Regen Fat Code: A Standardized Protocol for Facial Volumetry and Rejuvenation

Abstract Background Facial aging is a degenerative process that impairs contour and angle prominences. Rejuvenation is based on tissue replacement, volumization of the atrophic areas, improvement of flaccidity and cutaneous photoaging. Objectives The study aims to apply structural fat grafting to manage volumetric deficits of the face, following a new systematic protocol called “Regen Fat Code” (RF Code); created to standardize the structural lipotransfer methods. Methods This is a prospective clinical trial involving 80 healthy candidates for facial rejuvenation that were split into two groups. Group A underwent only structural lipotransfer and Group B was submitted to replacement of deep facial structures by face lifting plus structural lipotransfer. Structural lipotransfer followed the protocol “RF Code” and 3 clinical tools were adopted for facial volumetric analysis pre and postoperatively. Results Total Volume (ml) of lipotransfer in group A and B per area ranged between 1-20 ml (vol mean=12 ml; SD: 5): Nasolabial Fold (vol mean=3.32 ml - SD:0.92); Superior Lip (vol mean= 2.0 - SD: 0.62); Inferior Lip (vol mean= 2.76 - SD:0.71); Malar (vol mean= 8.51- SD:5.25), Inferior Eyelid (vol mean= 1.2 ml – SD: 0.54) and Chin (vol meas=7.18 ml – SD:1.99). Areas with less mobility showed a lower absorption index than dynamic areas. Conclusions The development of the present guide protocol demonstrated the potential of grouping many parameters based on the lipotransfer method to volumize and regenerate atrophic areas of the face. Easy to apply, allowed the proposition of different volumizing and regenerative effects, according to the surgical area’s demands.

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Fat Grafting for Facial Rejuvenation

Seminars in Plastic Surgery ◽

10.1055/s-0039-3402767 ◽

2020 ◽

Vol 34 (01) ◽

pp. 030-037 ◽

Cited By ~ 4

Author(s):

Kelly P. Schultz ◽

Anjali Raghuram ◽

Matthew J. Davis ◽

Amjed Abu-Ghname ◽

Edward Chamata ◽

...

Keyword(s):

Fat Grafting ◽

Facial Rejuvenation ◽

Nasolabial Fold ◽

Volume Depletion ◽

Systematic Method ◽

Face Lift ◽

Facial Aging ◽

Native Tissue ◽

The Face ◽

Injectable Fillers

AbstractFor optimal results, facial rejuvenation procedures should address both the tissue laxity and volume deflation associated with facial aging. The lift-and-fill face lift, in which fat grafting provides volumetric rejuvenation to the face while surgical lift effectively repositions and removes ptotic and redundant tissue, has revolutionized the plastic surgeon's approach to the aged face. An understanding of the intricate anatomy of distinct facial fat compartments and a systematic method to assess areas of fat atrophy and volume depletion are keys to provide patients with a natural and youthful result. Fat grafting may be used to improve contour in any area treatable by nonautologous injectable fillers, including the temples, forehead, upper and lower orbit, cheeks, perioral region, nasolabial fold, jawline, and chin—with the benefit of a more natural contour and integration with native tissue.

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A Mixed Method Study to Explore the Feasibility and Patient Satisfaction of Two Different Exercise Programs in Systemic Sclerosis Associated Microstomia

10.21203/rs.3.rs-100072/v1 ◽

2020 ◽

Author(s):

Ellinor Sydow ◽

Sabien Severi ◽

Kristien Van der Elst ◽

Patrick Verschueren ◽

René Westhovens ◽

...

Keyword(s):

Patient Satisfaction ◽

Systemic Sclerosis ◽

Mixed Method ◽

Mixed Method Study ◽

Exercise Programs ◽

Post Intervention ◽

Oral Aperture ◽

The Face ◽

Group A ◽

Group B

Abstract BackgroundSystemic sclerosis (SSc) is a severe autoimmune disease often leading to fibrotic cutaneous involvement of the face. Reduced oral aperture is associated with impaired food intake, oral hygiene and secondary dental problems. Stretching and oral augmentation exercises can increase oral aperture but are often hampered by low adherence rates. The aim of this mixed method study was to explore feasibility, patient satisfaction and effectiveness of two exercise programs in SSc-associated microstomia.MethodsAdult patients (<18 years) suffering from systemic sclerosis (fulfilling the ACR/EULAR 2013 criteria) and microstomia (maximal oral aperture <40mm) were randomized to two groups. Group A exercised with a passive jaw motion device (Therabiteâ), and Group B performed mouth-stretching exercises. Patients were expected to exercise for 10 minutes, 3 times/day for 3 months, completed an exercise diary and were contacted 4 times by telephone. Patients were evaluated at baseline, 3 months (period without intervention), 6 months (after 3 months of intervention) and at 9 months (post-intervention visit). At month 6 semi-structured one‐to‐one interviews were conducted, recorded, transcribed verbatim and analyzed using Qualitative Analysis Guide of Leuven (QUAGOL).ResultsWe included 6 women and 3 men, median age 60 years (range 40-75) and median disease duration 8 years (range 3-22). At 6 months, all patients in group A (n=4) and 4 in group B (n=5) improved with a median of 9mm (range 2-10) and 7mm (range 4-11), respectively. The proportion of executed to the planned number of exercises ranged between 63.7% and 98,9% in group A and between 48.5% and 97,4% in group B. Maintenance of the increase in oral aperture was noted in patients that continued to exercise daily. All 9 patients attended the interview that revealed three themes: drivers, challenges and perceived improvement. ConclusionBoth interventions improve maximal oral aperture. The adherence to therapy was high but none of the patients considered it feasible to continue practicing 3 times/day. Future studies are needed in order to define feasible long-term exercise programs.

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Silicone Implant Versus Silicone Implant Assisted by Stromal Enriched Lipograft Breast Augmentation: A Prospective Comparative Study

Medicines ◽

10.3390/medicines7050028 ◽

2020 ◽

Vol 7 (5) ◽

pp. 28

Author(s):

Aris Sterodimas

Keyword(s):

Patient Satisfaction ◽

Breast Augmentation ◽

Fat Grafting ◽

Silicone Implant ◽

Silicone Implants ◽

Complication Rates ◽

High Profile ◽

Group A ◽

Group B ◽

Age Range

Background: Implant-assisted breast augmentation is among the most performed surgeries performed by plastic surgeons today. This prospective study evaluated the patient satisfaction and complication rates using high-profile round silicone implant alone (traditional breast augmentation) Group A versus the high-profile round silicone implant assisted with stromal enriched lipograft (composite breast augmentation) Group B. Methods: A total of 50 female patient candidates to undergo breast augmentation between January to September 2017 were randomly assigned to either group. The periareolar technique for breast augmentation and the subfascial plane were used in both groups for the insertion of the high-profile round silicone implants. The stromal enriched lipograft (SEL) was used in Group B for the preparation of the autologous fat grafting to the breast. The satisfaction of each patient with body appearance following breast augmentation was rated using an already published scale of 1–5. The rate of complications was analysed. Results: AS performed all the surgeries. In Group A, the age range was between 19 and 48 years (mean of 22.5 years). In Group B, the age range was between 20 and 47 years (mean of 24.1 years). The average BMI of Group A was 24 m/kg2 and 23 m/kg2 of Group B. Patient satisfaction meta-analysis for Group A and B at 12 months shows that patients in Group B expressed a satisfaction that is superior when compared to Group A patients. The ability to camouflage the implant could explain the higher satisfaction rates in Group B. The rate of complications appears similar in both groups. Conclusions: Composite breast augmentation using a combination of round high-profile implants and SEL in breast augmentation can achieve a higher patient satisfaction and aesthetic outcome as compared to the round high-profile breast augmentation alone. The technique is safe, simple and fast with low complication rates. Large multicentre, controlled, prospective studies need to be performed to further confirm the favourable results that were observed in this study.

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Is Volume Retention of the Breast Affected by Menstrual Cycle Phase at the Time of Autologous Fat Grafting?

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa006 ◽

2020 ◽

Vol 40 (12) ◽

pp. 1301-1308

Author(s):

Keke Wang ◽

Dali Mu ◽

Xiaoyu Zhang ◽

Yan Lin

Keyword(s):

Menstrual Cycle ◽

Breast Augmentation ◽

Retention Rate ◽

Fat Grafting ◽

Retention Rates ◽

Autologous Fat ◽

Group A ◽

Group B ◽

Fat Volume ◽

Volume Retention

Abstract Background Autologous fat grafts are commonly employed in plastic surgery, especially for aesthetic breast augmentation. However, it is difficult to predict the postoperative fat volume retention rate. Objectives The authors conducted a retrospective study comparing the fat volume retention rates of breast lipoaugmentation performed during different phases of the menstrual cycle. Methods The study included patients who underwent autologous fat grafting (AFG) breast augmentation from January 2012 to December 2018. Forty-eight individuals (94 breasts) were separated into 3 groups according to their menstrual stage: Group A: 10 patients (18 breasts); follicular group (end of menstruation to approximately 10 days); Group B: 15 patients (30 breasts); ovulatory group (11-17 days); Group C: 23 patients (46 breasts); luteal group (approximately 18 days to the next menstrual cramps). Results Mean age, menarche age, menstrual cycle, menstruation, and body mass index were comparable among the groups (P > 0.05). Patients with a history of lactation were comparable among the groups (Group A, 50%; Group B, 53.33%; Group C, 43.48%, P > 0.05). The overall volume retention rate of patients who underwent AFG during ovulation was significantly higher (Group A, 26.94%; Group B, 49.06%, Group C, 35.73%, P = 0.023), with no significant difference in volume retention rates between the follicular and luteal phases (P > 0.05). Conclusions Fat volume retention rates were higher when AFG breast augmentation was performed during ovulation, providing a new direction to improve long-term retention rates of autologous fat grafts. However, due to the small sample size, incomplete medical records, and lack of test data, further research is needed. Level of Evidence: 4

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A mixed method study exploring patient satisfaction and feasibility of two exercise programs in systemic sclerosis associated microstomia

Rheumatology Advances in Practice ◽

10.1093/rap/rkab017 ◽

2021 ◽

Author(s):

Ellinor Sydow ◽

Kristien Van der Elst ◽

Patrick Verschueren ◽

Jan Lenaerts ◽

René Westhovens ◽

...

Keyword(s):

Patient Satisfaction ◽

Systemic Sclerosis ◽

Mixed Method ◽

Mixed Method Study ◽

Exercise Programs ◽

Post Intervention ◽

Oral Aperture ◽

The Face ◽

Group A ◽

Group B

Abstract Objectives Systemic sclerosis (SSc) is often leading to fibrotic cutaneous involvement of the face and reduced oral aperture with impaired food intake and oral hygiene. Oral exercises can increase oral aperture but are often hampered by low adherence rates. The aim of this mixed method study was to explore feasibility, patient satisfaction and effectiveness of two exercise programs in SSc-associated microstomia. Methods Adult patients suffering from SSc and microstomia (maximal oral aperture <40mm) were randomized to two groups. Group A exercised with a jaw motion device (Therabite®), and Group B performed mouth-stretching exercises. Patients were expected to exercise for 10 minutes, 3 times/day for 3 months. Patients were evaluated at baseline, 3 months (period without intervention), 6 months (after 3 months of intervention) and at 9 months (post-intervention). At month 6 semi-structured one-to-one interviews were conducted. Results We included 6 women and 3 men, median age 60 years and median disease duration 8 years. At 6 months, all patients in group A (n = 4) and 4 in group B (n = 5) improved with a median of 9mm and 7mm, respectively. The adherence ranged between 63.7% and 98,9% in group A and between 48.5% and 97,4% in group B. The interview that revealed three themes: drivers, challenges and perceived improvement. Conclusion Both interventions improve maximal oral aperture. The adherence to therapy was high but none of the patients considered it feasible to continue practicing 3 times/day. Future studies are needed in order to define feasible long-term exercise programs.

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Complementary Therapies for Idiopathic Hirsutism: Topical Licorice as Promising Option

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/659041 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Gita Faghihi ◽

Fariba Iraji ◽

Bahareh Abtahi-Naeini ◽

Bahar Saffar ◽

Ali Saffaei ◽

...

Keyword(s):

Controlled Study ◽

Alexandrite Laser ◽

Double Blind ◽

Idiopathic Hirsutism ◽

The Face ◽

Group A ◽

The Mean ◽

The Difference ◽

Hair Removal Laser ◽

Group B

Hirsutism is one of the most prevalent health problems in women. The aim of the study was to compare the effect of 755 nm alexandrite hair removal laser with that of alexandrite laser plus topical licorice on the improvement of idiopathic hirsutism. A double-blind, randomized placebo-controlled study was performed on 90 female subjects. The patients were divided into two groups: alexandrite laser plus 15% licorice gel (group A) and placebo (group B). Each subject received one of both products over one side of the face, twice daily for 24 weeks on the hirsute locations. Each group underwent five sessions of alexandrite laser at 6-week intervals. To minimize the effects of confounding variables, the test was performed on two separate zones of patients’ skin. The mean ± SD numbers of terminal hairs in group A were 7.05 ± 4.55 for zone 1 and 6.06 ± 3.70 for zone 2. In group B, they were 3.18 ± 1.75 for zone 1 and 2.49 ± 1.63 for zone 2. The difference in the mean number of terminal hairs was statistically significant between the two groups (p<0.001), and there were no serious adverse reactions. The treatment of idiopathic hirsutism with 755 nm alexandrite laser plus topical licorice is more effective than alexandrite laser only.

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Prognostic relevance of risk factors for obstetrical brachial plexopathy

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000100007 ◽

2006 ◽

Vol 64 (1) ◽

pp. 30-34 ◽

Cited By ~ 1

Author(s):

Carlos O. Heise ◽

José Luiz D. Gherpelli

Keyword(s):

Apgar Score ◽

Case Control Study ◽

Perinatal Asphyxia ◽

Brachial Plexopathy ◽

Forceps Delivery ◽

The Face ◽

Group A ◽

Group B ◽

Minute Apgar Score ◽

Control Study

We did a case-control study to verify if the birthweight, forceps delivery or perinatal asphyxia have any significant effect on the prognosis of obstetrical brachial plexopathy. Group A was composed of 25 infants who completely recovered at the age of 6 months. Group B was composed of 21 infants who were still not able to remove a blindfold from the face with the affected limb in the sitting position at the age of 12 months. There was no statistical difference of the median birthweight or median first minute Apgar score between the groups. There was also no relation between birthweight higher than 4000g, first minute Apgar score lower than 6 or forceps delivery with a poor prognosis.

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Facial Rejuvenation With Fat Grafting and Fillers

Aesthetic Surgery Journal ◽

10.1093/asj/sjab014 ◽

2021 ◽

Vol 41 (Supplement_1) ◽

pp. S31-S38

Author(s):

J Sarah Crowley ◽

Elizabeth Kream ◽

Sabrina Fabi ◽

Steven R Cohen

Keyword(s):

Calcium Hydroxyapatite ◽

Fat Grafting ◽

Facial Rejuvenation ◽

Volume Loss ◽

Level Of Evidence ◽

Tissue Replacement ◽

Dermal Thickness ◽

The Face ◽

Modality Approach ◽

A New Technique

Abstract Facial rejuvenation requires a multi-modality approach to address the sun damage, volume loss, and thinning of skin that occurs with aging. With age, the collagen fibrils that provide strength become fragmented and fibroblasts connections become weak, leading to skin laxity and loss of youthful skin. Fillers can lead to a more youthful appearance by providing volumetric support. Synthetic fillers such as hyaluronic acid products, calcium hydroxyapatite, polylactic acid, and polymethylmethacralate have bio-stimulatory affects, ranging from small effects on fibroblast production to prolonged stimulatory effects on dermal thickness and blood supply. Fat grafting is also an ideal technique for facial rejuvenation because it is readily available, natural, and has regenerative effects. This review describes a new technique of fat grafting for the face called Injectable Tissue Replacement and Regeneration that specifically addresses the different anatomic compartments of the face with volume loss. With this brief review, we aim to evaluate the currents trends of fat grafting and fillers in the management of facial rejuvenation, including the cellular changes that occur with facial aging, the bio-stimulatory effects of fillers, and the anatomic replacement of tissue with fat grafting. >Level of Evidence: 4

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Clinical Applications of a Pneumatic Intermittent Impulse Compression Device after Trauma and Major Surgery to the Foot and Ankle

Foot & Ankle ◽

10.1177/107110079301400404 ◽

1993 ◽

Vol 14 (4) ◽

pp. 198-203 ◽

Cited By ~ 48

Author(s):

Mark S. Myerson ◽

Michael R. Henderson

Keyword(s):

Volumetric Analysis ◽

Clinical Applications ◽

Major Surgery ◽

Daily Regimen ◽

Foot And Ankle ◽

Water Displacement ◽

Compression Device ◽

Group A ◽

Group B ◽

A Prospective Study

A prospective study was designed to evaluate the effect of a pneumatic intermittent impulse device in the treatment of postsurgical and posttraumatic swelling of the adult foot and ankle. Two groups of patients and their respective controls were studied. Group A consisted of 19 patients and 19 controls with acute swelling of the foot and ankle after major elective or posttraumatic surgery. Group B comprised 18 patients and 16 controls with chronic postsurgical or posttraumatic swelling. The pneumatic intermittent impulse device was used according to a predetermined daily regimen in both the control and experimental groups. The control patients were treated identically, except that their impulse device was modified to prevent effective compression. Reduction in swelling was measured by volumetric analysis with water displacement at selected intervals for each group. When compared with their respective controls, those patients who used an active impulse device had a statistically significant reduction in swelling. We conclude that this device is effective in the control of both acute and chronic swelling after trauma and surgery of the foot and ankle.

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Comparative study of localised intradermal microinjection of tranexamic acid and oral tranexamic acid for the treatment of melasma

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20183159 ◽

2018 ◽

Vol 4 (3) ◽

pp. 363 ◽

Cited By ~ 1

Author(s):

Vinma H. Shetty ◽

Monisha Shetty

Keyword(s):

Tranexamic Acid ◽

Comparative Study ◽

Subjective Assessment ◽

Therapeutic Modality ◽

Treatment Modalities ◽

Before And After ◽

The Face ◽

Group A ◽

Good Improvement ◽

Group B

Background: Melasma is an acquired hypermelanosis affecting the sun- exposed areas of the skin, most commonly the face and neck. Different treatment modalities have been utilized in different studies with varying, not so satisfactory outcomes. The aim of the study was to compare the efficacy of localized intradermal microinjection of tranexamic acid with oral tranexamic acid in melasma patients.Methods: It is a prospective comparative study. All patients enrolled in the study were divided into 2 groups - twenty in each treatment group. In group A, patients were given intradermal injections of tranexamic acid (4 mg/ml) once at three week intervals (0, 3, 6, 9, 12 weeks) for 12 weeks. Group B patients were given oral tranexamic acid 250 mg twice a day for 12 weeks. Following parameters were evaluated before and after 12 weeks of treatment: a) digital photographs b) MASI score c) patient subjective assessment d) dermoscopic photographs. Software (SPSS, version 16.0 statistical packages) was used.Results: Clinical efficacy of the treatment in 2 different groups showed higher efficacy with intradermal microinjection (35.6%) compare to oral tranexamic acid (21.7%). Patient's subjective assessment showed good improvement in 63.15% of cases in group A, whereas in group B 27.8% of cases showed good improvement.Conclusions: Intralesional localized microinjection of tranexamic acid is a promising new therapeutic modality for the treatment of resistant melasma.

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