Objective To investigate the mechanism of vascular stromal fraction (SVF) at the early stage after aspirated fat transplantation. Methods Fat was harvested from 5 cases of women undergoing abdominal liposuction operation, and SVF was isolated. Aspirated fat with (group B) or without (group A) SVF was injected subcutaneously into the back of nude mice, and the grafts were harvested at 1, 3, 5, and 7 days. Graft wet weight was measured; and immunohistochemical method (CD31) was performed and the secretion of vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) were qnantified by Western blot assay. Results The wet weight of transplanted adipose tissue showed an increasing tendency in groups A and B with time, and no significant difference was found between groups A and B (P gt; 0.05). At 1 and 3 days after transplantation, no CD31 positive cells was seen in 2 groups; the CD31 positive cells of group B were significantly more than those of group A at 5 and 7 days (P lt; 0.05), and the CD31 positive cells at 7 days were significantly more than those at 5 days in 2 groups (P lt; 0.05). Western blot test showed that VEGF expression reached peak at 3 days , then decreased gradually; the expression of VEGF protein in group B was significantly higher than that in group A at 1, 3, and 5 days (P lt; 0.05). The expression of HGF protein in groups A and B remained at a high level within 5 days, but it tended to decrease at 7 days, which was significantly higher in group B than that in group A (P lt; 0.05). Conclusion SVF can enhance angiogenesis by secretion of growth factors at the early stage after aspirated fat transplantation.
Objective To compare the clinical effects of two surgical approaches to treatment of horseshoe kidney.Methods From January 1965 to December 1982, 15 patients (11 males, 4 females; aged 14 months to 59 years with a median of 31 years) with horseshoe kidney underwent surgical treatment by the waist cretroperitoneal approach (the waist-approach group). The clinical symptoms and signs were as follows:pain in the waist and abdomen (12 patients), hematuria (7), urinary frequency (4), gastrointestinal disorder (3), and abdominal masses (2). The urography revealed urinary calculus in 10 patients, hydronephrosis in 3, renal cyst in 1, pyonephrosis in 1, renal tuberculosis in 1, and renal cell carcinoma in 1. From January 1977 to December 2005, 17patients (15 males, 2 females; aged 11 months to 56 years with a median of 29.4years) with horseshoe kidney underwent surgical treatment by the epigastric transperitoneal approach (theabdomenapproach group). The clinical symptoms and signs were as follows:pain in the waist and abdomen (15patients), hematuria (12), urinary frequency (10), gastrointestinal disorder (9), and abdominal masses (7). Theurography revealed urinary calculus in 12 patients, hydronephrosis in 10,renal cyst in 3, renal tuberculosis in 1, renal cell carcinoma in 1, and congenital spinal bifida in 1. The two surgical approaches were compared in the clinical therapeutic effects. Results There were no statistically significant differences in operating time, blood loss during operation, and the hospitalization after operation between the waistapproach group and the abdomen-approach group (129.59±23.25 min vs. 163.80±36.25min; 495.29±87.20ml vs. 553.00±92.27ml；13.17±1.14d vs. 13.75±0.21d; Pgt;0.05). Thepostoperative followup for 7 months to 6 years in 11 patients in the waistapproach group and in 6 patients in the abdomenapproach group revealed that there were statistically significant differences in postoperative complication and the recurrence rate of the renal calculus between the two groups (11.76%, 2/17 vs 26.67%, 4/15; 33.33%, 5/15 vs. 0, 0/17; Plt;0.05). The urography or CT taken 6 months to 2 years after operation in 4 patients in the waistapproach group and in 10 patients in the abdomenapproach group revealedthat there was a significant improvement hydronephrosis when compared with before operation.
To evaluate an improved treatment of an autologous fat injection for hemifacial atrophy to increase the survival rate of the fat graft and decrease complications including colliquation, necrosis, and absorption of the graft fat. Methods From March 1999 to October 2004, 31 patients with hemifacial atrophy underwent an improved treatment by an autologous fat injection for their diseases. There were 12 males and 19 females aged 1928 years (average, 23.5 years). The patients were divided into the following 3 groups according to the atrophy extent: the mild group (n=9), the moderate group (n=19), and the severe group (n=3). Based on the previous researches on the fat transplantation techniques, the improved treatment combined the following strategies that were simply called “3L3M”: low position for the fat donation, low pressure for the fat harvesting, and lowspeed centrifugation for purification of the fat; multipoint, multitunnel, and multiplane for injections of the fat graft. The preoperative and the postoperative photos were taken and the findings were compared to make clear whether the hard and firm masses and cysts existed; then, the decision was made about whether the patients needed another operation according to whether the patients had a natural facial expression and whether the patients had comfortable feelings as well as the ray findings. Results All the patients had a satisfactory symmetrical face after 1 injection of the fat in 15 patients, 2 injections in 13 patients, and 3 injections in 3 patients. The effect of the 3rd injection was better than that of the 2nd injection; the effect of the 2nd injection was better than that of the 1st injection; the fat volume for the injection could be gradually decreased. The fat volumes for injections were as follows: 814 ml (average, 11 ml) in the submaxillary region, 1525 ml (average, 20 ml) in the buccal region, 510 ml (average, 75 ml) in the zygomatic region, and 1820 ml (average, 19 ml) in the forehead region. The followup for 35 years revealed that there wasno infection, hard and firm mass, cyst or other complications. The pigmentationin the affected face was significantly improved. Conclusion Compared with the traditional treatments, the improved treatment of an autologousfat injection for hemifacial atrophy can achieve a satisfactory symmetry of theface with no injury to the donor site or complications in the recipient site. This improved method is an ideal treatment for hemifacial atrophy.
Objective To review the research progress of growth factor sustained-release microspheres in fat transplantation. Methods The recently published 1iterature at home and abroad related the growth factor sustained-release microspheres in fat transplantation was reviewed and analyzed. Results The sustained-release microsphere carrier materials include natural polymer materials and synthetic polymer materials.The sustained-release complexes of different microsphere materials with different growth factors can promote the vascularization of transplanted fat in a timely manner, improve the survival rate of grafts, and reduce the incidence of complications such as liquefaction, calcification, and necrosis. Conclusion The growth factor sustained-release microspheres have the characteristics of persistence and controllability, which is a research hotspot in the field of fat transplantation and has broad application prospects.
Objective To explore the therapeutic effect of micro-autologous fat transplantation (MAFT) based on anatomical sub-unit principle of mid-face deep fat tissue in mid-face volumetric augmentation operation. Methods From August 2014 to February 2016, 46 patients suffering volumetric defect of mid-face were divided into the research group and the control group with 23 in each. The MAFT method was used in the two groups. Patients in the research group underwent fat transplatation based on anatomical sub-unit principle of mid-face deep fat tissue, of whom 16 accepted fat transplantaion in suborbicularis oculi fat area, 23 in deep media cheek fat area and 13 in buccal fat area. Patients in the control group accept conventional fat transplantation method; the fat granule were uniformly transplanted to the deep and superficial mid-face fat tissue. The curative effiency and patients' satisfaction were compared between the two groups. Results The curative effiency and patients' satisfaction of the research group (91.3%, 82.6%) were better than those of the control group (60.9%, 43.5%), and there were significant differences (P<0.05). All patients were followed up for 6 months to 2 years, with an average of 1 year. No complication occurred in both groups. Conclusion The MAFT operation based on anatomical sub-unit principle of mid-face deep fat tissue could precisely perform mid-face volumetric augmentation and rejuvenation.
ObjectiveTo review the diagnosis and management of fat necrosis after autologous fat transplantation of breast.MethodsBased on the latest related literature, the pathology, clinical and radiographic examinations, influence factors, as well as the management of fat necrosis after autologous fat transplantation for breast augmentation and reconstruction were summarized.ResultsFat necrosis after breast autologous fat transplantation is histologically manifested as hyaline degeneration, fibrosis, and calcification. The diagnosis of fat necrosis includes clinical examination, imaging examination (ultrasound, mammography, and MRI), and biopsy. The occurrence of fat necrosis is closely related to patient’s own reason and fat transplantation technology. Optimizing the process of fat acquisition, purification, and transplantation can reduce the occurrence of fat necrosis. Intervention or not after fat necrosis depends on the nature of the nodules. According to the nature of the the nodules, various methods such as simple aspiration, vibration amplification of sound energy at resonance liposuction, or direct excision can be selected.ConclusionFat necrosis after autologous fat transplantation of breast are difficult to control. How to process fat to minimize the injury and maximize the activity of grafted fat needs further researches.
Objective To investigate the effectiveness of autologous nano-fat mixed granule fat transplantation in the treatment of facial soft tissue dysplasia in children with mild hemifacial microsomia (HFM). Methods A total of 24 children with Pruzansky-Kaban type Ⅰ HFM were admitted between July 2016 and December 2020. Among them, 12 children were treated with autologous nano-fat mixed granule fat (1∶1) transplantation as study group and 12 with autologous granule fat transplantation as control group. There was no significant difference in gender, age, and affected side between groups (P>0.05). The child’s face was divided into region Ⅰ(mental point-mandibular angle-oral angle), region Ⅱ (mandibular angle-earlobe-lateral border of the nasal alar-oral angle), region Ⅲ (earlobe-lateral border of the nasal alar-inner canthus-foot of ear wheel). Based on the preoperative maxillofacial CT scan+three-dimensional reconstruction data, the differences of soft tissue volume between the healthy and affected sides in the 3 regions were calculated by Mimics software to determine the amount of autologous fat extraction or grafting. The distances between mandibular angle and oral angle (mandibular angle-oral angle), between mandibular angle and outer canthus (mandibular angle-outer canthus), and between earlobe and lateral border of the nasal alar (earlobe-lateral border of the nasal alar), and the soft tissue volumes in regions Ⅰ, Ⅱ, and Ⅲ of healthy and affected sides were measured at 1 day before operation and 1 year after operation. The differences between healthy and affected sides of the above indicators were calculated as the evaluation indexes for statistical analysis. At 1 year after operation, the parents, the surgeons, and the nurses in the operation group made a self-assessment of satisfaction according to the frontal photos of the children before and after operation. Results The study group and the control group were injected with (28.61±8.59) and (29.33±8.08) mL of fat respectively, with no significant difference (t=0.204, P=0.840). After injection, 1 child in the control group had a little subcutaneous induration, and no related complications occurred in the others. All children in both groups were followed up 1 year to 1 year and 6 months, with an average of 1 year and 4 months in the study group and 1 year and 3 months in the control group. At 1 year after operation, the asymmetry of the healthy and affected sides improved in both groups; the satisfactions of parents, surgeons, and nurses in the study group were all 100% (12/12), while those of the control group were 100% (12/12), 83% (10/12), and 92% (11/12), respectively. The differences between healthy and affected sides in mandibular angle-oral angle, mandibular angle-outer canthus, earlobe-lateral border of the nasal alar, and the soft tissue volume in 3 regions of the two groups after operation were significantly smaller than those before operation (P<0.05). There was no significant difference in the above indexes between the two groups before operation (P>0.05). After operation, all indexes were significantly lower in study group than in control group (P<0.05). Conclusion Autologous nano-fat mixed granule fat transplantation and autologous granule fat transplantation can both improve the facial soft tissue dysplasia in children with mild HFM, and the former is better than the latter.