Facial contour deformities associated with pigmentary changes are of major concern for plastic surgeons being difficult to treat. No definite ideal treatment option is available to address simultaneously both the contour defects as well as related hyperpigmentation. The aim of the current study is to compare long-term effects of conventional adipose tissue grafting and ex-vivo expanded ASC-enriched adipose tissue grafting for the treatment of contour deformities related pigmentary changes on the face. In this study, 80 patients of contour deformities of face with hyperpigmentation were recruited after informed consent. Two techniques, that is, conventional fat grafting (C-FG) and fat grafts enriched with expanded adipose stem cells (FG-ASCs) were used to address the pigmentation. Both techniques were explained to patients and enrolled patients were divided into two groups, that is, C-FG and FG-ASCs as per patients' choice and satisfaction. Patients of the FG-ASCs group were treated with FG-ASCs while patients of C-FGs group were treated with C-FG (without expanded ASCs). Patients were followed for 12 months and improvement in face pigmentation was assessed clinically as well as measured objectively. Patients' satisfaction was also documented as highly satisfied, satisfied, and unsatisfied. This clinical trial was registered at www.clinicaltrials.gov with ID: NTC03564808. Mean age of patients was 24.42 (±4.49), 66 patients were females.Forehead was involved in 61.20% cases, cheek in 21.20% cases, chin in 11.20% cases, and nose in 6.20% cases. In GF-ASCs group, the integrated color density was decreased (1.08 × 10 6 ± 4.64 × 10 5 ) as compared with C-FG group (2.80 × 10 5 ± 1.69 × 10 5 ). Patients treated with fat grafts enriched with expanded ASCs were significantly more satisfied as compared with patients treated with C-FG only. In conclusion, ASC-enriched autologous fat grafting is preferred option for improving the contour deformities related increased pigmentation of face skin.

Background: Congenital and acquired lesions both cause marked elevation in anxiety due to decreased self-esteem and confidence. Plastic surgery can address and markedly improve the anxiety level by addressing such lesions. Medical and surgical concerns related to body may elevate baseline anxiety. Although females are more concerned and fretful about such lesions, we observed that males are also prone to similar levels of anxiety. Objective: The objective of the study is to find out effect of plastic surgery on anxiety level of males having facial lesions. Methods: This prospective study was conducted in Plastic Surgery Department of King Edward Medical University, Lahore, Pakistan from Feb 2018 to Jan 2019 and 100 male patients with either congenital or acquired lesions of face were enrolled and operated. Anxiety level was rated by applying Hamilton anxiety scale immediate preoperatively and satisfaction along with quality of scar was noted after 2 months. Results: 53% of enrolled patients were having educational status above secondary school, 63% patients were from urban, 56% patients were below 27 years of age, 44% were above 27 years of age and 33% were married. Trauma was the cause of lesion in 61% while 13% were with Rhomberg disease and 26% with congenital lesions disorder. Majority of patients had lesion involving forehead. On Hamilton anxiety scale, pre-operative anxiety score was high (21.76±5.846) as compared to postoperative score (10.04±4.537). Scar scoring with Vancouver Scar Scale was 4.36±1.798 post operatively. Majority of patients showed significant improvement in anxiety scores post operatively. Conclusion: Irrespective of age, socioeconomic status and education level, lesions involving face elevated baseline anxiety in males. Plastic surgery addresses these concerns permanently resulting in marked improvement in anxiety level.

Introduction: Anxiety is very common among our folks. Facial lesions, congenital as well as acquired, result in marked anxiety related to decreased self esteem and confidence particularly in females. These lesions can be addressed by plastic surgery techniques which ultimately cause significant improvement in anxiety level. The aim of the study is to find out changes in anxiety level of females with facial lesions before and after plastic surgery. Methodology: A prospective study conducted in Mayo Hospital, Lahore, Pakistan on 102 female patients having lesions on central face. Lesions were operated by plastic surgery techniques. Hamilton anxiety rating scale was applied to rate anxiety level preoperatively as well as 2 months post operatively. Patients' satisfaction and scar quality was assessed. Data was analyzed by using SPSS. Results: A total of 102 females were included in the study of which 58 (56.86%) were having educational status above matriculation 14 (13.72%) patients from rural background, 56 (54.9%) patients were below 25 years of age and 46 (45.1%) were above 25 years of age. Forty (39.21%) patients were married while 62 (60.78%) were unmarried or single. Twenty four (23.53%) patients were having post traumatic scarring, 24 (23.53%) were with congenital lesions like CMN while 54 (52.94%) were with lipomata or dermal or inclusion cysts on face. Most of the patients (23.5%) were having lesion on medial part of cheeks. Anxiety scoring noted preoperatively was 22.76±5.846. Vancouver grading of postoperative scars was 4.56±1.798. Patients' satisfactory level was 1-10 on visual analogue scale. A very high percentage (96%) of patients was having marked improvement in their anxiety scores after surgery.