Pezeshk Ronnie A, Stark Ran Y, Small Kevin H, Unger Jacob G, Rohrich Rod J
Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2015 Sep;136(3):301e-309e. doi: 10.1097/PRS.0000000000001506.
Autologous fat transfer to the deep compartments of the face has proven to be a powerful adjunct to volume restoration during rhytidectomy. However, to treat all components of volume deflation in facial aging, the perioral superficial compartments must be addressed. Various fillers have been used to augment these compartments; however, few studies have assessed the efficacy of autologous fat transfer to these areas. This study is the largest series to date to assess the utility of autologous fat transfer to the perioral superficial compartments.
A retrospective chart review was conducted on an individualized component rhytidectomy database. Patients who underwent autologous fat transfer to the perioral superficial fat compartments were identified; patients who did not undergo autologous fat transfer served as controls. All patients had follow-up images that had been obtained a minimum of 1 year postoperatively. Three independent observers reviewed preoperative and postoperative images using the Modified Fitzpatrick Wrinkle Scale.
Sixty-five consecutive patients underwent rhytidectomy without perioral rejuvenation (group A), and 65 patients underwent rhytidectomy with autologous fat transfer to the perioral superficial compartments (group B). Group B had a two times more significant improvement in perioral aesthetics than group A.
This study is the largest review to date demonstrating safety, longevity, and success of autologous fat as an ideal filler of the perioral superficial compartments. In light of the aesthetic improvements with autologous fat transfer to the perioral region, this surgical adjunct should be a fundamental component to achieve global facial rejuvenation during rhytidectomy.
自体脂肪移植至面部深层间隙已被证明是除皱术中恢复面部容量的有力辅助手段。然而,要治疗面部衰老中容量减少的所有部分,必须对面部口周浅表间隙进行处理。已使用多种填充剂来增加这些间隙的容量;然而,很少有研究评估自体脂肪移植至这些区域的疗效。本研究是迄今为止评估自体脂肪移植至口周浅表间隙效用的最大系列研究。
对一个个体化成分除皱术数据库进行回顾性病历审查。确定接受自体脂肪移植至口周浅表脂肪间隙的患者;未接受自体脂肪移植的患者作为对照。所有患者均有术后至少1年的随访图像。三名独立观察者使用改良的菲茨帕特里克皱纹量表对术前和术后图像进行评估。
连续65例患者接受了未进行口周年轻化的除皱术(A组),65例患者接受了自体脂肪移植至口周浅表间隙的除皱术(B组)。B组在口周美学改善方面比A组显著高出两倍。
本研究是迄今为止最大规模的综述,证明自体脂肪作为口周浅表间隙的理想填充剂具有安全性、持久性和有效性。鉴于自体脂肪移植至口周区域可改善美学效果,这种手术辅助手段应成为除皱术中实现全面面部年轻化的基本组成部分。