Autologous fat grafting is an important surgical technique in aesthetic and reconstructive procedures.Fat grafting for breast reconstruction is now an established procedure for adding volume and improving cutaneous pl...Autologous fat grafting is an important surgical technique in aesthetic and reconstructive procedures.Fat grafting for breast reconstruction is now an established procedure for adding volume and improving cutaneous pliability;it can be used independently to replace more invasive flap procedures or implants,or as an adjunct for smaller volume supplementation.The breadth of applications in the breast necessitates diversity in technique and approach,and while there is no universally agreed-upon protocol,basic principles have guided the evolution of some commonly adopted tenets.Broadly,fat grafting outcomes are highly favorable but dependent on patient and procedure factors,requiring learned patient selection and expertise in recipient site assessment.Common complications from fat grafting,such as fat necrosis and the development of nodules,are particularly troublesome for post-oncologic patients,requiring considerable pre-surgical consultation for patient education and managing expectations.In addition to volume and contour augmentation,fat grafting has additional beneficial effects that have recently drawn increased attention including pain reduction from implant capsular contracture or postmastectomy pain syndrome,improved skin quality and reduced fibrosis following radiation,and possible anti-tumorigenic effects.New developments in clinical fat grafting research that are promising include the use of adipose progenitor cells admixed with lipoaspirate for improved volume retention or alternative biologics such as platelet-rich plasma.Preclinically,research towards safe and effective regenerative medicine approaches is actively underway,with the ultimate goal of achieving predictable and increased graft retention,reducing the number of required surgical procedures and enabling on-table results to reflect procedure outcomes.展开更多
Fat redistribution through recycling of previously grafted fat hasn’t been reported. Two facial asymmetry patients are presented with history of fat grafting to the mandibular angle areas. Collected fat from these fo...Fat redistribution through recycling of previously grafted fat hasn’t been reported. Two facial asymmetry patients are presented with history of fat grafting to the mandibular angle areas. Collected fat from these formerly fat grafted zones and swollen on subsequent extra body weight gain has been re-grafted in the temporal regions for contour enhancement and has retained volume as photographically documented up to 30 months.展开更多
Background: Despite the popularity of autologous fat transfer applications, high resorption rates, and consequential volume loss, have been reported. Viable adipocyte content has been defined as a key determinant of f...Background: Despite the popularity of autologous fat transfer applications, high resorption rates, and consequential volume loss, have been reported. Viable adipocyte content has been defined as a key determinant of fat transfer longevity. Moreover, traces of blood, free oil fat and fibrotic tissue accelerate adipocyte degradation. Objective: To compare the effectiveness of a 1470 nm, radial emitting laser-assisted liposection device to a mechanical liposection device in maintaining adipocyte viability in fat tissue harvests. Methods: Bilateral subcutaneous adipose tissue samples were harvested from ten female patients. Fat was harvested from one side using the LipoLife laser-assisted liposuction device and from the other side with a Byron mechanical aspirator. Samples were visually analyzed and blood:fat ratios and cell viability were determined. Results: Laser-harvested samples separated into two distinct phases, with a negligible blood phase at the bottom (1.1%) and a significant adipose phase at the top (98.9%), containing small, uniform-sized cells, of which 95.7% ± 2.7% proved viable. Mechanically harvested samples separated into blood (18%), adipose (60%) and lipid (22%) phases. The adipose phase contained significant amounts of connective tissue, large adipose tissue fragments, large oil droplets and a mean 79.7% ± 18.3% viable adipocytes. Conclusions: Laser liposuctioning was superior to mechanical liposuctioning, providing both higher cell viability and enhanced sample quality. The 1470 nm diode laser bears the potential of improving long-term clinical outcomes of fat transfer procedures. Improved purity of the harvested sample and heightened preadipocyte content are projected to provide for extended graft longevity.展开更多
Since the advent of facelift surgery, there has been a progressive evolution in tech-nique. Methods of dissection trended towards progressively aggressive surgery with deeper dissection for repositioning of ptotic fac...Since the advent of facelift surgery, there has been a progressive evolution in tech-nique. Methods of dissection trended towards progressively aggressive surgery with deeper dissection for repositioning of ptotic facial tissues. In recent decades, the pendulum has swung towards more minimally invasive options. Likewise, there has been a shift in focus from repo-sitioning alone to the addition of volumization for facial rejuvenation. The techniques in this article are reviewed in a chronologic fashion with a focus on historical development as well as brief discussion on efficacy in relation to the other existing options. There is currently no gold standard technique with a plethora of options with comparable efficacy. There is controversy over which approach is optimal and future research is needed to better delineate optimal treatment options, which may vary based on the patient. Copyright a 2015 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
Background： Lipid storage myopathy （LSM） is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency （MADD） is a rather common form of LS...Background： Lipid storage myopathy （LSM） is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency （MADD） is a rather common form of LSM in China. Diagnosis and clinical management of it remain challenging, especially without robust muscle biopsy result and genetic detection. As the noninvasion and convenience, muscle magnetic resonance imaging （MRI） is a helpful assistant, diagnostic tool for neuromuscular disorders. However, the disease-specific MRI patterns of muscle involved and its diagnostic value in late-onset MADD have not been systematic analyzed. Methods： We assessed the MRI pattern and fat infiltration degree of the lower limb muscles in 28 late-onset MADD patients, combined with detailed clinical features and gene spectrum. Fat infiltration degree of the thigh muscle was scored while that ofgluteus was described as obvious or not. Associated muscular atrophy was defined as obvious muscle bulk reduction. Results： The mean scores were significantly different among the anterior, medial, and posterior thigh muscle groups. The mean of fat infiltration scores on posterior thigh muscle group was significantly higher than either anterior or medial thigh muscle group （P 〈 0.00 l）. Moreover, the mean score on medial thigh muscle group was significantly higher than that of anterior thigh muscle group （P 〈 0.01）. About half of the patients displayed fat infiltration and atrophy in gluteus muscles. Of 28 patients, 12 exhibited atrophy in medial and/ or posterior thigh muscle groups, especially in posterior thigh muscle group. Muscle edema pattern was not found in all the patients. Conclusions： Late-onset MADD patients show a typical muscular imaging pattern of fat infiltration and atrophy on anterior, posterior, and medial thigh muscle groups, with major involvement of posterior thigh muscle group and gluteus muscles and a sparing involvement of anterior thigh compartment. Our findings also suggest that mus展开更多
文摘Autologous fat grafting is an important surgical technique in aesthetic and reconstructive procedures.Fat grafting for breast reconstruction is now an established procedure for adding volume and improving cutaneous pliability;it can be used independently to replace more invasive flap procedures or implants,or as an adjunct for smaller volume supplementation.The breadth of applications in the breast necessitates diversity in technique and approach,and while there is no universally agreed-upon protocol,basic principles have guided the evolution of some commonly adopted tenets.Broadly,fat grafting outcomes are highly favorable but dependent on patient and procedure factors,requiring learned patient selection and expertise in recipient site assessment.Common complications from fat grafting,such as fat necrosis and the development of nodules,are particularly troublesome for post-oncologic patients,requiring considerable pre-surgical consultation for patient education and managing expectations.In addition to volume and contour augmentation,fat grafting has additional beneficial effects that have recently drawn increased attention including pain reduction from implant capsular contracture or postmastectomy pain syndrome,improved skin quality and reduced fibrosis following radiation,and possible anti-tumorigenic effects.New developments in clinical fat grafting research that are promising include the use of adipose progenitor cells admixed with lipoaspirate for improved volume retention or alternative biologics such as platelet-rich plasma.Preclinically,research towards safe and effective regenerative medicine approaches is actively underway,with the ultimate goal of achieving predictable and increased graft retention,reducing the number of required surgical procedures and enabling on-table results to reflect procedure outcomes.
文摘Fat redistribution through recycling of previously grafted fat hasn’t been reported. Two facial asymmetry patients are presented with history of fat grafting to the mandibular angle areas. Collected fat from these formerly fat grafted zones and swollen on subsequent extra body weight gain has been re-grafted in the temporal regions for contour enhancement and has retained volume as photographically documented up to 30 months.
文摘Background: Despite the popularity of autologous fat transfer applications, high resorption rates, and consequential volume loss, have been reported. Viable adipocyte content has been defined as a key determinant of fat transfer longevity. Moreover, traces of blood, free oil fat and fibrotic tissue accelerate adipocyte degradation. Objective: To compare the effectiveness of a 1470 nm, radial emitting laser-assisted liposection device to a mechanical liposection device in maintaining adipocyte viability in fat tissue harvests. Methods: Bilateral subcutaneous adipose tissue samples were harvested from ten female patients. Fat was harvested from one side using the LipoLife laser-assisted liposuction device and from the other side with a Byron mechanical aspirator. Samples were visually analyzed and blood:fat ratios and cell viability were determined. Results: Laser-harvested samples separated into two distinct phases, with a negligible blood phase at the bottom (1.1%) and a significant adipose phase at the top (98.9%), containing small, uniform-sized cells, of which 95.7% ± 2.7% proved viable. Mechanically harvested samples separated into blood (18%), adipose (60%) and lipid (22%) phases. The adipose phase contained significant amounts of connective tissue, large adipose tissue fragments, large oil droplets and a mean 79.7% ± 18.3% viable adipocytes. Conclusions: Laser liposuctioning was superior to mechanical liposuctioning, providing both higher cell viability and enhanced sample quality. The 1470 nm diode laser bears the potential of improving long-term clinical outcomes of fat transfer procedures. Improved purity of the harvested sample and heightened preadipocyte content are projected to provide for extended graft longevity.
文摘Since the advent of facelift surgery, there has been a progressive evolution in tech-nique. Methods of dissection trended towards progressively aggressive surgery with deeper dissection for repositioning of ptotic facial tissues. In recent decades, the pendulum has swung towards more minimally invasive options. Likewise, there has been a shift in focus from repo-sitioning alone to the addition of volumization for facial rejuvenation. The techniques in this article are reviewed in a chronologic fashion with a focus on historical development as well as brief discussion on efficacy in relation to the other existing options. There is currently no gold standard technique with a plethora of options with comparable efficacy. There is controversy over which approach is optimal and future research is needed to better delineate optimal treatment options, which may vary based on the patient. Copyright a 2015 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
基金grants from the National Natural Science Foundation of China，the National Key Clinical Specialty Discipline Construction Program,and Fujian Key Clinical Specialty Discipline Construction Program
文摘Background： Lipid storage myopathy （LSM） is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency （MADD） is a rather common form of LSM in China. Diagnosis and clinical management of it remain challenging, especially without robust muscle biopsy result and genetic detection. As the noninvasion and convenience, muscle magnetic resonance imaging （MRI） is a helpful assistant, diagnostic tool for neuromuscular disorders. However, the disease-specific MRI patterns of muscle involved and its diagnostic value in late-onset MADD have not been systematic analyzed. Methods： We assessed the MRI pattern and fat infiltration degree of the lower limb muscles in 28 late-onset MADD patients, combined with detailed clinical features and gene spectrum. Fat infiltration degree of the thigh muscle was scored while that ofgluteus was described as obvious or not. Associated muscular atrophy was defined as obvious muscle bulk reduction. Results： The mean scores were significantly different among the anterior, medial, and posterior thigh muscle groups. The mean of fat infiltration scores on posterior thigh muscle group was significantly higher than either anterior or medial thigh muscle group （P 〈 0.00 l）. Moreover, the mean score on medial thigh muscle group was significantly higher than that of anterior thigh muscle group （P 〈 0.01）. About half of the patients displayed fat infiltration and atrophy in gluteus muscles. Of 28 patients, 12 exhibited atrophy in medial and/ or posterior thigh muscle groups, especially in posterior thigh muscle group. Muscle edema pattern was not found in all the patients. Conclusions： Late-onset MADD patients show a typical muscular imaging pattern of fat infiltration and atrophy on anterior, posterior, and medial thigh muscle groups, with major involvement of posterior thigh muscle group and gluteus muscles and a sparing involvement of anterior thigh compartment. Our findings also suggest that mus
