Efficacy of Autologous Microfat Graft on Facial Handicap in Systemic Sclerosis Patients

Abstract

Background:Autologous adipose tissue injection is used in plastic surgery for correction of localized tissue atrophy and has also been successfully offered for treatment of localized scleroderma. We aimed to evaluate whether patients with systemic sclerosis (SSc) and facial handicap could also benefit from this therapy.Methods:We included 14 patients (mean age of 53.8 ± 9.6 years) suffering from SSc with facial handicap defined by Mouth Handicap in Systemic Sclerosis Scale (MHISS) score more than or equal to 20, a Rodnan skin score on the face more than or equal to 1, and maximal mouth opening of less than 55 mm. Autologous adipose tissue injection was performed under local anesthesia using the technique of subcutaneous microinjection. The main objective of this study was an improvement of the MHISS score 6 months after the surgical treatment.Results:The procedure was well tolerated. We observed a mean decrease in the MHISS score of 10.7 points (±5.1; P < 0.0001) at 6 months (35% improvement). Secondary efficacy parameters assessing perioral skin sclerosis, maximum mouth opening, sicca syndrome, and facial pain significantly improved at 3 and 6 months postsurgery. At a 6-month follow-up, 75% of patients were satisfied or very satisfied of the adipose tissue microinjection therapy.Conclusions:Our study suggests that subcutaneous perioral microfat injection in patients with SSc is beneficial in the treatment of facial handicap, skin sclerosis, mouth opening limitation, sicca syndrome, and facial pain. Thus, this minimally invasive approach offers a new hope for face therapy for patients with SSc.

Autologous Fat Grafting in the Treatment of Facial Scleroderma

“…Furthermore, they showed an increase in the neovascularization of the treated perioral skin after AFT [ 11 ]. Similarly, Sautereau et al demonstrated improvements in mouth opening, facial pain, and MHISS scores in all the 14 SSc patients who were treated with autologous micro fat grafting at 3 and 6 months after surgery [ 16 ].…”

“…They centrifuged lipoaspirate at 700 × g for 3 minutes before injection [ 11 ]. Whereas Sautereau et al used the pure graft filtration technique to purify the lipoaspirate from blood cells and free lipid content [ 16 ]. There is no agreement among authors regarding the best method for processing fat transfer.…”

Feasibility study of stem-cell enriched autologous lipotransfer to treat oro-facial fibrosis in systemic sclerosis (Sys-Stem): Protocol for open-label randomised controlled trial

“…Our group and others have suggested that it may improve skin fibrosis in different conditions including hypertrophic scars, burns, radiation-induced fibrosis, lichen sclerosis, and hemifacial atrophy [11] , [12] , [13] , [14] . Autologous lipotransfer has been also reported in small cohorts of SSc patients with facial or hand involvement [15] , [16] , [17] , [18] , [19] . A formal clinical trial assessing the safety and efficacy of autologous lipotransfer for facial involvement in SSc has not yet been reported and represents an unmet clinical need within the NHS.…”

Serial Injections of Cryopreserved Fat at −196°C for Tissue Rejuvenation, Scar Treatment, and Volume Augmentation

“…1 , 2 Many authors have since confirmed the utility of fat grafting in cosmetic and reconstructive surgery, 3 – 5 because the fat grafting is effective not only for volume augmentation but also for tissue rejuvenation and scar treatment (revitalization/fertilization). 5 – 7 …”