Autologous Fat Grafting in the Treatment of Fibrotic Perioral Changes in Patients with Systemic Sclerosis

Abstract

Autologous fat tissue grafting (AFTG) has been successfully used in the treatment of different sclerotic conditions, including localized scleroderma. Patients with advanced systemic sclerosis (SSc)-related perioral thickening and mouth opening limitation are candidates for this therapeutic approach. AFTG of the lips was performed to improve mouth opening in patients with SSc. We enrolled in the study 20 female patients with diffuse SSc (median age 35 ± 15 years and 11 ± 10 years of disease duration). Two-milliliter fractions of autologous fat drawn from trochanteric or periumbilical areas were injected in eight different sites around the mouth. Baseline and after-treatment mouth opening changes were assessed by measuring interincisal distance and oral perimeter, while skin hardness was tested by digital durometer. Pre-and posttreatment modifications of microvascular architecture were assessed by counting capillaries in the inferior lip videocapillaroscopy (VC) images and by scoring the microvascular density (MVD) in anti-CD34/CD31 immunohistochemical (IH) stained perioral skin biopsy sections. Similarly, histological sections were examined to evaluate dermoepidermic junction (DEJ) modifications. Three months after treatment, both the interincisal distance and oral perimeter significantly increased (p < 0.001). At the same time, a significant skin neovascularization became evident, both considering the VC images (p < 0.001) and MVD scores in IH sections (p < 0.0001). Finally, some skin histological aspects also improved, as shown by the significant changes in DEJ flattening scores (p < 0.0001). The present study suggests that, in patients with SSc, AFTG can improve mouth opening and function, induce a neovascularization, and partially restore the skin structure.

Lipotransfer for radiation-induced skin fibrosis

“…A durometer is a hand‐held probe that uses indentation force to measure skin hardness. More sophisticated durometers are equipped with a transducer, connected to a computer, and use ultrasound to generate results. The probe is applied to a desired area, where it indents the tissue.…”

The Versatility of Autologous Fat Transplantation in Correction of Facial Deformities: A Single-Center Experience

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Secretome of Adipose Tissue-Derived Stem Cells (ASCs) as a Novel Trend in Chronic Non-Healing Wounds: An Overview of Experimental In Vitro and In Vivo Studies and Methodological Variables

“…Commercial human ASC HMEC Stimulation of vessel-like structure formation [73] Human sub-cutaneous adipose tissue obtained from healthy females (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) years old).…”

“…In this context, increasing attention is focusing on the use of mesenchymal stem cells (MSCs), particularly adipose tissue-derived stem cells (ASCs), to treat chronic non-healing wounds through their trophic, paracrine, and immunomodulatory properties [16][17][18][19][20]. Multipotent adult ASCs could be easily harvested from subcutaneous adipose tissue through minimally invasive surgical procedures, such as liposuction.…”