Clinical effect of botulinum toxin type A combined with autologous fat grafting in patients with nasolabial fold depression

BACKGROUND Nasolabial fold(NLF)depression can affect the facial appearance of patients to some extent and increase their psychological burdens.In recent years,autologous fat grafting(AFG)combined with botulinum toxin A(BTX-A)injection(AFG+BTX-A injection)has been gradually applied in the treatment of patients with NLF depression.Although studies have been conducted on the efficacy and safety of AFG+BTX-A injection in treating NLF depression,the experimental design,observational indicators,and sample enrollment criteria vary remarkably,making it difficult to draw convincing and consistent conclusions.Thus,further relevant research is warranted.AIM To assess the esthetic improvement,efficacy,and safety of AFG+BTX-A injections in patients with NLF depression.METHODS This study included 60 patients with NLF depression who were treated in our hospital from February 2019 to April 2021.These patients were categorized into control(n=30)and observation(n=30)groups.The observation group received AFG+BTX-A injection,whereas the control group underwent AFG only.All patients were evaluated using the wrinkle severity rating scale(WSRS)and global aesthetic improvement scale.The compactness of facial contours,skin evaluation indexes,adverse reactions,and satisfaction of the two groups were evaluated 3 months postoperatively.RESULTS The WSRS scores of the observation group at 1,3,and 6 months postoperatively were lower than those of the control group(P<0.05).Three months postoperatively,facial fine lines and pores showed obvious improvement and the skin index score was higher in the observation group than in the control group(P<0.05).The compactness of facial contours was better in the observation group than in the control group(P<0.05).In addition,no remarkable differences were noted in the incidence of postoperative adverse reactions such as facial stiffness,facial asymmetry,facial bruising,and facial concavity inequality(P>0.05).CONCLUSION AFG+BTX-A injection is a highly safe,cost-effective,effective,and long-lasting treatment for NLF depression with high esthetic value,which should be promoted in the future.

Augmentation mammoplasty with autologous fat grafting

Considering the issues that can accompany prosthetic breast implants,augmentation mammoplasty(AM)with autologous fat grafting(AFG)has attracted growing interest globally,especially in the last two decades,as breast implant-associated anaplastic large cell lymphoma has been increasing in incidence over time.Here,we review the detailed processes of AFG to the breast and the pertinent complications associated with this procedure.This study aims to elucidate the critical points and technique improvements in AM with AFG in recent years,as well as discuss how to decrease complications related to this procedure.Attention was focused on the specific AFG steps,clinical outcomes,and complications to highlight the advantages and disadvantages of the available protocols.

A Systemic Review of Autologous Fat Grafting Survival Rate and Related Severe Complications

Objective：Clinical application ofautologous fat grafting （AFG） is quickly expanding.Despite the widely acceptance,long-term survival rate （SR） of AFG remains a question not yet solved.Meanwhile,although rare,severe complications related to AFG including vision loss,stroke even death could be seen in the literature.Data Sources：A comprehensive research of PubMed database to June 2013 was performed according to guidelines of the American Society of Plastic Surgeons Fat Graft Task Force Assessment Methodology.Articles were screened using predetermined inclusion and exclusion criteria.Study Selection：Data collected included patient characteristics,surgical technique,donor site,recipient site,graft amount,and quantified measurement methods.Patient cohorts were pooled,and SR was calculated.All the severe complications were also summarized according to the different clinical characteristics.Results：Of 550 articles,16 clinical articles and 10 animal studies met the inclusion criteria and provided quantified measurement methods.Totally,596 patients were included.SR varied from 34％ to 82％ in breast and 30-83％ in the facial area.Nude mice were applied to investigate human fat grafting SR （38.3-52.5％ after 15 weeks）.Rabbits were commonly used to study animal AFG SR （14.00-14.56％ after 1-year）.Totally,21 severe complications were reported,including death （2）,stroke （10）,vision loss （11,8 of which accompanied with stroke）,sepsis （3）,multiple abscess （1） and giant fat necrotic cyst （2）.Ten of these complications happened within 10 years.Conclusions：There is no unified measurement method to evaluate fat graft SR until now and no clinical evidence to show better SR according to different donor and recipient cite.Body mass index change between pre-and postoperation may be the bias factor in evaluating fat SR.Fat embolisms of the ophthalmic artery and the middle cerebral artery are the most severe complication of AFG and still lack of effective treatment.

Role of adipose tissue grafting and adipose-derived stem cells in peripheral nerve surgery

The application of autologous fat grafting in reconstructive surgery is commonly used to improve functional form.This review aims to provide an overview of the scientific evidence on the biology of adipose tissue,the role of adipose-derived stem cells,and the indications of adipose tissue grafting in peripheral nerve surgery.Adipose tissue is easily accessible through the lower abdomen and inner thighs.Non-vascularized adipose tissue grafting does not support oxidative and ischemic stress,resulting in variable survival of adipocytes within the first 24 hours.Enrichment of adipose tissue with a stromal vascular fraction is purported to increase the number of adipose-derived stem cells and is postulated to augment the long-term stability of adipose tissue grafts.Basic science nerve research suggests an increase in nerve regeneration and nerve revascularization,and a decrease in nerve fibrosis after the addition of adipose-derived stem cells or adipose tissue.In clinical studies,the use of autologous lipofilling is mostly applied to secondary carpal tunnel release revisions with promising results.Since the use of adipose-derived stem cells in peripheral nerve reconstruction is relatively new,more studies are needed to explore safety and long-term effects on peripheral nerve regeneration.The Food and Drug Administration stipulates that adipose-derived stem cell transplantation should be minimally manipulated,enzyme-free,and used in the same surgical procedure,e.g.adipose tissue grafts that contain native adipose-derived stem cells or stromal vascular fraction.Future research may be shifted towards the use of tissue-engineered adipose tissue to create a supportive microenvironment for autologous graft survival.Shelf-ready alternatives could be enhanced with adipose-derived stem cells or growth factors and eliminate the need for adipose tissue harvest.

Prospective application of poloxamer 188 in plastic surgery:A comprehensive review

An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it an extremely promising agent for plastic surgery.In this review,we summarize the positive roles of P188 in autologous fat grafting,wound healing,and cartilage transplantation.These roles include improving the survival rate of fat grafts and chondrocytes,stimulating the metabolic activity of adipocytes,promoting wound healing,and contributing to cartilage formation.Although further research is still needed,it is clear that P188 has great potential and application value in the field of plastic surgery.