Skip to main content

Advertisement

SpringerLink
Log in

Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction

  • Original Article
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Despite civilization and progress, burns occur frequently in the world. Remarkable discoveries of wound healing mechanisms have been reported. On the other hand, long-term outcomes from burn injuries represent a barrier to improvement of patients’ social, functional, and psychological condition. Lipofilling, described since the 1980s, currently is used for several clinical applications. This study aimed to verify whether lipofilling could ameliorate scar remodeling in three clinical cases.

Methods

Three adult patients with hemifacial hypertrophic scars and keloids resulting from severe burns 2 to 13 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman’s technique. Two injections (with a 13-month interval between) were administered at the dermohypodermal junction. Histologic examination of scar tissue punch biopsies (hematoxylin-eosin staining) before and after the treatment was performed as well as magnetic resonance scan with contrast.

Results

The clinical appearance and subjective patient feelings after a 6-month follow-up period suggest considerable improvement in the mimic features, skin texture, and thickness. Histologic examination shows patterns of new collagen deposition, local hypervascularity, and dermal hyperplasia in the context of new tissue, with high correspondence to the original.

Conclusions

The preliminary results show that lipofilling improves scar quality and suggest a tissue regeneration enhancing process.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Alster CS, Williams CM (1995) Treatment of keloid sternotomy scars by the 585-nm flashlamp-pumped pulsed-dye laser. Lancet 345:1198–1200

    Article  PubMed  CAS  Google Scholar 

  2. Billings E Jr, May JW Jr (1989) Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg 83:368–381

    Article  PubMed  Google Scholar 

  3. Boyadjiev C, Popchristova E, Mazgalova J (1995) Histomorphologic changes in keloids treated with Kenacort. J Trauma 38:299–302

    Article  PubMed  CAS  Google Scholar 

  4. Carney SA, Cason CG, Gowar JP, Stevenson JH, McNee J, Groves AR, Thomas SS, Hart NB, Auclair P (1995) Cica-Care gel sheeting in the management of hypertrophic scarring. Burns 20:163–167

    Article  Google Scholar 

  5. Carr-Collins JA (1992) Pressure techniques for the prevention of hypertrophic scar. Clin Plast Surg 19:733–743

    PubMed  CAS  Google Scholar 

  6. Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367

    PubMed  CAS  Google Scholar 

  7. Coleman SR (1995) Long-term survival of fat transplants: Controlled demonstrations. Aesth Plast Surg 19:421–425

    Article  CAS  Google Scholar 

  8. De Ugarte DA, Ashjian PH, Elbarbary A, Hedrick MH (2003) Future of fat as raw material for tissue regeneration. Ann Plast Surg 50:215–219

    Article  PubMed  Google Scholar 

  9. Ellenbogen R (2000) Fat transfer: Current use in practice. Clin Plast Surg 27:545–556

    PubMed  CAS  Google Scholar 

  10. Ersek RA (1991) Tranplantation of purified autologous fat: A 3-year follow-up is disappointing. Plast Reconstr Surg 87:219–227

    Article  PubMed  CAS  Google Scholar 

  11. Gibran NS, Heimbach DM (2000) Current status of burn wound pathophysiology. Clin Plast Surg 27:11–22

    PubMed  CAS  Google Scholar 

  12. Harrop AR, Ghahary A, Scott PG, Forsyth N, Uji-Friedland A, Tredget EE (1995) Regulation of collagen synthesis and mRNA expression in normal and hypertrophic scar fibroblasts in vitro by interferon-gamma. J Surg Res 58:471–477

    Article  PubMed  CAS  Google Scholar 

  13. Horl HW, Feller AM, Biemer E 1991 Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging. Ann Plast Surg 26:248–258

    PubMed  CAS  Google Scholar 

  14. Kesselring UK (1983) Regional fat aspiration for body contouring. Plast Reconstr Surg 72:610–619

    Article  PubMed  CAS  Google Scholar 

  15. Illouz YG (1983) Body contouring by lipolysis: A 5-year experience with over 3,000 cases. Plast Reconstr Surg 72:591–597

    Article  PubMed  CAS  Google Scholar 

  16. Illouz YG (1988) Present results of fat injection. Aesth Plast Surg 12:175–181

    Article  CAS  Google Scholar 

  17. Lawrence WT (1991) In search of the optimal treatment of keloids: Report of a series and review of the literature. Ann Plast Surg 27:164–178

    Article  PubMed  CAS  Google Scholar 

  18. Mojallal A, Foyatier JL (2004) Historical review of the use of adipose tissue transfer in plastic and reconstructive surgery. Ann Chir Plast Esthét 49:419–425

    Article  PubMed  CAS  Google Scholar 

  19. Neuber GA (1893) Fettransplantation. Langenbecks Arch Klin Chir Ver Dtsch Z Chir 22:66

    Google Scholar 

  20. Norris JE (1995) Superficial x-ray therapy in keloid management: A retrospective study of 24 cases and literature review. Plast Reconstr Surg 95:1051–1055

    Article  PubMed  CAS  Google Scholar 

  21. Rigotti G, Marchi A, Galie M, Baroni G, Benati D, Krampera M, Pasini A, Sbarbati A (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: A healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 119:1409–1422

    Article  PubMed  CAS  Google Scholar 

  22. Tholpady SS, Llull R, Ogle RC, Rubin JP, Futrell JW, Katz AJ (2006) Adipose tissue: Stem cells and beyond. Clin Plast Surg 33:55–62

    Article  PubMed  Google Scholar 

  23. Von Heimburg D, Pallua N (2001) Two-year histological outcome of facial lipofilling. Ann Plast Surg 46:644–646

    Article  Google Scholar 

  24. Von Heimburg D, Hemmrich K, Haydarlioglu S, Staiger H, Pallua N (2004) Comparison of viable cell yield from excised versus aspirated adipose tissue. Cells Tissues Organs 178:87–92

    Article  Google Scholar 

  25. Yowler CJ, Fratianne RB (2000) Current status of burn resuscitation. Clin Plast Surg 27:1–10

    PubMed  CAS  Google Scholar 

  26. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH (2001) Multilineage cells from human adipose tissue: Implications for cell-based therapies. Tissue Eng 7:211–228

    Article  PubMed  CAS  Google Scholar 

  27. Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295

    Article  PubMed  CAS  Google Scholar 

  28. Brzoska M, Geiger H, Gauer S, Baer P (2005) Epithelial differentiation of human adipose tissue-derived adult stem cells. Biochem Biophys Res Comm 330:142–150

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Daniel Levi, Paolo Gaetani, Luca Di Tommaso, and Silvio Veronese for their significant contribution to our research.

Author information

Authors and Affiliations

  1. Università degli Studi di Milano, Istituto di Chirurgia Plastica, Unità Operativa di Chirurgia Plastica, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089, Rozzano, Italy

    M. Klinger

  2. Centro di Riferimento Regionale Colture Cellulari, Ospedale Niguarda “Ca’ Granda”, Milano, Italy

    M. Marazzi

  3. Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Università degli Studi di Milano, Milano, Italy

    D. Vigo

  4. Dipartimento di Chimica Farmaceutica, Università degli Studi di Pavia, Pavia, Italy

    M. Torre

Authors
  1. M. Klinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Marazzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Vigo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Torre
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Klinger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Klinger, M., Marazzi, M., Vigo, D. et al. Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction. Aesth Plast Surg 32, 465–469 (2008). https://doi.org/10.1007/s00266-008-9122-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-008-9122-1

Keywords

Search

Navigation