Özalp Burhan, Çakmakoğlu Çağri
*Division of Plastic and Aesthetic Surgery, Dicle University, Diyarbakir, Turkey †Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.
J Craniofac Surg. 2017 Mar;28(2):449-453. doi: 10.1097/SCS.0000000000003356.
Facial fat grafting has been increasingly performed to create a more youthful face. Cigarette smoking might have potential harmful effects on fat graft survival. The aim of this study was to evaluate the effects of cigarette smoking on facial lipofilling.Eighteen smoker patients (13 females and 5 males) with a mean age of 37.4 years (range: 21-53 years) who underwent facial lipofilling were enrolled in this retrospective study. The patients were followed up for an average of 19.3 months (range: 14-32 months). The fat-graft survival rate, degree of skin improvement, and presence and severity of surgical complications (fat necrosis, oil cysts, and infection) were evaluated. A 10-point Likert scale was used to assess patient satisfaction with facial fat grafting surgery.The mean injected fat volume was 42 mL (range: 30-80 mL). Clinical and photographic evaluation by the surgical team led to an estimation of 40% for the mean fat survival rate. Four instances of fat necrosis, 2 oil cysts, and 1 infection were diagnosed and treated conservatively. Five patients underwent a second fat grafting surgical procedure; 3 of these had a third fat grafting surgery to obtain the desired facial fullness. Improvement of skin quality was better during the first months after surgery, but not long standing. Overall patient satisfaction in terms of aesthetic appearance, facial fullness, and rejuvenation was 74%.Although cigarette smoking causes low fat survival rates and impairs the improvement of skin quality, successful results can be obtained with facial lipofilling in the smokers.
面部脂肪移植越来越多地用于打造更年轻的面容。吸烟可能对脂肪移植的存活有潜在有害影响。本研究的目的是评估吸烟对面部脂肪填充的影响。本项回顾性研究纳入了18例接受面部脂肪填充的吸烟患者（13例女性和5例男性），平均年龄37.4岁（范围：21 - 53岁）。患者平均随访19.3个月（范围：14 - 32个月）。评估了脂肪移植存活率、皮肤改善程度以及手术并发症（脂肪坏死、油囊肿和感染）的发生情况及严重程度。采用10分制李克特量表评估患者对面部脂肪移植手术的满意度。平均注射脂肪量为42毫升（范围：30 - 80毫升）。手术团队通过临床和照片评估得出平均脂肪存活率估计为40%。诊断出4例脂肪坏死、2例油囊肿和1例感染，并进行了保守治疗。5例患者接受了第二次脂肪移植手术；其中3例进行了第三次脂肪移植手术以获得理想的面部饱满度。术后最初几个月皮肤质量改善较好，但持续时间不长。总体而言，患者在美观外观、面部饱满度和年轻化方面的满意度为74%。尽管吸烟导致脂肪存活率低并损害皮肤质量改善，但吸烟者进行面部脂肪填充仍可获得成功结果。
