 4.39 ± 0.59, improvement in skin tightening scored 4.42 ± 0.58 and the overall patient's satisfaction scored 4.59 ± 0.53. The patients' average recovered swelling from 4.35 ± 2.3 days. There were 5 patients (2.8%) with dyspigmentation, 3 patients (1.69%) with prolonged edema and 2 patients (1.12%) with skin bump and none of the patients had thermal burn. All of them resolve after 6 months of follow up. CONCLUSION: Patients with mild to moderate degree of eyebags who resist surgery are good candidates for laser-assisted lower eyelid blepharoplasty.