Total avulsion of the scalp is a serious traumatic injury and an absolute surgical emergency.Despite well-stocked literature on its immediate care,there is insufficient literature regarding its long-term complications...Total avulsion of the scalp is a serious traumatic injury and an absolute surgical emergency.Despite well-stocked literature on its immediate care,there is insufficient literature regarding its long-term complications.Here,we describe the case of a patient who developed chronic pain 24 months after replantation.The patient underwent several needle rigotomy sessions associated with lipofilling to reconstruct a sliding plane between the scalp and periosteum,followed by nanofat sessions to improve skin elasticity.This autologous fat injection treatment was successful,and the patient is currently pain-free.Therefore,lipofilling followed by nanofat injection is an effective treatment for this complication.展开更多
Background:Autologous fat grafting has gained popularity in breast augmentation.Various methods can be used to estimate the volume retention rate.This systematic review aimed to establish whether the type of method us...Background:Autologous fat grafting has gained popularity in breast augmentation.Various methods can be used to estimate the volume retention rate.This systematic review aimed to establish whether the type of method used for measuring breast volume is a factor that influences the reported volume retention rate.Methods:Studies were identified using the electronic databases PubMed,Embase,Cochrane Central Register of Controlled Trials,and Web of Science from inception of the database up to February 2019.Articles describing autologous fat grafting for breast augmentation were selected based on pre-determined inclusion and exclusion criteria.The characteristics of the included studies were summarized,and the reported volume retention rate from the studies was compared.A quality assessment of all included articles was performed using the methodological index for non-randomized studies criteria.Results:A total of 618 articles were identified,of which 12 studies,with a total of 1337 cases,were eligible.The retention rate of injected adipose tissue varied when the method of fat grafting and volume analysis used were both the same,as well as when the method of fat grafting was the same but the method of volumetric evaluation used was different.Conclusions:Currently,the tools available for estimating the volume retention rate come with limitations.In order to objectively evaluate the percentage of graft retention,a standard protocol that applies to the different methods should be established in the future.展开更多
Aim:Unpredictable retention outcomes remain a significant issue in autologous fat grafting procedures.Liposuction cannula variation leads to variability in fat particle size.Recent data suggest that the size of fat pa...Aim:Unpredictable retention outcomes remain a significant issue in autologous fat grafting procedures.Liposuction cannula variation leads to variability in fat particle size.Recent data suggest that the size of fat particles is closely related to graft healing outcomes;however,this remains a point of contention due to potential confounding variables such as tissue trauma with harvest.The aim of this study was to compare autologous fat grafting outcomes with variable fat particle sizes in an animal model which isolated fat particle size as the primary experimental variable.The overall goal of this work was to determine if reducing fat particle size is an effective method for enhancing graft retention in autologous fat grafting.Methods:The range of fat particle diameter harvested by four common liposuction cannulas was quantified to define relevant small and large particle target diameters.To determine if particle size impacted nutrient and oxygen permeability,small and large particles were incubated in vitro in a spinner flask with an abundance of culture media and vascular endothelial growth factor secretion was measured with enzyme-linked immunosorbent assay.Finally,small and large fat grafts were prepared from subcutaneous mouse fat pads and grafted in syngeneic Balb/CJ mice.Weight and volume retention were evaluated at 1,4,8,and 12 weeks.Histological analysis with Masson's trichrome and perilipin immunofluorescent staining was performed.Real-time quantitative polymerase chain reaction was performed foradipogenic,inflammatory and apoptotic genes.Results:The range of fat particle diameters harvested with four commonly used cannulas was 2-7 mm.In vitro studies showed that 5-7-mm particles had significantly increased VEGF secretion normalized to weight,indicating increased tissue hypoxia in these particles compared to 2-4-mm particles.Surprisingly,in vivo comparison in two unique studies showed 2-4-mm and 5-7-mm fat particles had comparable graft retention(P=0.5329).Masson's trichrome staining revealed increased e展开更多
Aim:To report the author’s experience in augmentation phalloplasty by studying a retrospective series of patients who underwent fat grafting for girth enhancement or a composite technique based on suspensory ligament...Aim:To report the author’s experience in augmentation phalloplasty by studying a retrospective series of patients who underwent fat grafting for girth enhancement or a composite technique based on suspensory ligament release plus fat grafting performed simultaneously.Methods:The author analyzed retrospectively the outcomes of 275 augmentation phalloplasty procedures performed in 259 patients until November 2013.Of these,127 correspond to girth augmentation with fat grafting and 148 to composite augmentation phalloplasty(girth augmentation with fat grafting and length improvement by suspensory ligament release).In 16 patients girth and length enhancement were performed in two separate procedures.Results:Of this 259 patients,87 underwent postoperative follow-up for at least 12 months and 160 patients underwent follow-up for at least 6 months.The average increase in circumference at 6 months was 1.7 cm(1.57 cm at 12 months)and the average increase in length of 3.2 cm(3.1 cm at 12 months).Twenty-two patients showed minor complications that were treated without sequelae and without influencing the final result.Conclusion:By judicious use of currently available techniques,it is possible to achieve stable increases in penis size.The use of composite techniques provides better final results than the use of individual techniques performed alone due to the increase of the actual volume of the penis.An adequate informed consent is essential in all patients due to the unrealistic expectations expressed by the majority of them.展开更多
文摘Total avulsion of the scalp is a serious traumatic injury and an absolute surgical emergency.Despite well-stocked literature on its immediate care,there is insufficient literature regarding its long-term complications.Here,we describe the case of a patient who developed chronic pain 24 months after replantation.The patient underwent several needle rigotomy sessions associated with lipofilling to reconstruct a sliding plane between the scalp and periosteum,followed by nanofat sessions to improve skin elasticity.This autologous fat injection treatment was successful,and the patient is currently pain-free.Therefore,lipofilling followed by nanofat injection is an effective treatment for this complication.
文摘Background:Autologous fat grafting has gained popularity in breast augmentation.Various methods can be used to estimate the volume retention rate.This systematic review aimed to establish whether the type of method used for measuring breast volume is a factor that influences the reported volume retention rate.Methods:Studies were identified using the electronic databases PubMed,Embase,Cochrane Central Register of Controlled Trials,and Web of Science from inception of the database up to February 2019.Articles describing autologous fat grafting for breast augmentation were selected based on pre-determined inclusion and exclusion criteria.The characteristics of the included studies were summarized,and the reported volume retention rate from the studies was compared.A quality assessment of all included articles was performed using the methodological index for non-randomized studies criteria.Results:A total of 618 articles were identified,of which 12 studies,with a total of 1337 cases,were eligible.The retention rate of injected adipose tissue varied when the method of fat grafting and volume analysis used were both the same,as well as when the method of fat grafting was the same but the method of volumetric evaluation used was different.Conclusions:Currently,the tools available for estimating the volume retention rate come with limitations.In order to objectively evaluate the percentage of graft retention,a standard protocol that applies to the different methods should be established in the future.
基金This work was funded by a Pilot Funding Program for Early Stage Medical Technology Research and Development grant from the Center for Medical Innovation,Swanson School of Engineering,University of Pittsburgh(award no.F_062-2013)by National Institutes of Health for Dr.Rubin,Department of Plastic SurgeryUniversity of Pittsburgh School of Medicine(award no.5R01CA114246).
文摘Aim:Unpredictable retention outcomes remain a significant issue in autologous fat grafting procedures.Liposuction cannula variation leads to variability in fat particle size.Recent data suggest that the size of fat particles is closely related to graft healing outcomes;however,this remains a point of contention due to potential confounding variables such as tissue trauma with harvest.The aim of this study was to compare autologous fat grafting outcomes with variable fat particle sizes in an animal model which isolated fat particle size as the primary experimental variable.The overall goal of this work was to determine if reducing fat particle size is an effective method for enhancing graft retention in autologous fat grafting.Methods:The range of fat particle diameter harvested by four common liposuction cannulas was quantified to define relevant small and large particle target diameters.To determine if particle size impacted nutrient and oxygen permeability,small and large particles were incubated in vitro in a spinner flask with an abundance of culture media and vascular endothelial growth factor secretion was measured with enzyme-linked immunosorbent assay.Finally,small and large fat grafts were prepared from subcutaneous mouse fat pads and grafted in syngeneic Balb/CJ mice.Weight and volume retention were evaluated at 1,4,8,and 12 weeks.Histological analysis with Masson's trichrome and perilipin immunofluorescent staining was performed.Real-time quantitative polymerase chain reaction was performed foradipogenic,inflammatory and apoptotic genes.Results:The range of fat particle diameters harvested with four commonly used cannulas was 2-7 mm.In vitro studies showed that 5-7-mm particles had significantly increased VEGF secretion normalized to weight,indicating increased tissue hypoxia in these particles compared to 2-4-mm particles.Surprisingly,in vivo comparison in two unique studies showed 2-4-mm and 5-7-mm fat particles had comparable graft retention(P=0.5329).Masson's trichrome staining revealed increased e
文摘Aim:To report the author’s experience in augmentation phalloplasty by studying a retrospective series of patients who underwent fat grafting for girth enhancement or a composite technique based on suspensory ligament release plus fat grafting performed simultaneously.Methods:The author analyzed retrospectively the outcomes of 275 augmentation phalloplasty procedures performed in 259 patients until November 2013.Of these,127 correspond to girth augmentation with fat grafting and 148 to composite augmentation phalloplasty(girth augmentation with fat grafting and length improvement by suspensory ligament release).In 16 patients girth and length enhancement were performed in two separate procedures.Results:Of this 259 patients,87 underwent postoperative follow-up for at least 12 months and 160 patients underwent follow-up for at least 6 months.The average increase in circumference at 6 months was 1.7 cm(1.57 cm at 12 months)and the average increase in length of 3.2 cm(3.1 cm at 12 months).Twenty-two patients showed minor complications that were treated without sequelae and without influencing the final result.Conclusion:By judicious use of currently available techniques,it is possible to achieve stable increases in penis size.The use of composite techniques provides better final results than the use of individual techniques performed alone due to the increase of the actual volume of the penis.An adequate informed consent is essential in all patients due to the unrealistic expectations expressed by the majority of them.
