van Dongen Joris A, van Boxtel Joeri, Harmsen Martin C, Stevens Hieronymus P
Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Department of Plastic Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Facial Plast Surg. 2019 Aug;35(4):358-367. doi: 10.1055/s-0039-1694762. Epub 2019 Aug 30.
Lipofilling, the transplantation of adipose tissue, has already been used since the end of the 19th century. For decades, lipofilling was used to restore loss of volume due to aging, trauma, or congenital defects. Later on, the indications for the use of lipofilling expanded by treating aged skin, scars, and improving wound healing. The expansion was caused by the discovery of adipose derived stromal cells (ASCs) in adipose tissue and the development of very fine harvesting and injection cannulas which made it possible to inject small adipose tissue particles in small volume areas, such as the face. ASCs are multipotent stromal cells which reside in the stromal vascular fraction (SVF) of adipose tissue and are able to differentiate in multiple cell lineages and secrete a plurality of growth factors with regenerative potentials. The discovery of ASCs led toward more experimental cell-based therapies, that is, ASCs or SVF isolated by means of enzymatic isolation procedures. Later on, enzymatic isolation procedures were forbidden in many countries by legislation and were replaced by mechanical isolation procedures, such as the Nanofat and Fractionation of Adipose Tissue (FAT) procedures. The Nanofat procedure has been extensively investigated, especially as treatment for skin rejuvenation in the face. Though, substantial evidence is lacking for using facial lipofilling or any therapeutic component, that is, ASCs or SVF for skin rejuvenation to date. In contrast, facial lipofilling to restore loss of volume seems to be promising.
脂肪填充，即脂肪组织移植，自19世纪末就已开始应用。几十年来，脂肪填充一直用于修复因衰老、创伤或先天性缺陷导致的容量缺失。后来，脂肪填充的适应证有所扩展，用于治疗老化皮肤、瘢痕以及促进伤口愈合。这种扩展是由于在脂肪组织中发现了脂肪来源的基质细胞（ASC），以及非常精细的采集和注射套管的发展，使得在诸如面部等小体积区域注射小的脂肪组织颗粒成为可能。ASC是多能基质细胞，存在于脂肪组织的基质血管成分（SVF）中，能够分化为多种细胞谱系，并分泌多种具有再生潜能的生长因子。ASC的发现促使了更多基于细胞的实验性治疗方法的出现，即通过酶分离程序分离出的ASC或SVF。后来，许多国家通过立法禁止了酶分离程序，取而代之的是机械分离程序，如纳米脂肪和脂肪组织分级分离（FAT）程序。纳米脂肪程序已得到广泛研究，尤其是作为面部皮肤年轻化的治疗方法。然而，迄今为止，对于使用面部脂肪填充或任何治疗成分（即ASC或SVF）进行皮肤年轻化，仍缺乏充分的证据。相比之下，通过面部脂肪填充来修复容量缺失似乎很有前景。
