Free Fat Autotransplantation for the Cosmetic Treatment of First Web Space Atrophy

Ghobadi, Fereydoon; Zangeneh, Mehdi; Massoud, Bryan

doi:10.1097/00000637-199508000-00014

Cited by 24 publications

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“…Liposuction followed by fat reinjection is accepted as the easiest method for soft tissue augmentation by many authors [5,6,7,8,10,15,23,25]. This technique allows fat to be harvested through blunt cannula under vacuum.…”

Section: Introductionmentioning

confidence: 99%

Tissue engineering of human fat for soft tissue augmentation: in vitro results

Kremer

Mühlbauer

2002

Eur J Plast Surg

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In our study we investigated whether human preadipocytes from human fat derived from routine abdominoplasty were suitable for the in vitro cultivation of fat. We could isolate and culture preadipocytes from patients of different ages and stimulate the cultured cells to differentiate into adipocytes and accumulate fat. We noticed age-related differences in the growth rate and differentiation capability into mature adipocytes. We believe that in the future a cell suspension of preadipocytes from a patient amplified in tissue culture might provide a relatively unlimited amount of injectable autologous transplant to fill soft tissue defects.

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Section: Introductionmentioning

confidence: 99%

Tissue engineering of human fat for soft tissue augmentation: in vitro results

Kremer

Mühlbauer

2002

Eur J Plast Surg

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“…6 Among the fillers used, structural fat grafting may be the safest and the most effective filler in rejuvenation surgery. 5 The procedure utilizes fat from the patient's abdomen or thigh which, after refining of the fat parcels, is placed in the dorsum of the hand.…”

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confidence: 99%

“…The main obstacle has always been fat resorption (the dissolution of adipose tissue) leading to unpredictable long-term results. 4,6 Since edema is the most consistent postoperative sequela associated with fat grafting, it is sensible to reevaluate patients at 16 weeks and again at 6 months after surgery to distinguish between tissue edema vs fat resorption. 5 Only a few minor complications have been reported from large case series.…”

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confidence: 99%

“…5 Only a few minor complications have been reported from large case series. These include an irregularity due to uneven fat distribution, 4,5 a burn-ing sensation at the operative site, 6 and skin infection requiring antibiotic treatment. 4 Patients express uniform satisfaction with the results.…”

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confidence: 99%

“…4 Patients express uniform satisfaction with the results. 4,6 Although Hirayama disease has primarily been reported in Japan and India, the proliferation of cases in Western countries creates a global problem. 7 Rejuvenation hand surgery with structural fat grafting is safe, natural-appearing, and can be repeated after The marker identified the area that was planned for structural fat grafting.…”

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confidence: 99%

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Treating the chief complaint: Hand rejuvenation for Hirayama disease

Puwanant¹,

Evangelisti²,

Griggs³

2011

Neurology

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Hirayama disease, also known as monomelic amyotrophy, is a relatively benign motor neuron disease, characterized by insidious muscle wasting and weakness, unilateral or asymmetric restricted to the distal upper limb, followed by a quiescent phase after onset in the second to third decades.1 Pathophysiology is uncertain and no treatment is available to restore weakness.2 Although the degree of disability does not interfere with activities of daily living, 2,3 the appearance of the hand is of major concern to the patient but is often minimized by clinicians concerned about the cause and the weakness. Here, we describe hand rejuvenation surgery, a procedure that restores youthful appearance to the hand, as a treatment of a patient's chief complaint in Hirayama disease.Level of evidence is class IV: single observational study without controls.Case report. Hirayama disease was diagnosed in a 36-year-old man with chief complaints of left hand atrophy and weakness which was noted soon after age 13 and did not progress after age 20. On examination, marked atrophy of left intrinsic hand muscles and forearm flexors was noted. Slight weakness was demonstrated in the C7, C8, and T1 myotomes. EMG disclosed a slightly active and chronic neurogenic pattern in the appropriate spinal segments. MRI revealed asymmetric anterior flattening and atrophy of midlower cervical cord. He consulted several neurologists who recommended occupational therapy with no benefit. Because of his great concern about hand appearance, "rejuvenation" hand surgery was recommended by a plastic surgeon.Hand rejuvenation procedure. This is a combination of 2 procedures. In the first procedure, infraumbilical fat was harvested using a liposuction cannula. The fat was then washed and refined. A total of 20 mL of fat parcels were serially injected into the first through fourth interosseous subcutaneous spaces with multiple passes at 0.25 mL increments. Fat molding was performed by gentle digital manipulation to achieve a uniform distribution. After structural fat grafting, the patient returned for moulage, the process of forming the shape and volume of the prosthesis using dental alginate to generate the permanent prosthesis out of the silicone rubber. In the second procedure, an incision was made through the skin and subcutaneous fat, the fascia was opened and separated from the muscle belly, which was severely atrophic. Soft silicone fillers were placed into anatomic positions of the first and fifth interosseous fascial compartments. Pressure dressing was applied after the skin was closed. The patient tolerated the procedures well. Tissue edema was the only postoperative sequela but gradually resolved. The patient immediately recognized a major improvement of his hand appearance (figure). Gradual loss of hand fullness secondary to partial graft resorption is noted 5 years after the procedures; nevertheless, the patient stated that he would have had this procedure performed again.

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Temporoparietal fascial free flap for correction of first web space atrophy

Kruavit

Visuthikosol

2009

Microsurgery

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Fourteen temporoparietal fascial free flaps were used for correction of first web space atrophy from ulnar nerve palsy in 13 patients. Ten sustained ulnar nerve injuries and three suffered from leprosy. The procedures were performed under general anesthesia except one leprosy patient with bilateral ulnar nerve palsy in which local anesthesia and brachial block were employed to harvest bilateral free flaps and recipient site preparations, respectively. The follow-up time varied from 4 to 64 months. The postoperative results were satisfactory and there was no resorption of the free flaps. The consistency of the augmented first web space was soft and compressible like natural feel. The size of the flap was more than enough for augmentation of first web space and donor site morbidity was minimal and accepted by all patients. We conclude that temporoparietal fascial free flap is an ideal autogenous tissue for correction of first web space atrophy.

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Free Fat Autotransplantation for the Cosmetic Treatment of First Web Space Atrophy

Cited by 24 publications

References 0 publications

Tissue engineering of human fat for soft tissue augmentation: in vitro results

Tissue engineering of human fat for soft tissue augmentation: in vitro results

Treating the chief complaint: Hand rejuvenation for Hirayama disease

Temporoparietal fascial free flap for correction of first web space atrophy

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