Adipose Grafting for Volume and Scar Release

Abstract

Adipose fat grafting (AFG) is a popular technique used to add volume in the face, breasts, and other tissue deficient areas of the body. In terms of scar release, not only has fat provided additional soft tissue coverage but also the relief of pain in scars in those patients suffering from disease processes, such as complex regional pain syndrome with steroid-induced atrophy, burn scars, morphea, and lupus. The purpose of this article is to demonstrate the senior author's technique and outcomes of using AFG in the face and body for treating volume deficiency, atrophic scarring, and deformities. A retrospective chart review of 127 AFG procedures of the face and body from September 2006 to September 2019 was performed. Of these, 14 patients had scar releases performed with fat grafting of areas of scar contracture. Fat was harvested from the abdomen, thighs, and flanks using Toomey syringes or an enclosed power-assisted system with 3.7- or 3.0-mm cannulas. Grafting in small areas, such as the face, was performed with the 0.9-mm blunt cannula. The majority of AFG was completed in the face (45%), followed by breasts (22%), and scar contracture (16%). The mean volume of fat grafted in procedures involving the breasts, buttocks, and face was 102, 182, and 21 mL, respectively. For scar contracture, the mean volume was 38 mL and for deformations, 27 mL. Sixteen percent of the cohort required at least 1 additional AFG procedure to achieve satisfactory results. There were no major complications, such as skin loss, vascular injury, embolization, or blindness. Minor complications, such as erythema, edema, and hematoma at the fat harvest or graft site, did occur and were managed with local measures. Autologous fat grafting has consistently resulted in volume correction. In addition, in patients with autoimmune disorders, burn scars, and retracted scars, not only has there been volume correction but also decreased pain in the area of treatment. In our series of patients, we described our technique of AFG for the face, body, and scar contracture. Our results demonstrate that AFG remains an inexpensive, safe, and effective treatment option to achieve volume.

Wound Healing after Acellular Dermal Substitute Positioning in Dermato-Oncological Surgery: A Prospective Comparative Study

“…Moreover, grafts also represent the reconstructive strategy of choice when tumor margins are not clearly definable with non-invasive techniques (such as dermoscopy, confocal microscopy, and OCT) and/or Mohs surgery is not feasible. However, grafts alone sometimes provide unsatisfactory functional and aesthetic results, possibly due to both scar contractures and excessive wound depth, with subsequent apparent depression of the grafted area [ 22 ].…”

The Safety of Fat Grafting: An Institutional Retrospective Review

“…Fat grafting continues to be a popular augmentation agent in the face, breasts, and other tissue deficient locations in the body 1,2 . Recent scientific progress has allowed fat grafting to become a time-efficient option to achieve volumization, with average operating room time at 125 minutes and with high rates of satisfaction among patients 3–5 . Agha and colleagues comment that there has been substantial diversity in the criteria used to determine the safety and efficacy of fat grafting between different studies and thus call into question the comparability of the current literature.…”

“…1,2 Recent scientific progress has allowed fat grafting to become a time-efficient option to achieve volumization, with average operating room time at 125 minutes and with high rates of satisfaction among patients. [3][4][5] Agha and colleagues comment that there has been substantial diversity in the criteria used to determine the safety and efficacy of fat grafting between different studies and thus call into question the comparability of the current literature. In a review of 22 articles including 3565 patients, Groen and colleagues 7 identified that the most common complications of autologous fat grafting in cosmetic breast augmentation included induration, persistent pain, and hematoma occurring at 33%, 25%, and 16%, respectively.…”

Meet the Founding Resident Ambassador: John M. Le, DDS, MD

“…John M. Le, DDS, MD (Fig 1) and his colleagues in the Department of Oral and Maxillofacial Surgery at the University of Alabama at Birmingham have made a serious impact on global OMS specialty. [4][5][6][7][8][9][10][11][12][13][14][15] Moreover, their article contribution to our journal in 2020 made a huge influence by attracting an international community of readers to our journal, making us enormously proud. The masterpiece was dedicated to the use of zygomatic implants for restoration of complex nasal defects.…”