O'Daniel Thomas Gerald, Kachare Milind D
Department of Surgery (Plastic & Reconstructive Surgery), University of Louisville, Louisville, KY, USA.
Aesthet Surg J Open Forum. 2022 Mar 4;4:ojac014. doi: 10.1093/asjof/ojac014. eCollection 2022.
For age-related volume loss, fat grafting is now recognized as an integral adjunctive procedure with facelift surgery. However, when there is continued and unpredicted volume loss postoperatively, the surgeon has limited options for restoring this lost volume.
Poly-l-lactic acid (PLLA) is a proven biostimulator that creates volumetric enhancement. This study is undertaken to demonstrate that PLLA is a safe and efficacious option for maintenance of post-facelift volume loss.
A retrospective review was conducted to identify all patients who underwent facelift surgery with fat grafting and postoperative PLLA injections from 2010 to 2018 by a single surgeon. Demographic and clinical data were collected and analyzed.
This review identified a total of 241 patients who had undergone a facelift with fat grafting and PLLA injections. Of these, 190 patients were treated with PLLA after facelift and fat grafting, while 51 patients received PLLA injections before their operation. We identified 5 common indications for use of PLLA after facelift surgery and fat grafting. These included unexplained early fat graft loss, significant weight loss in the postoperative period, normal aging process, and patients who had a high perioperative lean body mass. Additionally, PLLA was found to be an effective volumizer for site-specific areas that did not undergo fat grafting during the initial operation. There were no complications reported from the PLLA injections related to nodule formation, papules, or granulomas.
The high degree of variability in the survival of fat grafts with facelift surgery is an accepted reality. PLLA represents a safe and highly effective solution to restore volume loss in patients who have undergone facelifts with fat grafting.
对于与年龄相关的体积减少，脂肪移植如今已被视为面部提升手术不可或缺的辅助手术。然而，当术后出现持续且不可预测的体积减少时，外科医生恢复这种丢失体积的选择有限。
聚左旋乳酸（PLLA）是一种经证实的生物刺激剂，可增加体积。本研究旨在证明PLLA是维持面部提升术后体积减少的一种安全有效的选择。
进行了一项回顾性研究，以确定2010年至2018年由一位外科医生进行面部提升手术并同时进行脂肪移植和术后PLLA注射的所有患者。收集并分析了人口统计学和临床数据。
该回顾共确定了241例接受面部提升、脂肪移植和PLLA注射的患者。其中，190例患者在面部提升和脂肪移植后接受了PLLA治疗，而51例患者在手术前接受了PLLA注射。我们确定了面部提升手术和脂肪移植后使用PLLA的5个常见适应症。这些包括不明原因的早期脂肪移植丢失、术后显著体重减轻、正常衰老过程以及围手术期瘦体重较高的患者。此外，发现PLLA对于初次手术期间未进行脂肪移植的特定部位是一种有效的体积增大剂。未报告与PLLA注射相关的结节形成、丘疹或肉芽肿等并发症。
面部提升手术中脂肪移植存活的高度变异性是一个公认的现实。PLLA是一种安全且高效的解决方案，可恢复接受过面部提升和脂肪移植患者的体积减少问题。
