微颗粒脂肪改善颈纹的临床效果与其生物学特性的研究

Clinical application of microfat in improving neck wrinkles and its biological characteristics

目的:探讨微颗粒脂肪改善颈纹的临床效果及其组织结构与细胞活性。方法:2018年6月至2021年6月,于中国医学科学院整形外科医院形体雕塑与脂肪移植中心行微颗粒脂肪填充改善颈纹女性患者23例,20~59(38.1±10.7)岁。吸脂获得脂肪颗粒,轻柔离心制备微颗粒脂肪,用26 G锐针于颈纹线性凹陷的真皮内及真皮下少量多点注射脂肪。采用第三方医师等级评分及患者满意度评分对手术效果进行评估。通过扫描电镜观察组织结构、钙黄绿素-AM/碘化丙啶(Calcein-AM/PI)染色检测组织细胞活性、Muse细胞分拆仪计数基质血管成分(SVF)细胞明确微颗粒脂肪结构与活性。结果:23例患者均顺利完成手术,无感染、脂肪液化等并发症。随访3~30个月,颈纹得到有效改善,术后等级评分显著降低(P<0.05),患者满意度高,满意20例,占87.0%。扫描电镜下见脂肪颗粒细胞紧密排列、结构保留完整。Calcein-AM/PI染色见颗粒内大多数细胞存活。脂肪颗粒内活性SVF细胞数量为(9.34±2.68)×10^(5)/ml。结论:微颗粒脂肪易获取、颗粒活性高、适宜于颈纹填充,可获得较好地改善效果,患者满意度高,值得临床应用。

Objective To evaluate the clinical efficacy of microfat on neck wrinkles and its structure and viability.Methods A retrospective analysis was conducted to review the clinical data of 23 patients with neck wrinkles corrected by microfat injection from June 2018 to June 2021 at the Body Contouring and Fat Grafting Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences,aged(38.1±10.7)years old.A blunt cannula with multiple side holes of 0.8 mm was used to obtain fat particles under low negative pressure and to prepare the microfat by washing and soft centrifugation.A 26-gauge sharp needle was used to inject microfat with small amount and at multiple points into the intradermal and subdermal layer where the neck lines were linearly depressed.Regular follow-ups were carried out after the operation,and the efficacy of the operation was evaluated from routine neck examinations,third-party doctor′s grade scoring and patient′s scoring towards satisfaction.To clarify the structure and viability of microfat,scanning electron microscope was used to observe the structure of fat particles,Calcein-AM/propidium iodide(Calcein-AM/PI)staining to detect tissue viability and Musecell counting to count SVF cells.Results All of the 23 patients successfully completed the operation without complications such as infection and fat liquefaction.After a follow-up of 3 to 30 months,the neck wrinkles were effectively improved.The postoperative grade scores of third-party doctor was significantly reduced(P<0.05).And the satisfaction of patients was high,with 20 cases(87.0%)satisfied.Scanning electron microscopy showed that the fat granule cells were tightly arranged and the structure remained intact.Calcein-AM/PI staining showed that most cells in the granules survived.The number of viable SVF cells in fat particles was(9.34±2.68)×10^(5)/ml.Conclusions Microfat is easy to obtain with high tissue activity,which is suitable for neck wrinkle filling.Good effects can be achieved with high patients′satisfaction.It is worthy of clinical application.