Department of Plastic Surgery at the University of Pittsburgh Medical Center, Pittsburgh, PA.
Aesthet Surg J. 2019 Mar 14;39(4):405-412. doi: 10.1093/asj/sjy168.
Pedal fat grafting is a cosmetic procedure to treat the functional and aesthetic sequelae of pedal fat pad atrophy. Fat grafting has been found to mitigate these symptoms, but the exact mechanism is unknown.
The authors hypothesized that pedal fat grafting may improve skin quality, accounting for prolonged symptomatic improvement despite loss of grafted fat.
Patients with pedal atrophy were enrolled in a randomized crossover clinical trial. Group 1 underwent fat grafting upon enrollment with 2-year follow-up. Group 2 was managed conservatively for 1 year then placed into the fat grafting group with 1-year follow-up. Patients underwent pedal ultrasounds to determine thicknesses of the fat pad and dermis, and photographs were taken to assess skin quality.
Three men and 20 women with an average age of 63 ± 6 years and an average BMI of 26.0 ± 4.6 kg/m2 were enrolled in the study. Twenty-six feet were injected in Group 1 and 17 were injected in Group 2. Group 1 dermal thickness increased at 6 months post-injection (P < 0.05). This increase persisted through 24 months. Group 2 dermal thickness decreased prior to injection (P < 0.05) but returned to baseline after injection and through 12-month follow-up (P < 0.05). Fat pad thickness returned to baseline by study completion in both groups (P < 0.05).
Pedal fat grafting yielded a significant, sustained increase in dermal thickness, though grafted fat was not retained. Fat grafting may improve skin quality, which could contribute to improved clinical outcomes despite loss of grafted fat.
足背脂肪移植是一种治疗足背脂肪垫萎缩的功能和美容后遗症的美容手术。脂肪移植已被发现可减轻这些症状，但确切的机制尚不清楚。
作者假设足背脂肪移植可能会改善皮肤质量，这可以解释为什么尽管移植的脂肪丢失，但症状仍能持续改善。
招募了患有足背萎缩的患者参加一项随机交叉临床试验。第 1 组在入组时接受脂肪移植，并进行 2 年随访。第 2 组在入组时接受保守治疗 1 年，然后进入脂肪移植组并进行 1 年随访。患者接受足背超声检查以确定脂肪垫和真皮的厚度，并拍摄照片以评估皮肤质量。
共有 3 名男性和 20 名女性入组，平均年龄为 63 ± 6 岁，平均 BMI 为 26.0 ± 4.6 kg/m2。第 1 组有 26 只脚接受注射，第 2 组有 17 只脚接受注射。第 1 组的真皮厚度在注射后 6 个月（P < 0.05）增加。这种增加持续到 24 个月。第 2 组在注射前真皮厚度减少（P < 0.05），但在注射后和 12 个月随访时恢复到基线（P < 0.05）。两组的脂肪垫厚度在研究结束时均恢复到基线（P < 0.05）。
足背脂肪移植可显著且持续地增加真皮厚度，尽管移植的脂肪未被保留。脂肪移植可能会改善皮肤质量，这有助于改善临床结局，尽管移植的脂肪丢失。
