Analysis of a Series of Autologous Fat Tissue Transfer for Lower Limb Atrophies

Mojallal, Ali; Veber, Michael; Shipkov, Christo; Ghetu, Nikolai; Foyatier, J.-L.; Braye, F.

doi:10.1097/sap.0b013e318164088f

Cited by 38 publications

(14 citation statements)

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“…The average percentage of fat obtained after each centrifugation was 70.1% without any significant difference in relation to the donor site. [ 27 ] There is no evidence to support the belief that a specific donor site is optimal for a specific recipient site. Some authors also believed that the SR was related to the amount of fat injected in the certain volume, which caused the rapid increase in local tissue pressure.…”

Section: Discussionmentioning

confidence: 99%

A Systemic Review of Autologous Fat Grafting Survival Rate and Related Severe Complications

Huang

Zhang

et al. 2015

Chinese Medical Journal

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Objective:Clinical application of autologous fat grafting (AFG) is quickly expanding. Despite the widely acceptance, long-term survival rate (SR) of AFG remains a question not yet solved. Meanwhile, although rare, severe complications related to AFG including vision loss, stroke even death could be seen in the literature.Data Sources:A comprehensive research of PubMed database to June 2013 was performed according to guidelines of the American Society of Plastic Surgeons Fat Graft Task Force Assessment Methodology. Articles were screened using predetermined inclusion and exclusion criteria.Study Selection:Data collected included patient characteristics, surgical technique, donor site, recipient site, graft amount, and quantified measurement methods. Patient cohorts were pooled, and SR was calculated. All the severe complications were also summarized according to the different clinical characteristics.Results:Of 550 articles, 16 clinical articles and 10 animal studies met the inclusion criteria and provided quantified measurement methods. Totally, 596 patients were included. SR varied from 34% to 82% in breast and 30–83% in the facial area. Nude mice were applied to investigate human fat grafting SR (38.3–52.5% after 15 weeks). Rabbits were commonly used to study animal AFG SR (14.00–14.56% after 1-year). Totally, 21 severe complications were reported, including death (2), stroke (10), vision loss (11, 8 of which accompanied with stroke), sepsis (3), multiple abscess (1) and giant fat necrotic cyst (2). Ten of these complications happened within 10 years.Conclusions:There is no unified measurement method to evaluate fat graft SR until now and no clinical evidence to show better SR according to different donor and recipient cite. Body mass index change between pre- and postoperation may be the bias factor in evaluating fat SR. Fat embolisms of the ophthalmic artery and the middle cerebral artery are the most severe complication of AFG and still lack of effective treatment.

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Section: Discussionmentioning

confidence: 99%

A Systemic Review of Autologous Fat Grafting Survival Rate and Related Severe Complications

Huang

Zhang

et al. 2015

Chinese Medical Journal

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“…It is still lower than the number of reports on the use of fat grafting in the reconstruction of post-traumatic, congenital, or iatrogenic lower leg sequela. Mojallal, et al analyzed a series of 20 cases of traumatic, congenital, and iatrogenic origin treated with fat grafting with excellent results [ 12 ]. The use of flaps and prostheses can improve certain defects but lacks fundamental aspects, which are desirable in some of these patients: low invasiveness and regenerative potential.…”

Section: Discussionmentioning

confidence: 99%

Autologous Fat Grafting in Severe Lower Extremity Asymmetries: Report of Four Cases

Monreal

2015

Cureus

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Background: Lower extremity asymmetries are challenging problems in plastic and aesthetic surgery practice. Regardless of their origin, atrophies and asymmetries can be extremely varied and difficult to solve with simple techniques.Objectives: The author reports his experience in the treatment of four patients suffering from severe lower extremity atrophy and asymmetry of different etiologies with autologous fat grafting.Methods: A total of four cases are presented. Patient selection was based on the severity of atrophy and asymmetry. Two patients were treated with two sessions of simple fat grafting and two patients with one session of cell-enriched fat grafting. The end point in each session was determined by tension/blanching of soft tissues. All patients were followed up for at least 12 months after the last session. During the postoperative follow-up, variables, such as objective volume improvement, objective girth loss, return to daily activities, and patient satisfaction, were analyzed.Results: The initial analysis of postoperative results showed a good patient satisfaction rate with no relevant complications and an early return to daily activities. Estimated mean volume improvement for simple fat grafting cases was estimated as 44% after two treatments. Mean volume improvement in cell-enriched fat grafting cases was estimated as 25% after only one treatment.Conclusions: Autologous fat grafting is a safe, effective, and reliable technique to perform aesthetic and reconstructive reshaping of a lower extremity in cases of atrophy or severe asymmetry. Depending on the preoperative soft tissue compliance, cell-assisted fat grafting will play an important role in reducing the number of sessions to perform.

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“…116,117 They also have optimal outcomes for graft retention compared with alternative methods. 116,117 They also have optimal outcomes for graft retention compared with alternative methods.…”

Section: Cell-supplemented Lipotransfermentioning

confidence: 99%

Lipotransfer

Widgerow

Tussardi²

2015

Annals of Plastic Surgery

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The development of autologous fat grafting to augment or reconstruct tissue defects has become an increasingly popular modality among plastic surgeons. Despite its popularity, a standardized fat grafting protocol has yet to be developed. Great variations exist with regard to almost all the technical features, yielding a reported fat graft survivability that ranges from 40% to 80%. Recent bench approaches have been proposed to improve the long-term viability of fat grafts: although promising results have been shown, empirical evidence has yet to prove the superiority of one particular method. Nevertheless, currently available literature still provides some evidence for optimal results in differing clinical scenarios, in the wait of validating and ultimate studies.The issues of enriched fat grafting techniques and variations in harvesting and delivery in the background of US regulatory constraints demand alterations and variations in techniques. These only complicate the process of validation of any single technique. However, recent studies have brought us closer to making informed decisions on technical choices in lipotransfer. These are elaborated on in this review.

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Analysis of a Series of Autologous Fat Tissue Transfer for Lower Limb Atrophies

Cited by 38 publications

References 35 publications

A Systemic Review of Autologous Fat Grafting Survival Rate and Related Severe Complications

A Systemic Review of Autologous Fat Grafting Survival Rate and Related Severe Complications

Autologous Fat Grafting in Severe Lower Extremity Asymmetries: Report of Four Cases

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