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Lipofilling Enriched with Adipose-Derived Mesenchymal Stem Cells Improves Soft Tissue Deformities and Reduces Scar Pigmentation: Clinical and Instrumental Evaluation in Plastic Surgery

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  • Fat Injection
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Abstract

Background

Scars and soft tissue deformities (S-STDs), often resulting from hemifacial atrophy, trauma, and outcomes of burns, were usually associated with hyperpigmentation of overlying skin.

Objectives

This study aimed to evaluate the long-term effects of fat grafting commonly called “Lipofilling” enhanced with adipose-derived mesenchymal stem cells (Lipofilling-AD-MSCs) for treating S-STDs with pigmentary changes.

Methods

A cohort study has been performed. 50 patients affected by S-STDs with hyperpigmentation treated with Lipofilling-AD-MSCs and 50 patients treated with Lipofilling not enhanced (Lipofilling-NE) were prospectively assessed. The pre-op evaluation included a clinical evaluation, a photographic assessment, magnetic resonance imaging, and ultrasound. Post-op follow-up was performed at 1, 3, 7, 12, 24, 48, weeks, and then annually.

Results

Improvement in volume contours and pigmentation was clinically assessed. All people who underwent the treatments (Lipofilling-AD-MSCs and Lipofilling-NE) were satisfied with the improving pigmentation, texture, and volume contours with some differences. However, the results reported displaying a better trend in patients treated with Lipofilling-AD-MSCs to be more satisfied than patients treated with Lipofilling-NE (p < 0.0001).

Conclusions

In conclusion, Lipofilling-AD-MSCs was the preferred option for improving the contour deformities related to increased pigmentation of scars.

Level of Evidence IV

Evidence obtained from cohort studies.

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References

  1. Grimaldi M, Gentile P, Labardi L, Silvi E, Trimarco A, Cervelli V (2008) Lipostructure technique in Romberg syndrome. J Craniofac Surg 19:1089–1091

    Article  PubMed  Google Scholar 

  2. Cervelli V, Gentile P (2009) Use of cell fat mixed with platelet gel in progressive hemifacial atrophy. Aesthetic Plast Surg 33:22–27

    Article  CAS  PubMed  Google Scholar 

  3. Cervelli V, Gentile P, Spallone D, Nicoli F, Verardi S, Petrocelli M, Balzani A (2010) Ultrapulsed fractional CO2 laser for the treatment of post-traumatic and pathological scars. J Drugs Dermatol 9:1328–1331

    PubMed  Google Scholar 

  4. Gentile P, De Angelis B, Pasin M, Cervelli G, Curcio CB, Floris M, Di Pasquali C, Bocchini I, Balzani A, Nicoli F, Insalaco C, Tati E, Lucarini L, Palla L, Pascali M, De Logu P, Di Segni C, Bottini DJ, Cervelli V (2014) Adipose-derived stromal vascular fraction cells and platelet-rich plasma: basic and clinical evaluation for cell-based therapies in patients with scars on the face. J Craniofac Surg 25:267–272

    Article  PubMed  Google Scholar 

  5. Carnio J, Camargo PM, Chen JW, Leung HY, Pirih FQ (2018) The modified apically repositioned flap technique and its potential to regain gingival melanin pigmentation. Clin Adv Periodontics 8:92–96

    Article  Google Scholar 

  6. Larrabee Y, Jowett N (2021) Fillers, Botulinum toxin, mid-facial implants, and tissue expansion. Facial plastic and reconstructive surgery. Springer, Cham, pp 299–320

    Chapter  Google Scholar 

  7. Boen M, Wilson MJV, Wu DC, Goldman MP (2019) Laser depigmentation in extensive vitiligo. Dermatol Surg 45:621–623

    Article  CAS  PubMed  Google Scholar 

  8. Budania A, Mandal S, Pathania YS, Lahoria U, Khan MA, Puri I, Mishra R (2021) Comparing novel versus conventional technique of platelet-rich plasma therapy in periorbital hyperpigmentation: a randomized prospective split-face study. J Cosmet Dermatol 20:3245–3252

    Article  PubMed  Google Scholar 

  9. Uysal CA, Ertas NM (2017) Platelet-rich plasma increases pigmentation. J Craniofac Surg 28:e793

    Article  PubMed  Google Scholar 

  10. Egro FM, Coleman SR (2019) Facial fat grafting fat grafting to the face for rejuvenation, contouring, or regenerative surgery. An Issue Clin Plast Surg E-Book 47:1

    Google Scholar 

  11. Schultz KP, Raghuram A, Davis MJ, Abu-Ghname A, Chamata E, Rohrich RJ (2020) Fat grafting in plastic surgery: fat grafting for facial rejuvenation. Semin Plastic Surg 34:30–37

    Article  Google Scholar 

  12. Fontes T, Brandão I, Negrão R, Martins MJ, Monteiro R (2018) Autologous fat grafting: harvesting techniques. Ann Med Surg 36:212–218

    Article  Google Scholar 

  13. Xie Y, Huang R-L, Wang W, Cheng C, Li Q (2019) Fat grafting for facial contouring (temporal region and midface). Fat grafting to the face for rejuvenation, contouring, or regenerative surgery. Clin Plast Surg E-Book 47:81

    Article  Google Scholar 

  14. Borrelli MR, Patel RA, Sokol J, Nguyen D, Momeni A, Longaker MT et al (2019) Fat chance: the rejuvenation of irradiated skin. Plast Reconstr Surg Global Open 7(2):e2092

    Article  Google Scholar 

  15. Yin Y, Li J, Li Q, Zhang A, Jin P (2020) Autologous fat graft assisted by stromal vascular fraction improves facial skin quality: a randomized controlled trial. J Plast Reconstr Aesthet Surg 73:1166–1173

    Article  PubMed  Google Scholar 

  16. Schuklenk U, Ashcroft R (2000) International research ethics. Bioethics 14:158–172

    Article  CAS  PubMed  Google Scholar 

  17. Von Elm E, Altman DG, Egger M et al (2008) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349

    Article  Google Scholar 

  18. Balaratnasingam C, Messinger JD, Sloan KR, Yannuzzi LA, Freund KB, Curcio CA (2017) Histologic and optical coherence tomographic correlates in drusenoid pigment epithelium detachment in age-related macular degeneration. Ophthalmology 124:644–656

    Article  PubMed  Google Scholar 

  19. Gentile P, De Angelis B, Di Pietro V et al (2018) Gentle is better: the original “Gentle Technique” for fat placement in breast Lipofilling. J Cutan Aesthet Surg 11:120–126

    Article  PubMed  PubMed Central  Google Scholar 

  20. Oranges CM, Striebel J, Tremp M, Madduri S, Kalbermatten DF, Harder Y et al (2019) The preparation of the recipient site in fat grafting: a comprehensive review of the preclinical evidence. Plast Reconstr Surg 143:1099–1107

    Article  CAS  PubMed  Google Scholar 

  21. Al-Chalabi NJA, Al-Quisi AF, Lateef TA (2018) Single session facial lipostructure by using autologous fat mixed with platelet-rich fibrin injected by using facial autologous muscular injection technique. J Craniofacial Surg 29:e267–e271

    Article  Google Scholar 

  22. Chopan M, White JA, Sayadi LR, Buchanan PJ, Katz AJ (2019) Autogenous fat grafting to the breast and gluteal regions: safety profile including risks and complications. Plast Reconstr Surg 143:1625–1632

    Article  CAS  PubMed  Google Scholar 

  23. Gentile P, Piccinno MS, Calabrese C (2019) Characteristics and potentiality of human adipose-derived stem cells (hASCs) obtained from enzymatic digestion of fat graft. Cells 8:282

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Gontijo-de-Amorim NF, Charles-de-Sá L, Rigotti G (2017) Mechanical supplementation with the stromal vascular fraction yields improved volume retention in facial Lipotransfer: A 1-year comparative study. Aesthet Surg J 37:975–985

    Article  PubMed  Google Scholar 

  25. Tissiani LA, Alonso N (2016) A prospective and controlled clinical trial on stromal vascular fraction enriched fat grafts in secondary breast reconstruction. Stem Cells Int 2016:2636454

    Article  CAS  PubMed  Google Scholar 

  26. Gentile P, Kothari A, Casella D, Calabrese C (2020) Fat graft enhanced with adipose-derived stem cells in aesthetic breast augmentation: clinical, histological, and instrumental evaluation. Aesthet Surg J 40:962–977

    Article  PubMed  Google Scholar 

  27. Gentile P (2021) Breast silicone gel implants versus autologous fat grafting: biomaterials and bioactive materials in comparison. J Clin Med 10:3310

    Article  PubMed  PubMed Central  Google Scholar 

  28. Gentile P, Sterodimas A, Pizzicannella J, Dionisi L, De Fazio D, Calabrese C, Garcovich S (2020) Systematic review: allogenic use of stromal vascular fraction (SVF) and Decellularized extracellular matrices (ECM) as advanced therapy medicinal products (ATMP) in tissue regeneration. Int J Mol Sci 21:4982

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Cohen SR, Wesson J, Willens S, Nadeau T, Hillman C, Dobke M, Tiryaki T (2022) Standardized anatomic and regenerative facial fat grafting: objective photometric evaluation 1 to 19 months after injectable tissue replacement and regeneration. Aesthet Surg J 42(4):327–339

    Article  PubMed  Google Scholar 

  30. Mailey B, Saba S, Baker J, Tokin C, Hickey S, Wong R, Wallace AM, Cohen SR (2013) A comparison of cell-enriched fat transfer to conventional fat grafting after aesthetic procedures using a patient satisfaction survey. Ann Plast Surg 70(4):410–415

    Article  CAS  PubMed  Google Scholar 

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Funding

The author received no financial support for this article’s research, authorship, and publication.

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Authors and Affiliations

  1. Associate Professor of Plastic and Reconstructive Surgery, Department of Surgical Science, “Tor Vergata” University, 00173, Via Montpellier 1, 00133, Rome, Italy

    Pietro Gentile

  2. Scientific Director of Academy of International Regenerative Medicine and Surgery Societies (AIRMESS), 1201, Geneva, Switzerland

    Pietro Gentile

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  1. Pietro Gentile
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Contributions

PG designed the studies, performed the procedures, analyzed the results, wrote the paper, wrote an editing review, dealt with methodology and validation, performed the data analysis, and conducted the study as the leader.

Corresponding author

Correspondence to Pietro Gentile.

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Conflict of interest

The author declared no potential conflicts of interest concerning the research, authorship, and publication of this article.

Ethical Approval

The protocols adopted were performed following the European rules (1394/2007 EC) and EMA/CAT recommendations (20 June 2014 EMA/CAT/600280/2010 Rev 1). This paper has been the object of a research contract between the author P.G. and the “Tor Vergata” University, approved by Rectoral Decree R.D n. #1467/2017, continued in associate professor contract #13489/2021.

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Gentile, P. Lipofilling Enriched with Adipose-Derived Mesenchymal Stem Cells Improves Soft Tissue Deformities and Reduces Scar Pigmentation: Clinical and Instrumental Evaluation in Plastic Surgery. Aesth Plast Surg 47, 2063–2073 (2023). https://doi.org/10.1007/s00266-023-03325-y

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  • DOI: https://doi.org/10.1007/s00266-023-03325-y

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