The Retention-Rate Improvement of Stromal Vascular Fraction Gel in Prefrontal Filling With Botulinum Toxin-A Injection: A Retrospective Analysis

Abstract

Background As a derivative of adipose tissues, stromal vascular fraction gel has been widely used in facial soft tissue filling, but it still does not achieve the expected effect in forehead filling. The reason may be related to the corrugator muscles movements. Objectives The authors aimed to evaluate the effect of botulinum toxin-A (BTX-A) on the retention rate of stromal vascular fraction gel by limiting the corrugator muscles movements and provide a theoretical basis that short-term inhibition of movement in the affected area could improve the effects of the fat graft. Methods From January 2019 to June 2021, patients with stromal vascular fraction gel facial filling (including frontal and temporal parts) were selected. According to whether or not BTX-A treatment was received, patients were divided into the injected and the non-injected groups. A questionnaire and the global aesthetic improvement scale (GAIs) were administered with two-dimensional (2D) photos. The retention rate and curvature were calculated with three-dimensional (3D) images using the Artec Studio 13 Professional (Artec Europe Sàrl, Senningerberg, Luxembourg) and MATLAB (Natick, MA) software. Results The graft retention, forehead curvature, and GAIs scores were all higher in the injected group than in the non-injected group (P < 0.01). In the questionnaire, the injected group also showed a more satisfactory attitude towards the treatment effect and were more willing to recommend the treatment to their friends. Conclusions BTX-A injection can improve the retention rate of prefrontal stromal vascular fraction gel filling with higher satisfaction and better postoperative effects.

Enhanced Fat Graft Viability and Remodeling Using a Helium-based Radiofrequency Device to Prepare the Recipient Site

“…Approaches to overcome poor retention for soft tissue augmentation increase tissue oxygen levels, the survival and number of progenitor cells, and growth factors in the recipient site. The main strategies include physical manipulation of the recipient site (e.g., BRAVA®, microneedling, biostimulation of tissue) [ 6 , 7 ], or injection of either botulinum toxin for facial fat graft [ 8 ], growth factors [ 9 – 11 ], or progenitor cells during the fat graft, i.e., cell-assisted lipotransfer (CAL) [ 12 ]. Supplementation of autologous fat grafts with ASCs [ 13 ], platelet-rich plasma (PRP) [ 14 ], stromal vascular fraction (SVF) [ 15 ], or exosomes [ 16 ] either alone or in combination have increased fat graft retention [ 17 ].…”