The Role of Fat Grafting in Alleviating Neuropathic Pain: A Critical Review of the Literature

Abstract

Background: Neuropathic pain is one of the more severe types of chronic pain and presents a great challenge as response to medical therapy remains often unpredictable. With the opioid epidemic and the search for ways to avoid narcotics, physicians are seeking other modalities to treat neuropathic pain. In recent years, surgeons have explored various surgical avenues to improve outcomes. The aim of this review was to evaluate the current clinical evidence regarding the efficacy of fat grafting for the treatment of neuropathic pain. Methods: A critical review was conducted to examine the current clinical evidence of fat grafting as a therapy for neuropathic pain caused by neuromas, peripheral neuralgia, migraine and headaches, neuropathic scar pain, and postmastectomy pain syndrome. Results: The precise mechanism role of fat grafting in modulating neuropathic pain remains unclear, but it appears to reduce pain levels through the anti-inflammatory effects of adipose-derived stem cells and mechanical cushioning by fat. Conclusions: Fat grafting is an emerging therapy for chronic neuropathic pain of various etiologies. Although promising results have been reported, sample size and level of evidence of current studies are low. The encouraging results, however, are worthy of further clinical and scientific study. The minimally invasive nature of fat grafting and favorable risk profile make this an attractive therapy for neuropathic pain.

Outcomes in Hybrid Breast Reconstruction: A Systematic Review

“…However, fat grafting has also been advocated as adjuvant treatment in implant-based reconstruction in order to optimize the implant's interaction with the surrounding tissue and improve acquired breast contour deformities [38]. Moreover, fat grafting has been proven effective in revitalizing the microvascular damage and interstitial fibrosis found in chronically radio-damaged tissues [17,20,39,40]; thus, it can be exploited in breast reconstruction for both its regenerative and volumetric properties, allowing for use in lower-volume implants, which remain a foreign body, reducing postmastectomy pain and improving breast contour and consistency, leading to a more natural-looking breast [10,14,16,19,20,41,42].…”

“…Autologous fat transplant (AFT) has been associated with increased skin trophism and vascularization, reduced post-operative pain, and improved cosmetic results [9][10][11]. However, the debate is still ongoing over fat grafting in breast reconstruction due to some important limitations.…”

Cell therapies for chondral defects of the talus: a systematic review

“…Most of the cell therapy modalities included in the present study promoted MSCs migration and proliferation [ 51 , 52 , 54 – 57 ]. In addition to their cellular differentiation potential, the paracrine activity of MSCs interact with the microenvironment, enhancing tissue regeneration and modulating inflammation, promoting T and B cell proliferation, and NK cell activity [ 25 , 26 , 73 ]. The power of regenerative medicine relies in the signalling and mutual interaction patterns between stem cells and environment [ 74 – 76 ].…”

Favorable Transverse Maxillary Development after Covering the Lateral Raw Surfaces with Buccal Fat Flaps in Modified Furlow Palatoplasty: A Three-Dimensional Imaging–Assisted Long-Term Comparative Outcome Study

“…The long-term clinical benefit-reduction of need for orthodontic intervention, 16,19,20 improving anteroposterior development of the maxilla, 17 and increasing cleft surgery-first orthognathic surgery 54 -of attenuating posterior transverse maxillary collapse by covering lateral relaxing incisions with buccal fat flaps should also be explored in future investigation when the cohort of included patients reach skeletal maturity. Although a growing body of literature has shown that autogenous fat tissue could promote wound healing, improve scar quality, and reduce postoperative pain, [55][56][57] other potential advantages of using buccal fat flap in palatoplasty such as time to recovery of feeding postoperatively and quality of tissue at lateral palatal recipient regions should be addressed by a well-delineated research study design.…”