Efficacy, safety and complications of autologous fat grafting to the eyelids and periorbital area: A systematic review and meta-analysis

Yang, Fan; Ji, Zhenyu; Peng, Liwei; Fu, Ting; Liu, Kun; Dou, Wenjie; Li, Jing; Li, Yuejun; Long, Yong; Weilu, Zhang

doi:10.1371/journal.pone.0248505

Cited by 18 publications

(9 citation statements)

References 43 publications

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“…Thus, the surgical method and approach must be planned according to the patients' anatomical characteristics to improve surgical results. Common complications of infraorbital fat transplantation include insufficient volume or an over-correction of volume, local excessive bloating leading to obvious midface sagging after transplantation, infection, granuloma and inflammation, vascular embolism with a loss of vision, or cerebral infarction (13)(14)(15). In the mid-face, facial arteriovenous terminal branches traverse the muscular fascial system near the side of the nose.…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of corrective effect of infraorbital depression by fat granule auto-transplantation via oral mucosa incision

Guo¹,

Song²,

Chen³

et al. 2022

Ann Transl Med

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Background: Moderate facial depression is an important manifestation of aging, and traditional fat grafting is filled through the skin approach, and there may be damage to the terminal branch of the surface artery, thereby increasing the risk of fat embolism, so there is a safety implication. Therefore, a safe and effective filling pathway is a key point in the study of facial fat grafting in the suborbital area. Based on the results of anatomical research, this study looks for the filling level of non-well-known blood vessels, improves the path and surgical method of suborbital fat grafting in the suborbital region, and discusses the treatment of intraoral fat grafting through oral incision in the suborbital region Efficacy and safety.Methods: In this study, 107 patients who visited our hospital from January 2017 to January 2022 all had local depressions in the suborbital area and facial asymmetry, requiring fat grafting to improve. The age range of patients is 28-50 years, with an average age of 38 years. The effectiveness of the operation is assessed based on the patient's self-evaluation and a comparison of preoperative and postoperative photographs. A grading scale is used in the first half of the postoperative period for patient satisfaction assessment.Results: A total of 107 patients were followed for 6 to 24 months, with an average follow-up time of 12 months, 67.3% of patients said "very satisfied", 29.0% of patients said "satisfied", 3.7% of patients said "average", and no patients rated the results as "not satisfied". No complications such as skin ulcers, infections, local indurations, and fat liquefaction occurred after surgery.Conclusions: Fat grafting through oral incision is a safe and effective way to improve fat depression in the suborbital area, in addition, it is necessary to pay attention to preoperative and postoperative oral disinfection and care during this operation to prevent the occurrence of complications such as fat infection.

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Section: Discussionmentioning

confidence: 99%

Clinical evaluation of corrective effect of infraorbital depression by fat granule auto-transplantation via oral mucosa incision

Guo¹,

Song²,

Chen³

et al. 2022

Ann Transl Med

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“…We divided the facial areas into the malar eminence, infraorbital area, and nasolabial fold area to assess 4 items: volume consistency, softness, irregularity, and overall satisfaction. Each item was evaluated on a 5-point scale ranging from 1 to 5 points (1=extremely dissatisfied, 2=dissatisfied, 3=neutral, 4=satisfied, and 5=extremely satisfied), (Supplemental Table 1, Supplemental Digital Content 2, http://links.lww.com/SCS/E518) as previously described 11–14. The questionnaire was administered twice 3 and 6 months after surgery.…”

Section: Methodsmentioning

confidence: 99%

“…Each item was evaluated on a 5-point scale ranging from 1 to 5 points (1 = extremely dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied, and 5 = extremely satisfied), (Supplemental Table 1, Supplemental Digital Content 2, http://links.lww.com/SCS/ E518) as previously described. [11][12][13][14] The questionnaire was administered twice 3 and 6 months after surgery. FIGURE 1.…”

Section: Patient Evaluation and Criteriamentioning

confidence: 99%

Intraoral Approach to Fat Grafting Based on the Mimetic Muscle Unit

Kim¹,

Lee²,

Kim³

2022

Journal of Craniofacial Surgery

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Background: Recently, the concepts of anatomic-based fat grafting and mid-facial anatomy have been studied. However, there is no clear consensus on the optimal fat grafting technique. We aimed to introduce a novel intraoral approach to fat grafting based on mid-facial mimetic muscles, wherein a substantial amount of fat was injected into appropriate locations to increase patient satisfaction and decrease the need for additional surgical techniques. Methods: Sixty-four Asian women (mean age, 41.2 y) who had undergone fat grafting through the intraoral approach between 2014 and 2019 were enrolled. We sequentially performed the following steps: fat harvesting, centrifugation, and fat injection. All patients were followed at an outpatient clinic for 6 to 12 months. We obtained photographs of their face before and at 3 and 6 months postoperatively and conducted a 5-point scale questionnaire survey at the 2 time points postoperatively to evaluate the satisfaction of patients and surgeons. We divided the mid-facial areas into malar eminence, infraorbital, and nasolabial fold areas and evaluated the following items: volume consistency, softness, irregularity, and overall satisfaction. Results: Patients reported “satisfactory” for the postoperative results. There were only 2 cases of complication among the 64 cases which resolved spontaneously. The highest and lowest satisfaction were reported for the malar eminence and nasolabial fold areas, respectively. Conclusions: Fat grafting through the intraoral approach based on the mimetic muscle unit is an effective and safe method for mid-facial rejuvenation.

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“…Coleman fat, which is processed using a standard technique comprising aspiration, centrifugation, and grafting, is effective for periorbital grafting [ 14 – 16 ]. However, other studies of fat grafting in the periorbital region with Coleman fat have reported various postoperative complications, including persistent edema, fatty nodules, cysts, calcification, and asymmetric fat displacement [ 3 , 17 , 18 ]. In 2016, a novel fat-derived stromal vascular fraction (SVF) gel that retains a higher percentage of the stromal vascular fraction and stem cells was developed by Feng Lu and his team.…”

Section: Introductionmentioning

confidence: 99%

Correction of Mild-to-Moderate Sunken Upper Eyelids of Asians with Stromal Vascular Fraction Gel

Ding

Shen

et al. 2022

Ophthalmol Ther

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Introduction: Fat grafting is an efficient and safe procedure for the correction of upper eyelid sulcus deepening. Stromal vascular fraction (SVF) gel has been proven to be an ideal fat derivative and can be widely used for facial augmentation. We aimed to determine the efficacy of SVF gel for the correction of a mildto-moderate sunken superior sulcus among Asian patients. Methods: Patients with a mild-to-moderate sunken superior sulcus underwent SVF gel grafting of the sunken upper periorbital area.The primary result was the quantitative volume difference in the superior sulcus region before and after grafting. This was evaluated through three-dimensional VECTRA Ò imaging. The secondary results included the aesthetic quantitative evaluation results (upper lid area and pretarsal space ratio), global aesthetic improvement scale (GAIS) score, and complications. Results: Thirty-one patients with mild-tomoderate sunken upper eyelids were included in this study. The average unilateral injected amount was 1.235 mL (± 0.171 mL). The 1-year delta volume was 0.801 ± 0.086 mL, and the effective survival volume was 65.3% (± 6.1%). The median preoperative pretarsal space and upper lid area ratio was 1.010 (± 0.150). The median postoperative pretarsal space and upper lid area ratio at 1 year was 0.159 (± 0.031) (n = 62; P \ 0.0001), indicating a significantly reduced sunken appearance. The average GAIS score was 2.174 (± 0.391). All patients were satisfied with their surgical outcomes. The reoperation rate was 12.9%. Conclusions: SVF gel is safe and effective for the treatment of a mild-to-moderate sunken superior sulcus and is associated with satisfactory clinical outcomes and short recovery times.

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Efficacy, safety and complications of autologous fat grafting to the eyelids and periorbital area: A systematic review and meta-analysis

Cited by 18 publications

References 43 publications

Clinical evaluation of corrective effect of infraorbital depression by fat granule auto-transplantation via oral mucosa incision

Clinical evaluation of corrective effect of infraorbital depression by fat granule auto-transplantation via oral mucosa incision

Intraoral Approach to Fat Grafting Based on the Mimetic Muscle Unit

Correction of Mild-to-Moderate Sunken Upper Eyelids of Asians with Stromal Vascular Fraction Gel

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