When using free fat autologous grafts as a filling material was first proposed in 1893 by Neuber, the idea rapidly gained enthusiasm and endorsements. Our early experience with autologous fat transplantation was disappointing, but even then it was clear that fat could be transferred with partial success. Since then, further clinical works by Guerrerosantos, Coleman, and others have shown that it is possible, by careful handling of transplanted fat, to improve the survival of this tissue. We have reviewed our recent experiences and have found several patients with whom autologous fat transplant has been successful with up to an 8-year postoperative follow-up.
LPG Endermologie is a machine-assisted massage system that allows positive pressure rolling, in conjunction with applied negative pressure to the skin and subcutaneous tissues (LPG Endermologie U.S. A. (800-222-3911). Endermologie was originally developed in the late 1970s in France to soften scars and standardize physical therapy; however, patients treated with the LPG machine also showed improvement in body contour and skin texture. Since then, Endermologie machines have been used in France, the United States, and many other nations as an alternative method to altering fat distribution in the subcutaneous plane. The authors have continued their study of determining the safety and efficacy of this machine. Since our last report in March 1997 (Ersek RA et al., Aesth. Plast. Surg. 21(2):61-67, 1997), we have compiled records of 85 additional patients. With this larger patient pool, we can expect more statistically accurate results. This study is composed of 85 women between the ages of 21 to 61. The study group exhibited a wide range of body habitus, initial weights, and final results. Out of 85 patients, 46 patients completed seven sessions of treatment and showed a mean index reduction in body circumference of 1.34 cm, while 39 patients who completed 14 sessions of treatments showed a mean index reduction in body circumference of 1.83 cm. A decrease in mean body circumference index was seen regardless of loss or gain in patients' weight in most cases.
The development of small, textured implant particles suspended in a hydrogel has allowed for subdermal injection therapy to fill tissue defects. The microimplant particles were placed subdermally into the ears of white New Zealand rabbits in order to characterize the foreign body response and the permanence of the implant. Serial micrometer readings were performed on the implant sites to determine any change in thickness of the augmentation following baseline measurement. An initial increase in the thickness was noted approximately 20-30 days postimplantation, as expected. A stable thickness was noted for the remainder of the experiment. Serial histological sections were performed at irregular intervals from one week to one year. Histology demonstrated a mild foreign body response with collagen surrounding each individual microimplant particle. The response was stable after 30-40 days and has remained stable for over one year. It was determined that the histology demonstrated a Boros 1A type, or nonimmunogenic, low-turnover foreign body reaction.
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