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Background Localized scleroderma (LoS) is a rare autoimmune disease characterized by skin fibrosis and subcutaneous tissue atrophy, resulting in aesthetic impairment on patients. Fat grafting has been used to treat LoS patients, achieving aesthetic and therapeutic improvement. Aims This article summarized the epidemiology and pathophysiology of LoS and the current progress and thorny questions of basic and clinical research on fat grafting treating LoS. Methods The literature of the last 20 years concerning fat grafting of treating LoS was reviewed. Results Fat grafting has been proved to produce aesthetic and therapeutic outcomes on LoS patients, including the improvement of soft tissue atrophy, skin fibrosis and pigmentation. Due to the inflammatory microenvironment of scleroderma, however, fat grafting still faces many difficulties, such as low fat retention. Novel fat grafting methods in order to supplement the deficiency of adipose‐derived stem cells and improve fat retention in LoS groups have been proposed whose effectiveness and feasibility is still needed further study. Conclusion Currently, fat grafting has been regarded as an effective treatment with a combination of aesthetic and therapeutic outcomes on LoS patients.

Background With the popularity of facial filler injections, increased severe adverse events, such as cerebral embolism, have been reported. Objectives This article aims to summarize the clinical manifestations, and proposed mechanism of the filler-induced cerebral embolism (FICE) cases. Methods A literature review was performed with the search keywords including “filler injection, hyaluronic acid, fat graft, cerebral infarction/embolism, stroke, cerebrovascular infarction, disorders of consciousness, and hemiplegia”. Results Among the 43 cases of FICE from 35 articles enrolled, 37 patients were female, and 6 were male. Twenty-nine of these patients received fat grafting, followed by 12 who received HA injection. Most of the injection sites of FICE patients were at the glabella, followed by temporal, forehead, and nasal areas. Among 30 patients receiving injection under local anesthesia, 43.33% presented with neurological symptoms during the procedure. The main symptoms were consciousness disorders and hemiplegia. Most of the embolization sites were in the middle cerebral artery, followed by frontal lobe infarction and anterior cerebral artery infarction. Three patients developed cerebral hemorrhage after embolism. Twenty-six patients presented with newly acquired vision loss, and 17 patients did not have newly acquired vision loss. The management for FICE cases included embolectomy, thrombolysis, decompressive craniectomy, antiplatelet/anticoagulant therapy and symptomatic and nutritional treatment. Nearly half of the patients recovered or improved in neurological manifestations but not the visual loss. Five patients died. Conclusions FICE is a severe complication following facial filler injection. Careful prevention, timely identification and treatment are crucial to decrease the morbidity and mortality of FICE.