Le John M, Bosworth Jeremy W, Honeywell Brandon, Ananthasekar Shivani, Collawn Sherry S
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
From the School of Medicine.
Ann Plast Surg. 2021 Jun 1;86(6S Suppl 5):S487-S490. doi: 10.1097/SAP.0000000000002873.
Adipose fat grafting (AFG) is a popular technique used to add volume in the face, breasts, and other tissue deficient areas of the body. In terms of scar release, not only has fat provided additional soft tissue coverage but also the relief of pain in scars in those patients suffering from disease processes, such as complex regional pain syndrome with steroid-induced atrophy, burn scars, morphea, and lupus. The purpose of this article is to demonstrate the senior author's technique and outcomes of using AFG in the face and body for treating volume deficiency, atrophic scarring, and deformities.A retrospective chart review of 127 AFG procedures of the face and body from September 2006 to September 2019 was performed. Of these, 14 patients had scar releases performed with fat grafting of areas of scar contracture. Fat was harvested from the abdomen, thighs, and flanks using Toomey syringes or an enclosed power-assisted system with 3.7- or 3.0-mm cannulas. Grafting in small areas, such as the face, was performed with the 0.9-mm blunt cannula.The majority of AFG was completed in the face (45%), followed by breasts (22%), and scar contracture (16%). The mean volume of fat grafted in procedures involving the breasts, buttocks, and face was 102, 182, and 21 mL, respectively. For scar contracture, the mean volume was 38 mL and for deformations, 27 mL. Sixteen percent of the cohort required at least 1 additional AFG procedure to achieve satisfactory results. There were no major complications, such as skin loss, vascular injury, embolization, or blindness. Minor complications, such as erythema, edema, and hematoma at the fat harvest or graft site, did occur and were managed with local measures.Autologous fat grafting has consistently resulted in volume correction. In addition, in patients with autoimmune disorders, burn scars, and retracted scars, not only has there been volume correction but also decreased pain in the area of treatment. In our series of patients, we described our technique of AFG for the face, body, and scar contracture. Our results demonstrate that AFG remains an inexpensive, safe, and effective treatment option to achieve volume.
脂肪移植（AFG）是一种常用的技术，用于增加面部、乳房和身体其他组织缺损部位的容积。在瘢痕松解方面，脂肪不仅提供了额外的软组织覆盖，还缓解了患有诸如复杂区域疼痛综合征伴类固醇诱导性萎缩、烧伤瘢痕、硬斑病和狼疮等疾病过程的患者瘢痕处的疼痛。本文的目的是展示资深作者在面部和身体使用AFG治疗容积不足、萎缩性瘢痕和畸形的技术及效果。
对2006年9月至2019年9月期间127例面部和身体AFG手术进行了回顾性病历审查。其中，14例患者对瘢痕挛缩区域进行了脂肪移植瘢痕松解。使用图米注射器或带有3.7毫米或3.0毫米套管的封闭式动力辅助系统从腹部、大腿和侧腹采集脂肪。在面部等小区域移植时，使用0.9毫米钝头套管。
大多数AFG手术在面部完成（45%），其次是乳房（22%）和瘢痕挛缩（16%）。涉及乳房、臀部和面部的手术中，平均移植脂肪量分别为102毫升、182毫升和21毫升。对于瘢痕挛缩，平均移植量为38毫升，对于畸形为27毫升。16%的队列患者需要至少额外进行1次AFG手术才能获得满意结果。没有发生重大并发症，如皮肤坏死、血管损伤、栓塞或失明。确实发生了轻微并发症，如脂肪采集或移植部位的红斑、水肿和血肿，通过局部措施进行处理。
自体脂肪移植一直能实现容积矫正。此外，在自身免疫性疾病、烧伤瘢痕和挛缩性瘢痕患者中，不仅实现了容积矫正，治疗区域的疼痛也有所减轻。在我们的系列患者中，我们描述了用于面部、身体和瘢痕挛缩的AFG技术。我们的结果表明，AFG仍然是一种实现容积增加的廉价、安全且有效的治疗选择。
