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Background: Despite the pivotal role of fat grafting in plastic, reconstructive, and aesthetic surgery, inconsistent survival rates of transplanted adipose tissue, primarily due to early ischemic and hypoxic insults, remain a significant challenge. The infusion of healthy mitochondria has emerged as a promising intervention to support tissue recovery from ischemic, hypoxic, and other types of damages across various organ systems. Objectives: This study aims to evaluate the impact of supplementing human adipose tissue grafts with healthy exogenous mitochondria on their volume and mass retention rates when transplanted into the subcutaneous layers of nude mice. This approach seeks to improve and optimize fat grafting techniques. Methods: Human adipose tissues were preconditioned with exogenous mitochondria (10 µg/mL), a combination of exogenous mitochondria and the inhibitor Dyngo-4a, Dyngo-4a alone, or PBS, and then transplanted into the subcutaneous tissue of 24 nude mice. Samples were harvested at 1 and 3 months post-transplantation for analysis of mass and volume retention. The structural morphology and integrity of the adipose tissues were assessed using Hematoxylin and Eosin (H&E) staining. Results: Mitochondrial preconditioning significantly enhanced the retention of mass and volume in fat grafts, demonstrating superior structural morphology and integrity compared to the control group. Conclusions: This study highlights the potential of exogenous mitochondrial augmentation in fat transplantation to significantly improve fat graft survival, thereby optimizing the success of fat grafting procedures. [ABSTRACT FROM AUTHOR]

Background: Fat grafting is widely used in breast reconstruction and aesthetic plastic surgery. However, the success rate and effects of fat grafting, especially in elderly female donors, are observed. This study aimed to explore the difference in the survival rate of donor fat from elderly women and young women in fat grafting. Methods: We collected adipose tissue samples from two healthy Chinese women: a young woman and an elderly woman. In addition, adipose tissue samples were collected from female nude mice in four experimental groups—CON-Y, CON-O, OVX-Y, and OVX-O—after fat transplantation. Grafts were harvested, weighed, and subjected to assessment of histology and angiogenesis. Results: An ovariectomy model was successfully established to validate the effect of low estrogen levels on fat grafting results. Due to the influence of low estrogen levels, the graft survival rate of donor site fat was significantly higher in elderly women than in young women, accompanied by a lesser degree of angiogenesis. Low estrogen levels led to adipocyte hypertrophy, which may be related to decreased AQP-7 expression. Conclusions: AQP-7 downregulation due to low estrogen levels induces adipocyte hypertrophy, and donor fat from elderly women exhibits a higher survival rate after fat transplantation. Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Facial balance significantly impacts aesthetics, particularly in the middle and lower thirds. Patients with chin retrusion often benefit from sagittal plane chin advancement in rhinoplasty, enhancing surgical outcomes and satisfaction. Objectives: This article presents a method for analyzing chin deformities and discusses a hybrid treatment approach to harmonize facial features, complementing rhinoplasty. Methods: The chin positions of patients treated by the senior author were assessed. A retrospective analysis included 49 patients with chin retrusion of 2.5–6 mm. Among them, 22 patients initially offered chin implants declined, leading to planned chin augmentation. Fat grafting was exclusively performed for 20 patients lacking sufficient cartilage. The "Hybrid Chin Advancement" technique involved supporting tissues beneath muscles with nasal septum cartilage and fat injections and tissues above muscles with fat injection alone. Results: Pre- and postoperative Legan angle measurements and chin advancements were compared across three groups. While preoperative Legan angles were statistically similar, postoperative Legan angles and advancement changes were significantly higher in the implant group (p < 0.0001). Comparing hybrid chin advancement and fat grafting groups, postoperative Legan angles and advancement changes were significantly higher in the hybrid chin group (p < 0.0001). Conclusions: Fat grafting suffices for mild advancements (~ 2 mm), while the hybrid chin method is effective for moderate advancements (~ 4 mm). For advancements exceeding 6 mm, implants or osseous genioplasty are optimal. Our study's hybrid approach offers an easy, safe, and reliable method for achieving facial harmony in the lower two-thirds without compromising patient expectations. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Successfully restoring facial contours continues to pose a significant challenge for surgeons. This study aims to utilize head-mounted display-based augmented reality (AR) navigation technology for facial soft tissue defect reconstruction and to evaluate its accuracy and effectiveness, exploring its feasibility in craniofacial surgery. Methods: Hololens 2 was utilized to construct the AR guidance system for facial fat grafting. Twenty artificial cases with facial soft tissue defects were randomly assigned to Group A and Group B, undergoing filling surgeries with the AR guidance system and conventional methods, respectively. All postoperative three-dimensional models were superimposed onto virtual plans to evaluate the accuracy of the system versus conventional filling methods. Additionally, procedure completion time was recorded to assess system efficiency relative to conventional methods. Results: The error in facial soft tissue defect reconstruction assisted by the system in Group A was 2.09 ± 0.56 mm, significantly lower than the 3.23 ± 1.15 mm observed with conventional methods in Group B (p < 0.05). Additionally, the time required for facial defect filling reconstruction using the system in Group A was 25.45 ± 2.58 min, markedly shorter than the 37.05 ± 3.34 min needed with conventional methods in Group B (p < 0.05). Conclusion: The visual navigation offered by the fat grafting AR guidance system presents obvious advantages in facial soft tissue defect reconstruction, facilitating enhanced precision and efficiency in these filling procedures. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Patients/Methods Results Conclusions Autologous fat grafting is a widely used technique in plastic and reconstructive surgery for soft tissue augmentation. Despite its advantages, the primary limitation is the unpredictable retention rate of transplanted fat. Recent studies suggest that botulinum toxin type A (BTX‐A) can enhance fat graft survival by promoting angiogenesis and muscle paralysis.This review explores the potential of BTX‐A as an adjuvant in autologous fat grafting, providing insights into its mechanisms, benefits, and the need for further clinical validation.A literature review was conducted using PubMed, Web of Science, MEDLINE, and Embase. Keywords related to BTX‐A, fat grafting, fat graft survival, and angiogenesis were used. Comparative studies reporting histological changes following BTX‐A application in fat grafting were included. Exclusion criteria involved case reports with fewer than three animals, reviews, and letters.The initial search yielded 108 articles, with seven experimental studies meeting the criteria. These studies demonstrated that BTX‐A enhances fat graft retention by promoting vascularization and adipose‐derived stem cell differentiation. However, these results are mainly based on small animal models.While BTX‐A shows promise in improving autologous fat grafting outcomes, its efficacy and safety in humans need validation through large‐scale clinical trials. Translating these preclinical findings into human trials is crucial to establish standardized protocols and optimize clinical outcomes. Future research should focus on optimizing dosage and injection sites, conducting long‐term follow‐up studies, and performing multicenter trials to verify the findings. [ABSTRACT FROM AUTHOR]

Objective: Numerous studies have proposed the utilization of stromal vascular fraction (SVF), adipose-derived stem cells (ADSCs), and platelet products as auxiliary grafting techniques to improve the survival rate of fat grafts. This study aimed to evaluate the efficacy and safety of various fat grafting methods since 2010 through a network meta-analysis, aiming to identify the most effective technique for fat grafting. Methods: Clinic trials on assisted fat grafting were searched from Pubmed, Embase, Web of Science, and the Cochrane Library, spanning the period from January 1, 2010 to March 2024. The risk of bias in the included trials was meticulously assessed using the Cochrane risk of bias tool. The survival rate of fat grafts served as the primary evaluation metric for effectiveness, while complications were employed as the indicator for safety. Results: The study incorporated 31 clinic trials, involving a total of 1656 patients. The findings indicated that the survival rate with assisted fat grafting significantly surpassed that of simple fat grafting (SUCRA, 10.43%). Notably, ADSC-assisted fat grafting exhibited the highest survival rate (SUCRA, 82.17%), followed by Salvia miltiorrhiza (SM)-assisted fat grafting (SUCRA, 69.76%). In terms of safety, the most prevalent complications associated with fat grafting were fat sclerosis and fat necrosis. Adc-assisted fat grafting was correlated with the lowest incidence of complications (SUCRA, 41.00%), followed by simple fat grafting (SUCRA, 40.99%). However, PRP-assisted (SUCRA, 52.86%) and SVF-assisted fat grafting (SUCRA, 65.14%) showed higher complication rates. Conclusion: Various methods of assisted fat grafting can significantly enhance the survival rate, but they often fail to effectively mitigate the incidence of complications. Compared to other methods, adipose mesenchymal stem cells-assisted fat grafting consistently yielded a higher survival rate of grafts and fewer complications. Consequently, this approach represents a relatively effective method for assisting in fat grafting at present. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is a huge problem in modern medicine, even surpassing breast cancer in women. A very common method of treatment is mastectomy which is, in most cases, followed by breast reconstruction, the course of which changes dynamically. The process is aimed at improving patient satisfaction, minimizing the risk of tumor recurrence, and preventing complications. That is why we decided to look at the trend in the abovementioned procedures. We have described important types of surgical treatment of breast cancer, such as modified radical mastectomy, breast-conserving surgery, contralateral prophylactic mastectomy, and robotic mastectomy. We have also discussed breast reconstruction, focusing on implants, acellular dermal matrix, autologous reconstruction, robotic breast reconstruction, and fat grafting. Background: Breast cancer continues to be a significant diagnostic and therapeutic problem. Mastectomy is still a frequently used treatment method, but its form is changing with progress in medicine. Methods: We have described important types of surgical treatments for breast cancer, such as modified radical mastectomy, breast-conserving surgery, contralateral prophylactic mastectomy, and robotic mastectomy. Breast reconstruction is also a very important element of treatment because it directly affects the mental state of patients after the procedure. We have also described types of breast reconstruction, such as implants, acellular dermal matrices, autologous reconstruction, robotic breast reconstruction, and fat grafting. Results: The aim of our study was to compare available types of surgical treatment for breast cancer and breast reconstruction to help tailor personalized treatment to patients. [ABSTRACT FROM AUTHOR]

Background/Objectives: Breast cancer treatment increasingly incorporates immediate prepectoral prosthetic reconstruction after conservative mastectomy, including nipple-sparing (NSMs) and skin-sparing mastectomies (SSMs). Although recent data from the literature show that postmastectomy radiotherapy (PMRT) after prepectoral reconstruction presents good clinical results, with reduction in capsular contracture and implant migration, compared to the traditional submuscular technique, these patients have higher rates of long-term complications when compared with nonradiated patients. This study evaluates the protective effects of autologous fat grafting to reduce long-term radiotherapy-induced complications in breast cancer patients submitted for prepectoral reconstruction with polyurethane-covered (PU) implants. Methods: A pilot study with two parallel cohorts of patients undergoing an NSM or SSM followed by PMRT was conducted. Patients were randomly assigned to either of the two groups to ensure homogeneity. One cohort underwent autologous fat grafting sessions, individually tailored based on periodic evaluations by the principal investigator (PI), M. Salgarello, at least six months after PMRT. The control group received standard clinical follow-ups without fat grafting. Inclusion criteria ensured participants were disease-free, non-smokers, and had a LENT-SOMA score within 2. Results: Preliminary findings indicate significant differences between the groups, with improved outcomes observed in patients undergoing tailored lipofilling. Specifically, these patients experienced a notable reduction in capsular contracture severity and reported higher satisfaction with the aesthetic results compared to the control group. Conclusions: Autologous fat grafting, customized per patient by the PI based on ongoing evaluations, appears to mitigate some adverse effects of radiotherapy in prepectoral breast reconstruction, suggesting a viable option for enhancing surgical outcomes in irradiated patients. Further research is needed to substantiate these findings and evaluate long-term benefits. [ABSTRACT FROM AUTHOR]

There are multiple methods to prepare lipoaspirate for autologous fat transfer; however, graft retention remains unpredictable. The purpose of this study was to compare the cellular and protein composition of adipose grafts and the stromal vascular fraction (SVF) resulting from three common techniques to prepare adipose grafts. Adipose grafts were harvested from healthy donors and processed via three techniques: centrifugation (C), a single-filter (SF) device, and a double-filtration (DF) system. Part of each graft was analyzed or further processed to isolate the SVF. Cell viability, surface markers, cytokine, and growth factors were compared between the graft and SVF as well as adipose-derived stem cells (ASCs). Overall, we found variations across the three processing techniques and among the graft components (ASCs, SVF, and fat). Cell viability within the grafts was similar (94.6%, 92.3%, and 93.6%; P = 0.93). The trend was a greater percentage of ASCs from SF versus DF or centrifugation (6.95%, 4.63%, and 1.93%, respectively, P = 0.06). Adipogenic markers (adiponectin and leptin) were similar among all three grafts (P = 0.45). Markers of tissue remodeling were greatest in the SVF compared with fat and ASCs, regardless of processing technique. There was higher relative expression of MMP-9 (2×), Extracellular matrix metalloproteinase inducer (EMMPRIN) (2.5×), endoglin (5×), and IL-8 (1.5×) in the SVF (P < 0.005). Our study identified differences in cytokine expression in adipose grafts and the SVF, particularly in cytokines important in inflammation and wound healing. These secretomes may impact graft retention and fat necrosis and have the potential implications in cell-assisted lipotransfer. There were no significant differences between the final products of any of the processing techniques. [ABSTRACT FROM AUTHOR]

Background: High-definition body sculpting has revolutionised body contouring surgery worldwide. Intramuscular fat grafting for cosmetic purposes has been utilised for many years to enhance the underlying muscular anatomy. The purpose of this study is to present a novel technique of muscular fat grafting to the oblique muscles aimed at enhancing the outcomes of high-definition body contouring surgeries. This technique is referred to as the Semilunaris Parallel to Rectus Fat Transfer technique (SPARTAN). Methods: This method of oblique muscle amplification can be executed under direct vision during an abdominoplasty or under ultrasound (US) guidance in patients undergoing liposuction alone. The objective is to infiltrate fat tissue into the oblique muscles, thereby enhancing the athletic appearance of the abdominal region. Results: The SPARTAN technique was applied to 51 patients, with no complications observed. This procedure complemented the Rectus Abdominis Fat Transfer (RAFT) and Ultrasound-guided Rectus Abdominis Fat Transfer (Ug-RAFT) techniques. Conclusions: The SPARTAN technique serves as an adjunct to muscle enhancement, achieving a more defined and athletic look in high-definition body contouring. It can be performed under direct vision or with US assistance. Level of Evidence: Level IV, therapeutic study. [ABSTRACT FROM AUTHOR]

Background: Surgical dissection and partial detachment of the temporalis muscle during neurosurgical procedures might result in a temporal depression known as "temporal hollowing". Reconstructive procedures to correct this condition include the implantation of synthetic materials (e.g., hydroxyapatite, methacrylate or polyethylene), injection of autologous fat or fillers as well as the use of flaps (e.g., temporo-parietal local flap and latissimus dorsi free flap). However, none of these techniques proved to be an ideal option due to a high complication rate or need for invasive and complex surgery. Adipo-dermal grafts are autologous; the resorption rate seems to be limited and the complexity of the procedure is minor. Moreover, autologous fat grafting can be performed to enhance the final outcome by correcting residual contour deformities. Methods: In this series of five patients, an institutional experience is presented using multi-layered adipo-dermal grafts harvested from the supra-pubic area for the restoration of volume and contour in post-surgical temporal hollowing. During the last follow-up, patients were asked to express their satisfaction, which was assessed by a survey. Results: this approach demonstrates a marked improvement in temporal hollowing associated with a low complication rate and good patient satisfaction. Conclusions: the aim of this consecutive case series is to emphasize the effectiveness of this surgical technique as one of the options to address temporal hollowing. [ABSTRACT FROM AUTHOR]

Background/Objectives: This retrospective observational study sought to determine the efficacy and safety of an innovative combined treatment protocol using guided Superficial Enhanced Fluid Fat Injection (SEFFI) and calcium hydroxylapatite (CaHA) in facial rejuvenation. Methods: A total of 158 patients (149 females and 9 males) underwent the combined treatment of guided SEFFI and diluted/hyperdiluted CaHA. The study evaluated treatment outcomes at 30, 90, and 150 days post-treatment using the Global Aesthetic Improvement Scale (GAIS) and three-dimensional photogrammetric analysis. Results: The combined treatment demonstrated consistent enhancement in skin quality and facial volume across temporal, malar, zygomatic, and jawline regions. At 90 days post-treatment, substantial improvements were observed, with the GAIS scores reflecting significant enhancements in both skin quality and volume, which were sustained or slightly improved by 150 days. Minor complications, predominantly ecchymosis at the injection sites, resolved within a week, confirming the treatments' safety. Conclusions: The integration of guided SEFFI and CaHA resulted in significant improvements in skin quality and facial volume with minimal complications. Further research is recommended to consolidate these findings and explore long-term outcomes. [ABSTRACT FROM AUTHOR]

Autologous fat grafting is a common technique in cosmetic and reconstructive surgery, addressing facial rejuvenation, breast contouring, scar mitigation, and soft tissue corrections. However, clinical outcomes can be inconsistent and unpredictable. While extensive research has explored the mechanisms of harvesting, purifying, and transplanting adipose tissue, there is a notable gap in understanding the impact of donor-related factors on fat grafting success. This review aims to fill this gap by examining how variables like donor age, sex, health status, and anatomical site of fat harvest influence the biological efficacy of adipose-derived stem cells (ASCs). Younger donors often exhibit higher ASC proliferation rates and regenerative potential, while older donors may have reduced cell viability. Hormonal differences between sexes and donor health conditions, such as obesity or diabetes, can also impact ASC functionality and graft outcomes. The anatomical source of the fat further affects its cellular composition and regenerative potential. Understanding these donor-related factors is vital for optimizing fat grafting techniques. The review also explores innovative strategies, such as adipose tissue cryopreservation and acellular fat matrices, to mitigate donor variability. These approaches offer promising avenues for enhancing the predictability and effectiveness of fat grafting. By synthesizing current knowledge and highlighting novel strategies, this review aims to improve clinical outcomes and advance the field of aesthetic and reconstructive surgery.

Abstract Background Successfully restoring facial contours continues to pose a significant challenge for surgeons. This study aims to utilize head-mounted display-based augmented reality (AR) navigation technology for facial soft tissue defect reconstruction and to evaluate its accuracy and effectiveness, exploring its feasibility in craniofacial surgery. Methods Hololens 2 was utilized to construct the AR guidance system for facial fat grafting. Twenty artificial cases with facial soft tissue defects were randomly assigned to Group A and Group B, undergoing filling surgeries with the AR guidance system and conventional methods, respectively. All postoperative three-dimensional models were superimposed onto virtual plans to evaluate the accuracy of the system versus conventional filling methods. Additionally, procedure completion time was recorded to assess system efficiency relative to conventional methods. Results The error in facial soft tissue defect reconstruction assisted by the system in Group A was 2.09 ± 0.56 mm, significantly lower than the 3.23 ± 1.15 mm observed with conventional methods in Group B (p

Abstract Background Despite the pivotal role of fat grafting in plastic, reconstructive, and aesthetic surgery, inconsistent survival rates of transplanted adipose tissue, primarily due to early ischemic and hypoxic insults, remain a significant challenge. The infusion of healthy mitochondria has emerged as a promising intervention to support tissue recovery from ischemic, hypoxic, and other types of damages across various organ systems. Objectives This study aims to evaluate the impact of supplementing human adipose tissue grafts with healthy exogenous mitochondria on their volume and mass retention rates when transplanted into the subcutaneous layers of nude mice. This approach seeks to improve and optimize fat grafting techniques. Methods Human adipose tissues were preconditioned with exogenous mitochondria (10 µg/mL), a combination of exogenous mitochondria and the inhibitor Dyngo-4a, Dyngo-4a alone, or PBS, and then transplanted into the subcutaneous tissue of 24 nude mice. Samples were harvested at 1 and 3 months post-transplantation for analysis of mass and volume retention. The structural morphology and integrity of the adipose tissues were assessed using Hematoxylin and Eosin (H&E) staining. Results Mitochondrial preconditioning significantly enhanced the retention of mass and volume in fat grafts, demonstrating superior structural morphology and integrity compared to the control group. Conclusions This study highlights the potential of exogenous mitochondrial augmentation in fat transplantation to significantly improve fat graft survival, thereby optimizing the success of fat grafting procedures.

Purpose: In recent years, fat grafting has gained importance as a valuable technique in breast surgery. As a breast center that has embraced this approach, we aimed to investigate the indications and complications of fat grafting. Methods: In this retrospective study, we examined a total of 263 lipofilling treatments on 121 patients. Five groups were identified: the reconstruction group (72.7%), consisting of 24.8% autologous and 38% implant-based reconstructions after cancer, and correction of the tuberous breasts (10.7%). An almost equivalent group (10.7%), consisted of patients treated for cosmetic reasons. Patients after breast-conserving therapy amounted to 16.5%. Twenty patients (16.5%) were treated to alleviate pain. Results: No major complications, and no cancer recurrence or metastasis were observed. One case of infection occurred at the injection site (infection rate: 0.38%). ANOVA showed statistically significant results for age (p < 0.001) and mean fat volume (p = 0.001). Posthoc analysis showed that the mean age of the tuberous group (21 years) was significantly smaller compared to all other categories (p < 0.001). Post-hoc analysis for fat volume indicated that the mean value for the cosmetic category (447.08 cc) was significantly greater than that of the breast-conserving and implant reconstruction categories (p = 0.009 and p = 0.030, respectively), while not significantly different from the tuberous and autologous reconstruction categories (p = 0.928 and p = 0.648, respectively). Conclusions: Lipofilling has proven a valuable adjunct in reconstructive and aesthetic breast surgery with a low complication profile. The versatility of this low-cost technique and the low rate of complications make it a powerful asset of modern breast centers. [ABSTRACT FROM AUTHOR]

Le front est la partie crânienne de la face et représente une composante importante de l'esthétique faciale. Les déformations liées aux craniosténoses sont typiques par les modifications en hauteur, en largeur et en angulation du front. Les traitements chirurgicaux crâniofaciaux sont codifiés et basés sur une découpe osseuse frontale suivie de son repositionnement avec ostéosynthèse résorbable chez l'enfant. Les techniques ont peu changé depuis les descriptions princeps. Aujourd'hui, la distraction ou les ressorts permettent des remodelages précoces avec des morbidités faibles. Les séquelles sont essentiellement liées à des défauts de croissance à la jonction frontotemporale et sont corrigées le plus souvent par greffe de graisse autologue. L'existence de mutations génétiques associées à la craniosténose augmente le risque de reprise chirurgicale dans les six premières années de vie. The forehead is the cranial part of the forehead, and represents an important component of facial esthetics. The deformations linked to craniosynostoses are characterized by modifications in height, width, and angulation. Their surgical correction during childhood is based on well-established techniques of remodeling using resorbable osteosynthesis. Today, distraction and springs allow less invasive procedures with good outcomes. Sequellae mainly correspond to hypotrophies of the temporal region, corrected with fat grafting. The presence of a mutation increases the risk of reoperation in the first six years of life. [ABSTRACT FROM AUTHOR]

Introduction The history of wounds dates back to the evolution of mankind. Throughout the centuries, management modalities of wounds have undergone drastic changes. With the advent of technology, we have multiple options for wound care, but none of them can be called the gold standard of wound care. Autologous fat grafting (AFG) is one of the most routinely performed procedures in aesthetic surgery. Fat grafting has shown beneficial effects in the healing of wounds. The regenerative potential of autologous fat is contributed by the adipose-derived stem cells present within the stromal vascular fraction, which are capable of differentiating into multiple cell types. This study aims to analyze the usefulness of AFG in cutaneous wound healing.

High‐quality fat (HQF) improves the survival rate of fat and volumetric filling compared to traditional Coleman fat. However, this HQF strategy inevitably leads to a significant amount of unused fat being wasted. "CEFFE" (cell‐free fat extract) is an acellular aqueous‐phase liquid, rich in bioactive proteins. The remaining fat from preparing HQF can be further processed into CEFFE to promote the survival of HQF. HQF was obtained and the remaining fat was processed into CEFFE, then HQF was transplanted subcutaneously in nude mice. Animal studies showed that CEFFE significantly improved the survival rate of HQF. Histological analysis revealed that CEFFE improved the survival rate of HQF, by enhancing cell proliferation activity, reducing apoptosis, increasing angiogenesis, and improving the inflammatory state. Under simulated anaerobic conditions, CEFFE also improved the viability of HQF. In vitro, studies demonstrated that CEFFE enhanced the survival rate of HQF through multiple mechanisms. Transcriptomic analysis and qPCR showed that CEFFE increased the expression of angiogenesis‐related genes in ADSCs while enhancing their proliferation‐related gene expression and suppressing the expression of three differentiation‐related genes. Moreover, functional experiments demonstrated that CEFFE‐induced ADSCs exhibited stronger proliferation and adipogenic differentiation abilities. Tube formation and migration assays revealed that CEFFE promoted tube formation and migration of HUVECs, indicating its inherent pro‐angiogenic properties. CEFFE facilitated the development of M0 to M2 macrophages, suggesting its role in improving the inflammatory state. This innovative clinical strategy optimizes HQF transplantation strategy, minimizing fat wastage and enhancing the efficiency of fat utilization. [ABSTRACT FROM AUTHOR]

Background: Autologous fat grafting is a widely adopted approach to optimize outcomes in breast reconstruction and augmentation. Although fat necrosis is a well-known consequence of autologous fat grafting, it remains inconsistently defined in the literature. In late 2014, the Food and Drug Administration released a draft guidance to restrict future autologous fat grafting—a statement that was permissively modified in late 2017. In the context of evolving guidelines and autologous fat grafting outcome data, the language and descriptions of fat necrosis are inconsistent in the literature. Methods: Five databases were queried for studies reporting fat necrosis following autologous fat grafting for breast reconstruction or augmentation from inception to August 11, 2022. Studies were temporally stratified according to released FDA guidelines: pre-2015, 2015–2017, and 2018–2022. Results: Sixty-one articles met inclusion criteria. Prior to 2015, 6 of 21 studies (28.6%) offered clear definitions of fat necrosis. In contrast, the 2015–2017 period demonstrated an absence of clear fat necrosis definitions (0/13 studies, p = 0.03). Though the 2018–2022 period exhibited a rise in annual publications compared with the pre-2015 period (5.4 vs. 1.9, respectively, p = 0.04), this was not matched by a rise in clear fat necrosis reporting (14.8% studies, p = 0.45). Across all periods, only 16.4% of articles offered clear definitions, which exhibited wide heterogeneity. Conclusion: Despite the increasing popularity of autologous fat grafting, fat necrosis remains inconsistently defined and described, especially in the context of changing FDA guidelines. This limits the reliable interpretation and application of the current literature reporting fat necrosis outcomes. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Introduction: Mycobacterium abscessus infection after liposuction/fat grafting is a rare complication that is hard to diagnose and treat. Misdiagnosis could result in treatment failure and prolonged hospital stays. The paradoxical reaction is another complication that rarely occurs in non-HIV patients infected with nontuberculosis mycobacteria. This study reported 3 cases infected with M. abscessus complicated by the paradoxical reaction after liposuction and fat grafting. It highlighted characteristics giving clues of the paradoxical reaction and a successful strategy. Also, a systematic review was conducted to comprehensively provide varied aspects of M. abscessus infection after liposuction and/or fat grafting. Methods: Three cases were retrospectively included reporting data characteristics of patients, cosmetic procedures, and treatment strategy. PubMed, Scopus, Virtual Health Library (VHL), and Global Health Library (GHL) were searched to find and include cases with M. abscessus infection after liposuction and/or fat grafting based on defined selection criteria. Relevant data were extracted and summarized. The risk of bias in included studies was assessed using JBI critical appraisal checklists. Results: Twenty-four articles were included in the systematic review. Symptoms often developed approximately 1 month after the cosmetic surgery. Culture, AFB, and PCR were common methods of diagnosis of M. abscessus after liposuction and/or fat grafting. It took about 33 days on average from the presentation to isolate and detect the pathogens. Antibiotics based on susceptibility testing results along with surgical interventions were effective methods of treatment. Our three cases which were complicated by the paradox were addressed by adding methylprednisolone for 2 weeks to the macrolide-based therapy. Conclusions: Awareness of this disease should be widely raised among physicians for early diagnosis and proper treatments. Cultures of specimens and AFB should be repeated many times before excluding the possibility of Mycobacterium spp. A paradoxical reaction should be suspected if the symptoms were worse after the antibiotic therapy based on susceptibility testing results and proper surgical interventions, especially if patients had taken corticosteroids before being admitted. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Introduction The history of wounds dates back to the evolution of mankind. Throughout the centuries, management modalities of wounds have undergone drastic changes. With the advent of technology, we have multiple options for wound care, but none of them can be called the gold standard of wound care. Autologous fat grafting (AFG) is one of the most routinely performed procedures in aesthetic surgery. Fat grafting has shown beneficial effects in the healing of wounds. The regenerative potential of autologous fat is contributed by the adipose-derived stem cells present within the stromal vascular fraction, which are capable of differentiating into multiple cell types. This study aims to analyze the usefulness of AFG in cutaneous wound healing. Materials and Methods This prospective, study was conducted in our institute between April 2021 and May 2023. Eighteen patients with nonhealing wounds were included in the study. For assessing wound healing all the patients were first managed with conventional dressing for 2 weeks before surgery. After routine preoperative workup, the procedure was performed under local anesthesia in most cases. Fat was harvested from the lower abdomen and after emulsification, was injected into the edge and floor of the ulcer. The dressing was changed on the third postoperative day and the outcome was assessed. Results Eighteen patients (M:F ratio 8:1), with a mean age of 35.61 ± 12. 64 years (range 10–65 years), were included in this study. The most common etiology was trauma (44%), others being postop infection (17%), veno-lymphatic ulcer (17%), burns (11%), insect bite (5%), and trophic ulcer (5%). Majority of the wounds (95%) healed without the need for any extra intervention. The mean period taken for complete wound healing was 5.05 weeks. Conclusion Complete wound healing was achieved in majority of the patients without any complications. We recommend the usage of AFG for nonhealing wounds, as the procedure is relatively simple and can be performed after basic training. Larger-scale randomized controlled trials should be conducted to prove their efficacy in the management of complicated wounds. [ABSTRACT FROM AUTHOR]

Background: To evaluate the efficacy and safety of stromal vascular fraction (SVF), platelet rich plasma (PRP), and 1064‐nm Q‐switched Nd:YAG laser in reducing nanofat treated dark circles and wrinkles under the eyes. Method: This study was a single‐blinded randomized clinical trial conducted on patients with suborbital darkening under the eyes that randomly divided into control and case groups. In the control group, 15 patients were treated with one session of nanofat injection only, and five patients of each intervention groups received one session of nanofat+SVF injection, nanofat+PRP injection, and nanofat injection+Nd:YAG laser, respectively. Assessments methods were (1) evaluation of the degree of darkness and repair under the eyes by a blinded dermatologist based on clinical photographs, (2) investigating patient satisfaction, (3) using biometric variables for color, thickness, and density of the skin (only 3 months after the treatment), and (4) recording the possible adverse effects. Conclusion: In terms of the extent of reduction in the intensity of darkness under the eyes, the combined treatment of nanofat injection together with SVF, PRP, and Nd:YAG laser had a much greater therapeutic effect than nanofat injection alone. In all three groups of combined treatments, patients were 100% satisfied. In terms of biometric variables, amount of changes in colorimeter, complete and dermal thickness, complete and dermal density, between the different groups was statistically significant. The use of combined treatments including nanofat with SVF injection, PRP, and 1064 Q‐switched Nd:YAG laser may be more effective than nanofat alone, in reducing infraorbital dark circles and wrinkles. [ABSTRACT FROM AUTHOR]

Background: Although endoscopic mastectomy has been associated with good tolerance and enhanced patient satisfaction, limitations such as the implant or flap size for reconstruction with small incisions remain unresolved. Fat grafting (FG) can expand tissue volume with pinhole skin incisions. Herein, we evaluated the safety and efficacy of endoscopic mastectomy followed by immediate FG. Methods: Patients who underwent endoscopic mastectomy with immediate FG reconstruction from 2015 to 2021 were retrospectively evaluated to establish surgical outcomes and prognosis. Results: Twenty-three patients with clinical stage 0 or I breast cancer underwent unilateral endoscopic mastectomy with immediate FG. The median age was 45 years (41–55), and the median body mass index was 19.3 kg/m2 (15.8–26.6). Endoscopically performed procedures included skin-sparing mastectomies in 18 patients (78%) and nipple-sparing mastectomies in five patients (22%). The median procedure duration was 295 min (242–346). The median specimen weight was 133 g (71–334), and the median grafted fat volume was 200 mL (136–320). No patient required reoperation or additional procedures for complications. One patient experienced recurrence at a median follow-up of 56.1 months and underwent resection; the patient was alive without recurrence 54 months post-resection. Conclusion: To the best of our knowledge, this is the first report of endoscopic mastectomy with immediate FG for reconstruction. When compared with other immediate autologous reconstructions, our strategy could minimize the skin incision and procedure duration, as well as limit complications. Further prospective investigations are needed to evaluate oncological safety, surgical outcomes, and patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Hyperpigmented scars, particularly in exposed body areas, can be difficult to conceal and may evoke psychological distress. While the precise causes of scar dyschromia are not fully understood, alterations in melanogenic activity appear to hold more significance than changes in melanocyte quantity. Current treatments encompass laser interventions. However, it is essential to consider their costs and potential complications in relation to their limited proven effectiveness. Fat grafting has gained interest as a scar modulation technique due to its regenerative properties, and its efficacy in reducing scar hyperpigmentation is currently under investigation. Methods: A systematic review and meta-analysis was reported according to PRISMA guidelines. PubMed, Embase, and Cochrane Library databases were accessed. PROSPERO registration number is CRD42023457778. The primary outcome was a change in scar pigmentation after fat grafting. Pigmentation changes after fat grafting were calculated using the standardized mean difference (SMD) between baseline and postoperative scores according to POSAS and VSS scales. Bias assessment was conducted according to the National Institute for Health and Clinical Excellence quality assessment tool. Results: A total of 8 articles meeting inclusion and exclusion criteria were identified, involving 323 patients with hyperpigmented scars treated with fat grafting. A significant difference in scar pigmentation was noted after treatment with fat grafting according to observers' ratings, with a SMD of − 1.09 [95% CI: − 1.32; − 0.85], p<0.01. The SMD for patient-reported scar pigmentation after treatment with fat grafting was − 0.99 [96% CI: − 1.31; − 0.66], p<0.01. Four studies provided objective measurements of melanin changes after fat grafting and revealed inconsistent findings compared to subjective observations. Conclusions: Fat grafting shows promise in ameliorating hyperpigmented scars based on subjective assessments, but further corroborating evidence from objective measures is required. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

The heightened public interest in and usage of non-invasive cosmetic procedures has translated to the practice of jawline and chin augmentation. Implants have historically been a cornerstone of chin augmentation; however, more recently, as non-invasive procedural techniques and modalities develop, questions have been raised as to whether there is still a need for implants. Francesca Ramadan explores the innovative options available to address even the most acute patient concerns. [ABSTRACT FROM AUTHOR]

Post-mastectomy pain syndrome (PMPS), characterized by persistent pain lasting at least three months following mastectomy, affects 20–50% of breast surgery patients, lacking effective treatment options. A review was conducted utilizing EMBASE, MEDLINE, and all evidence-based medicine reviews to evaluate the effect of fat grafting as a treatment option for PMPS from database inception to 29 April 2023 (PROSPERO ID: CRD42023422627). Nine studies and 812 patients in total were included in the review. The overall mean change in visual analog scale (VAS) was −3.6 in 285 patients following fat grafting and 0.5 in 147 control group patients. There was a significant reduction in VAS from baseline in the fat grafting group compared to the control group, n = 395, mean difference = −2.17 (95% CI, −2.95 to −1.39). This significant improvement was also noted in patients who underwent mastectomy without reconstruction. Common complications related to fat grafting include capsular contracture, seroma, hematoma, and infection. Surgeons should consider fat grafting as a treatment option for PMPS. However, future research is needed to substantiate this evidence and to identify timing, volume of fat grafting, and which patient cohort will benefit the most.

Mahmoud A Rageh,1 Shady Mahmoud Attia Ibrahim,1 Noha Abdallah,2 Abeer Attia Tawfik2 1Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 2Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Giza, EgyptCorrespondence: Mahmoud A Rageh, Department of Dermatology, Faculty of Medicine, Al-Azhar University, Al-Darrasah, Cairo, 11633, Egypt, Email dr.mahmoudrageh@gmail.comBackground: Atrophic acne scarring is a widely prevalent condition and one of the most distressing complications of acne vulgaris. Numerous options with variable outcomes are available for the treatment of acne scarring. Laser is considered a first‐line therapy for acne scars, and recently there has been a growing interest in using stem cells and their derivatives for treating acne scars. In addition, combined therapeutic modalities often achieve more satisfactory results than a single treatment.Objective: We tried to evaluate the role of nanofat and fractional CO2 laser as a combined treatment approach for atrophic acne scarring.Methods: Twenty-five patients with atrophic acne scarring were enrolled. They received a single session of intradermal nanofat injection, at different points 1 cm apart, for acne scars. Two weeks later, they were treated with three sessions of fractional CO2 laser at monthly intervals. Patients were evaluated three months after the last session using the quantitative Goodman and Baron scoring system. Pain, side effects, and patients’ satisfaction were also evaluated.Results: There were two males and 23 females with a mean age of 25.96 years. Their skin type ranged between Fitzpatrick skin type III, IV, and V. Boxcar scars were the most common scar type in 13 patients (52%). After treatment, there was a significant reduction (p < 0.05) in the quantitative Goodman and Baron scores. The improvement was more evident in rolling scars. Seven patients reported significant improvement, and 12 reported marked improvement.Conclusion: This study showed that combining nanofat and fractional CO2 laser is a safe and effective treatment modality for atrophic acne scars.Keywords: acne scars, fractional laser, fat grafting, nanofat

Introduction: Addressing post traumatic lower limb neuropathic pain is challenging across medical specialties. To address this potentially devastating condition, several invasive and non-invasive approaches have been proposed with inconsistent results. Adipose fat transfer (AFT), also known as fat grafting, is a regenerative medicine technique in which a patient's own fat is harvested from one area of the body (usually through liposuction) and then injected into another area for various purposes, such as aesthetic contour enhancement or reconstruction and regeneration of scarred tissues. Methods: We analyze the effects of fat grafting for neuropathic pain combined with neuroma excision (hybrid technique, hAFT) or alone (AFT). A retrospective review was conducted on 22 patients with neuropathic lower limb pain, after trauma or orthopedic surgery treated with hAFT (n = 9) or AFT (n = 13). Results: Reduction in VAS scale more than 50 % was observed in 6 patients (66 %) treated with hybrid technique and in eleven patients (85 %) treated with AFT alone. Among these, complete pain reduction (>91 %) was achieved in 33.3 % of hAFT and 54 % of AFT technique. A 3.2 points reduction in VAS was found in the hAFT group versus 5.8 points in the AFT group (p = 0.035). Conclusion: This pioneering use of AFT emerges as a minimally invasive breakthrough, promising significant improvement in reconstructing scarred subcutaneous tissue and managing neuropathic pain.

The unpredictable survival rate of autologous fat grafting (AFG) seriously affects its clinical application. Improving the survival rate of AFG has become an unresolved issue in plastic surgery. Peroxisome proliferator-activated receptor-γ (PPAR-γ) regulates the adipogenic differentiation of adipocytes, but the functional mechanism in AFG remains unclear. In this study, we established an animal model of AFG and demonstrated the superior therapeutic effect of PPAR-γ regulation in the process of AFG. From day 3 after fat grafting, the PPAR-γ agonist rosiglitazone group consistently showed better adipose integrity, fewer oil cysts, and fibrosis. Massive macrophage infiltration was observed after 7 days. At the same time, M2 macrophages begin to appear. At day 14, M2 macrophages gradually became the dominant cell population, which suppressed inflammation and promoted revascularization and fat regeneration. In addition, transcriptome sequencing showed that the differentially expressed genes in the Rosiglitazone group were associated with the pathways of adipose regeneration, differentiation, and angiogenesis; these results provide new ideas for clinical treatment. [ABSTRACT FROM AUTHOR]

Post-mastectomy pain syndrome (PMPS), characterized by persistent pain lasting at least three months following mastectomy, affects 20–50% of breast surgery patients, lacking effective treatment options. A review was conducted utilizing EMBASE, MEDLINE, and all evidence-based medicine reviews to evaluate the effect of fat grafting as a treatment option for PMPS from database inception to 29 April 2023 (PROSPERO ID: CRD42023422627). Nine studies and 812 patients in total were included in the review. The overall mean change in visual analog scale (VAS) was −3.6 in 285 patients following fat grafting and 0.5 in 147 control group patients. There was a significant reduction in VAS from baseline in the fat grafting group compared to the control group, n = 395, mean difference = −2.17 (95% CI, −2.95 to −1.39). This significant improvement was also noted in patients who underwent mastectomy without reconstruction. Common complications related to fat grafting include capsular contracture, seroma, hematoma, and infection. Surgeons should consider fat grafting as a treatment option for PMPS. However, future research is needed to substantiate this evidence and to identify timing, volume of fat grafting, and which patient cohort will benefit the most. [ABSTRACT FROM AUTHOR]

Backgrounds and Objective: During fat transplantation, adipose tissue is removed from the body and injected into different areas under the skin. The goal of this review article is to look into the efficacy and applicability of fat transplantation in regenerative medicine and rejuvenation, including Nanofat, Microfat, and Millifat. Methods: As a search strategy and study selection, we searched the PubMed and Medline databases until 2023 using related keywords (e.g., Nanofat, Microfat and Millifat, Regenerative Medicine, and Rejuvenation). Results: Autologous fat transplantation has no risk of an allergic reaction or rejection of the transplant by the individual. Autologous adipose tissue is considered an ideal filler for facial rejuvenation and is suggested as the most biocompatible and non‐immunogenic skin filler. Adipose tissue transplant may have semi‐permanent to permanent effects. According to recent reports, adipose tissues possess a high percentage of mature stem cells. The effect of regenerating adipose tissue and its intrinsic cells can be described as an obvious process. Variations in the sizes of adipose tissues can result in different results depending on the surgical site. Based on topographic assessment, graft fats are assigned depending on the anatomical locations and the size such as Millifat (2–2.5 mm), Microfat (1 mm), and Nanofat (500 μm or less). Conclusion: Some characteristics of fat tissue increase its effectiveness, such as increasing stem cells, growth factors, cytokines, and compounds effective in repair, regeneration, and rejuvenation. [ABSTRACT FROM AUTHOR]

Background: Since the 1980s, autologous fat grafting has been one of the most widely used methods in plastic surgery to treat volume and contour problems. There are many advantages of autologous fat, i.e., it is cheap, biocompatible, and readily available autologous tissue in large quantities, minimal morbidity. Objective was to compare the outcomes of fat grafting combined with STSGs and STSGs alone in patients with chronic non-healing wounds presenting at a tertiary care hospital. Methods: It was a prospective cohort study carried out at the Department of plastic surgery, Civil hospital Karachi, Pakistan from 11th April to 12th October 2023. Patients aged 18-60 years with chronic non-healing wounds due to burn, trauma, or infection lasting at least six weeks were included. Group A received fat grafting followed by STSGs, while Group B received STSGs alone. Follow-up for both groups continued for 4-5 weeks, focusing on graft uptake and healing, with successful graft take defined as wound healing upon clinical examination. Data was analyzed by SPSS version 25. Results: Overall, the mean age of the patients was 36.47±8.57 years. In Group A, the median width was 8.00 cm, and in Group B, it was 7.00 cm, this difference was statistically significant (p=0.005). The proportion of healing in group A was significantly higher as compared to group B (66.7% vs 30%, (p=0.001). The odds of wound healing were 0.21 times lower in group B as compared to group A (95% CI=0.07 to 0.63). After adjusting for duration and width of wound, the odds of wound healing in group B remains significantly lower as compared to odds of wound healing in group A (OR=0.13, 95% CI=0.03 to 0.54). Conclusion: The combination of fat grafting with split-thickness skin grafts holds promising result for improved wound healing in patients with chronic non-healing wounds. [ABSTRACT FROM AUTHOR]

Purpose: Fat grafting to the breast for aesthetic indications has become increasingly popular. Herein, methods, aesthetic outcomes, and complications are reviewed in a retrospective case series. Methods: Female patients (n=165) with an average age of 45 years (range: 17–78 years) who underwent fat grafting to breast were evaluated. Demographic parameters, the type of procedure, the amount of fat transferred, the site(s) of fat harvest, operative times, and the patient's postoperative recovery and outcomes were recorded. Results: Of the 165 patients, 105 had breast augmentation with fat only. Of these 105 patients, 14(8%) had implant removal with and without capsulectomy, and 61(37%) had mastopexies. Composite augmentation was performed in the remaining 60 patients. The average amount of fat used was 208 cc (range: 10 to 945 cc) per breast. Forty-five patients (27%) underwent a second procedure. Of the 165 patients, 37(22%) had adverse events unrelated to the fat graft, including suture abscesses, scarring, and minor incision cite skin breakdown. Four patients (2.4%) had a complication related to fat grafting including 'lump' formation between the breast, abnormal mammograms, and the need for simple aspiration of a lipid cyst. Conclusions: Autologous fat grafting should be considered for both primary and secondary aesthetic breast surgery to enhance outcomes. Complications related to fat grafting are uncommon. Revisional and secondary surgeries may be needed to achieve the desired outcome. Power-assisted liposuction, with vibratory infiltration of the tumescent solution, auto-infusion of fat, and Expansion Vibration Lipofilling using a closed system has become our preferred technique. Fat grafting to breast can be considered for both primary and secondary aesthetic breast surgery Complications related to fat grafting are uncommon There does not appear to be an overall increase in complications of associated mastopexy and composite augmentation Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: The popularity of gluteal augmentation has surged in recent decades, primarily due to satisfactory aesthetic results. Objectives: The primary goal of this retrospective analysis was to present the key characteristics of a large patient cohort from Europe, comprising 185 female patients who underwent gluteal augmentation with ultrasound-guided fat grafting. Methods: A retrospective analysis was conducted on 185 female patients who underwent gluteal augmentation with ultrasonic liposuction and fat grafting from February 2020 to July 2023. The procedures were performed in accordance with the latest safety recommendations. Results: Information concerning the patient demographic, volume of fat graft, and complications was analyzed. Additionally, patient satisfaction was evaluated through a questionnaire. The mean Body Mass Index (BMI) of the patients was 23.00 kg/m2 (SD = 2.62). Furthermore, the volume of transferred fat graft ranged from 500.00 mL to 800.00 mL, with a mean of 596.75 mL (SD = 67.29). The most frequent complication was the formation of seroma (5.41%). All complications were treated successfully. Conclusions: Using ultrasonic liposuction and ultrasound-guided fat grafting to enhance buttock contours is a reliable technique. Nevertheless, it is crucial to exert caution and take all necessary steps to reduce the risk of potentially life-threatening complications. [ABSTRACT FROM AUTHOR]

Skin scarring and fibrosis affect millions of people worldwide, representing a serious clinical problem causing physical and psychological challenges for patients. Stem cell therapy and regenerative surgery represent a new area of treatment focused on promoting the body's natural ability to repair damaged tissue. Adipose-derived stem cells (ASCs) represent an optimal choice for practical regenerative medicine due to their abundance, autologous tissue origin, non-immunogenicity, and ease of access with minimal morbidity for patients. This review of the literature explores the current body of evidence around the use of ASCs-based regenerative strategies for the treatment of scarring and skin fibrosis, exploring the different surgical approaches and their application in multiple fibrotic skin conditions. Human, animal, and in vitro studies demonstrate that ASCs present potentialities in modifying scar tissue and fibrosis by suppressing extracellular matrix (ECM) synthesis and promoting the degradation of their constituents. Through softening skin fibrosis, function and overall quality of life may be considerably enhanced in different patient cohorts presenting with scar-related symptoms. The use of stem cell therapies for skin scar repair and regeneration represents a paradigm shift, offering potential alternative therapeutic avenues for fibrosis, a condition that currently lacks a cure. [ABSTRACT FROM AUTHOR]

The fat-augmented latissimus dorsi (FALD) flap is an evolution of the traditional latissimus dorsi (LD) flap, which allows to obtain a total autologous breast reconstruction (BR) avoiding the use of breast implants. The aim of this study was to develop a predictive preoperative formula in order to estimate and optimize the amount of fat to be transferred during FALD flap BR, using only anthropometric measurements. We conducted a prospective clinical study between September 2020 and April 2023. All patients underwent back pre-operative ultrasound scan to assess the subcutaneous skin paddle thickness (SPT) and a regression analysis was performed to evaluate which anthropometric variable had a better correlation with this thickness. Data from 66 FALD flaps were collected. The mean SPT was 11.95 mm (SD 4.56). A significant correlation between SPT and body mass index (BMI) was found (r = 0.640, p < 0.0001). Using the fat-to-capacity ratio (113%), the following formula (the FALD-V) was developed to predict the needed fat transfer into FALD flap: [−509 + 12.32 × BMI + 11.71 × skin paddle width + 17.43 × skin paddle height] × 1.13. The considered variables (BMI, skin paddle width and skin paddle height) were statistically significant (p < 0.001, p = 0.0483, p = 0.0154, respectively). The cross-validation confirmed the accuracy of the formula (r = 0.810). The FALD-V can be used as an innovative complimentary device in the planning of FALD flap one-stage total autologous BR. To enhance its application, a 3.0 WebApp at www.braflap.com (and www.breast-v.com) is available free of charge for both iOS and Android devices. II [ABSTRACT FROM AUTHOR]

Implant-based breast reconstruction (IBBR) is the most frequently performed procedure for breast reconstruction following mastectomy, which involves the surgical placement of breast implants. The approach to breast reconstruction can be divided into two main categories, namely prepectoral breast reconstruction (PPBR) and subpectoral breast reconstruction (SPBR), based on the implant plan and placement technique. In recent years, there has been a significant surge in the popularity of prepectoral implant-based breast reconstruction, where the implants are positioned above the chest muscle, as opposed to beneath it in the subpectoral approach. However, despite this growing preference, there is a lack of comprehensive data regarding the national trends in the utilization of this technique, thus necessitating further investigation. This narrative review aims to ascertain the current global patterns linked to prepectoral breast reconstruction and elucidate the considerations surrounding patient and implant selection, reconstructive techniques, the utilization of meshes in prepectoral reconstruction, the ensuing outcomes and complications, the ramifications of radiotherapy, and the potential advantages of integrating fat infiltration into the implementation of this technique in breast reconstruction with a focus on published papers in last five years. Conclusion: Prepectoral breast reconstruction has emerged as an appropriate surgical option for individuals seeking breast reconstruction. This development can be attributed to the recent progress made in implant technology, which has significantly enhanced the outcomes of this procedure. Additionally, advancements in mastectomy techniques, autologous fat grafting, and the use of acellular dermal matrices (ADMs) have also played a vital role in improving the aesthetic results of prepectoral breast reconstruction. As a result, the significance and effectiveness of this technique in the field of breast reconstruction have been firmly established, making it an essential component of the overall armamentarium available to plastic surgeons for breast reconstruction purposes. [ABSTRACT FROM AUTHOR]

Background: Measuring satisfaction with aesthetic treatment and health related quality of life of patients has become one of the indicators of the success of aesthetic interventions. Therefore, the aim of our study was to examine and compare the satisfaction of patients and surgeons with combined Aptos thread lifting treatment, fat grafting and laser treatment. Methods: In total, 48 patients underwent a combination Aptos thread lifting, fat grafting and laser treatment from August 2020 to august 2021. The outcome of treatment was assessed using the Global Scale of Aesthetic Improvement, both subjectively (patient satisfaction assessments) and objectively (blind surgeons assessments). Results: The study included 48 respondents, with an average age of 51.8 years, of whom 90% were women. The average intervention time was 66 min. Patient satisfaction was highest in the first month after treatment (mean, 4.7/5.0), and consequently tends to decline up to 1 year after treatment (3.8/5.0). The trend of the results on the objective assessment was stable during the entire follow-up period (4.5/5.0 after first month; 4.1/5.0 after one year). Conclusion: Our results show what is the key period when the patient has a subjective need to request reintervention. The duty of the aesthetic physician is to help the patient understand and choose the most appropriate evidence-based rejuvenation treatment. Level of evidence IV: Level of evidence IV Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]