Total Facial Autologous Fat Grafting for Treating Skin Manifestations in Scleroderma

Abstract

Systemic sclerosis (SSc) or scleroderma, is a rare, systemic autoimmune connective tissue disease that can cause fibrosis of cutaneous tissue and visceral organs. Facial involvement can have a deleterious effect on patients’ function, cosmetic appearance and quality of life. This study describes our experience and results with total facial autologous fat grafting for treating scleroderma. It includes 14 women and 3 men with SSc, at an average age of 51.3 years who underwent 32 autologous fat grafting surgeries between 2017–2022. The surgical technique is further described and demographic and surgical data, including preoperative and postoperative measurements were analyzed. Patients who had multiple surgeries ultimately received grafts with twice the volume of fat than in the first procedure. The oral opening increased an average of 33%. All patients reported improvement in quality of life and were very satisfied with the aesthetic outcomes. The use of autologous fat grafting to treat SSc patients successfully increased oral openings and improved facial manifestations. The procedure is reproducible, safe and leads to improvement in facial manifestations and patients’ quality of life. It can be repeated over time to preserve or enhance the results.

Treatment of Scleroderma-Related Microstomia Using Hyaluronic Acid: An Interventional Study

“…Studies have shown an improvement in the aesthetic appearance, along with a significant effect on tissue elasticity and pliability. This modality has also been shown to increase the size of the oral opening [43]. The use of fat grafting over multiple procedures permitted the injection of increased volumes due to improved facial elasticity [43].…”

“…This modality has also been shown to increase the size of the oral opening [43]. The use of fat grafting over multiple procedures permitted the injection of increased volumes due to improved facial elasticity [43]. Evidence regarding fat grafting and improvements in the oral aperture is thought to be due to various mechanisms and tissue regeneration [44,45].…”

Advances in Systemic Sclerosis: From Pathogenetic Pathways toward Novel Therapeutic Targets

“…The topic of SSc orofacial manifestations has also been addressed in a retrospective study conducted by Berl et al, in which the authors described their experience and results with total facial autologous fat grafting in SSc patients. To perform this, the authors had made use of a technique consisting of the subcutaneous injection of fat in all regions of the face, including the superficial temporal fascia and superficial muscular aponeurotic system [ 11 ]. In the treated SSc patients, the oral opening increased by an average of 33%, and all of them reported improvement in quality of life and satisfaction with the aesthetic outcomes [ 11 ].…”

“…To perform this, the authors had made use of a technique consisting of the subcutaneous injection of fat in all regions of the face, including the superficial temporal fascia and superficial muscular aponeurotic system [ 11 ]. In the treated SSc patients, the oral opening increased by an average of 33%, and all of them reported improvement in quality of life and satisfaction with the aesthetic outcomes [ 11 ]. Interestingly, patients who underwent multiple surgeries were able to be injected with increasing amounts of fat over time, indicating that the treatment may led to improved facial tissue elasticity [ 11 ].…”

“…In the treated SSc patients, the oral opening increased by an average of 33%, and all of them reported improvement in quality of life and satisfaction with the aesthetic outcomes [ 11 ]. Interestingly, patients who underwent multiple surgeries were able to be injected with increasing amounts of fat over time, indicating that the treatment may led to improved facial tissue elasticity [ 11 ].…”