Standardized Anatomic and Regenerative Facial Fat Grafting: Objective Photometric Evaluation From 1-19 Months After Injectable Tissue Replacement and Regeneration (ITR2)

2021 ◽  
Author(s):  
Steven R Cohen ◽  
Jordan Wesson ◽  
Sierra Willens ◽  
Taylor Nadeau ◽  
Chloe Hillman ◽  
...  
Keyword(s):  
Weight Change ◽  
Imaging System ◽  
Dynamic Change ◽  
Rebound Effect ◽  
Preliminary Evidence ◽  
Skin Aging ◽  
Fat Grafting ◽  
Autologous Fat Transfer ◽  
Tissue Replacement ◽  
Novel Approach

Abstract Background A standardized technique for facial fat grafting, Injectable Tissue Replacement and Regeneration (ITR 2), was developed to address both anatomic volume losses in superficial and deep fat compartments as well as skin aging, incorporating newer regenerative approaches. Objectives The authors sought to track the short and long terms effects of a new standardized technique for facial fat grafting in the midfacial zone across a 19-month time period. Methods Twenty-nine female were analyzed for mid-facial volume changes after autologous fat transfer with ITR 2. Across 19 months, volumes were evaluated using the Vectra XT 3D Imaging System to calculate differences between a predefined, 3-dimensional mid-facial zone measured preoperatively and serially after fat grafting with novel approach using varying fat parcel sizes. Results Patient data was analyzed collectively as well as separately by age (< and > 55 years). Collective analysis revealed a trend of initial volume loss within the first 1-7 months followed by an increase within the 8–19-month range, averaging 56.6% postoperative gain and ending at an average of 52.3% gain in volume by 14-19 months. A similar trend was observed for patients <55 years of age, but to a greater extent, with a 54.1% average postoperative gain and final average of 75.2%. Conversely, patients above 55 years of age revealed a linear decay beginning at 60.6% and steadily declining to 29.5%. Multiple regression analysis revealed no statistically significant influence of weight change during the study duration. Conclusions Preliminary evidence shows a dynamic change in facial volume, with an initial decrease in facial volume followed by a rebound effect that demonstrated improvement of facial volume regardless of patient weight change or amount of fat injected 19 months after treatment. Volume improvement occurred to a greater extent in patients under 55 years old, whereas in patients older than 55 volume gradually decreased. To our knowledge, this study represents the first time that progressive improvement in facial volume has been shown 19 months after treatment with a new standardized technique of fat grafting.

scholarly journals Principles and Applications of Fat Grafting in Plastic Surgery

2019 ◽  
Vol 33 (03) ◽  
pp. 147-154 ◽  
Author(s):  
Amjed Abu-Ghname ◽  
Aurelia Trisliana Perdanasari ◽  
Edward M. Reece
Keyword(s):  
Plastic Surgery ◽  
Clinical Applications ◽  
Fat Grafting ◽  
Soft Tissue Augmentation ◽  
Fat Transplantation ◽  
Basic Principles ◽  
Autologous Fat ◽  
Autologous Fat Transfer ◽  
Autologous Fat Transplantation ◽  
Injection Techniques

AbstractAutologous fat transplantation has become increasingly popular in recent years. Its biocompatable properties and availability made it a widely used treatment modality for soft tissue augmentation and volume replacement in both reconstructive and aesthetic plastic surgery. Multiple protocols and clinical applications have been described in the literature, with wide variations in the harvesting, processing, and injection techniques. In this review, the authors will discuss the basic principles and clinical applications of fat grafting in plastic and reconstructive surgery. The article will then conclude with a discussion of fat grafting limitations as well as potential future applications, giving the reader a well-rounded understanding of autologous fat transfer.

scholarly journals A novel approach to Verify air gap and SSD for proton radiotherapy using surface imaging

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xiao Wang ◽  
Chi Ma ◽  
Rihan Davis ◽  
Rahul R. Parikh ◽  
Salma K. Jabbour ◽  
...  
Keyword(s):  
Body Surface ◽  
Imaging System ◽  
Air Gap ◽  
Surface Imaging ◽  
Proton Radiotherapy ◽  
Optical Surface ◽  
Air Gaps ◽  
Novel Approach ◽  
Proton Treatment ◽  
The Absolute

Abstract Purpose To develop a novel approach to accurately verify patient set up in proton radiotherapy, especially for the verification of the nozzle – body surface air gap and source-to-skin distance (SSD), the consistency and accuracy of which is extremely important in proton treatment. Methods Patient body surfaces can be captured and monitored with the optical surface imaging system during radiation treatment for improved intrafraction accuracy. An in-house software package was developed to reconstruct the patient body surface in the treatment position from the optical surface imaging reference capture and to calculate the corresponding nozzle – body surface air gap and SSD. To validate this method, a mannequin was scanned on a CT simulator and proton plans were generated for a Mevion S250 Proton machine with 20 gantry/couch angle combinations, as well as two different snout sizes, in the Varian Eclipse Treatment Planning Systems (TPS). The surface generated in the TPS from the CT scan was imported into the optical imaging system as an RT Structure for the purpose of validating and establishing a benchmark for ground truth comparison. The optical imaging surface reference capture was acquired at the treatment setup position after orthogonal kV imaging to confirm the positioning. The air gaps and SSDs calculated with the developed method from the surface captured at the treatment setup position (VRT surface) and the CT based surface imported from the TPS were compared to those calculated in TPS. The same approach was also applied to 14 clinical treatment fields for 10 patients to further validate the methodology. Results The air gaps and SSDs calculated from our program agreed well with the corresponding values derived from the TPS. For the phantom results, using the CT surface, the absolute differences in the air gap were 0.45 mm ± 0.33 mm for the small snout, and 0.51 mm ± 0.49 mm for the large snout, and the absolute differences in SSD were 0.68 mm ± 0.42 mm regardless of snout size. Using the VRT surface, the absolute differences in air gap were 1.17 mm ± 1.17 mm and 2.1 mm ± 3.09 mm for the small and large snouts, respectively, and the absolute differences in SSD were 0.81 mm ± 0.45 mm. Similarly, for patient data, using the CT surface, the absolute differences in air gap were 0.42 mm ± 0.49 mm, and the absolute differences in SSD were 1.92 mm ± 1.4 mm. Using the VRT surface, the absolute differences in the air gap were 2.35 mm ± 2.3 mm, and the absolute differences in SSD were 2.7 mm ± 2.17 mm. Conclusion These results showed the feasibility and robustness of using an optical surface imaging approach to conveniently determine the air gap and SSD in proton treatment, providing an accurate and efficient way to confirm the target depth at treatment.

scholarly journals Breast Augmentation by Water-Jet Assisted Autologous Fat Grafting: A Report of 300 Operations

2016 ◽  
Vol 02 (02) ◽  
pp. e19-e30 ◽  
Author(s):  
Daniel Muench
Keyword(s):  
Breast Augmentation ◽  
Fat Grafting ◽  
Water Jet ◽  
Fat Cell ◽  
Volume Increase ◽  
Fat Transfer ◽  
Autologous Fat ◽  
Autologous Fat Transfer ◽  
Fat Deposits ◽  
Moderate Volume

Background The BEAULI -method (Breast Augmentation by Lipotransfer) is available for extraction and processing of large transplantable fat quantities. The aim of this work is to describe the surgical technique precisely and reproducibly and to provide an overview of the autologous fat transfer based on surgical experience. Method The author performed 300 autologous fat transplantations on 254 women between September 3, 2010, and May 13, 2015. Patients desiring moderate volume increase, fuller and firmer breasts, as well as an optimization of the silhouette, ideally with the concurrent desire of the correction of unwanted fat deposits, were selected. The fat was extracted via water-jet assisted liposuction (Body-jet, Human Med AG, Schwerin, Germany), and the fat cells were subsequently separated with the Lipocollector® (Human Med AG, Schwerin, Germany). Results The results were assessed with a control exam and photo comparison and were based on the responses on a questionnaire. Overall, 35.9% of the patients defined the result as very good, 38.6% as good, 22.4% as satisfactory, and 3.1% as poor. Conclusion This study shows that the autologous fat cell transplantation into the female breast via water-jet assisted liposuction achieves a moderate and harmoniously appearing breast volume enlargement as well as contour improvement. Further studies with more cases and longer observation periods over several years could contribute to improving the method of the autologous fat transfer regarding the grow-in rate, efficiency, and safety.

Phase II study of induction therapy with gemcitabine and nab-paclitaxel followed by consolidation with mFOLFIRINOX in patients with metastatic pancreatic cancer.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 233-233
Author(s):  
Ramesh K. Ramanathan ◽  
Peter Lee ◽  
Joseph W. Leach ◽  
Stephen Patrick Anthony ◽  
Glen J. Weiss ◽  
...  
Keyword(s):  
Phase Ii ◽  
Induction Therapy ◽  
Phase Ii Study ◽  
Performance Status ◽  
Preliminary Evidence ◽  
Induction Phase ◽  
Novel Approach ◽  
Early Image ◽  
Adequate Organ Function ◽  
One Year

233 Background: We designed a phase II study to evaluate the efficacy, toxicity and feasibility of administering nab-paclitaxel/gemcitabine (NabP-Gem) followed by mFOLFIRINOX in MPC. Methods: Eligible patients had evidence of untreated MPC with performance status of ECOG 0-1 and adequate organ function. Induction therapy was with Nab-P (125 mg/m2) and Gem (1000 mg/ m2) weekly x 3 every 4 weeks for a maximum of 6 months (6 cycles). mFOLFIRINOX every 2 weeks (Consolidation regimen) was initiated after 6 cycles of the Induction regimen, or earlier in case of progression, and given upto 6 months (12 cycles). The FOLFIRINOX regimen (NEJM,364:1817-25: 2011) was modified to omit the bolus 5FU and requires addition of granulocyte growth factor prophylaxis. A primary endpoint is to increase 1 year survival (n=30) to >70%, (95% confidence intervals for one year survival rate is +/- 20%). Results: As of 9/1/2012, 26 of 30 subjects have been accrued. M/F ratio is 58%/42%, median is 65 years. In 20 patients treated on the induction phase, 75% have a > 90% decrease in CA 19-9 levels. The partial response rate (PR) in the first 19 patients who have completed 4 cycles is 50%. Early image analysis on 9 subjects with concurrent CT and PET showed 44% PR (RECIST 1.1) but 89% by CHOI and PET criteria. A novel approach to interrogate tumor texture composition demonstrated substantial change in lesion texture following induction therapy. To date selected Grade > 3 adverse events are neutropenia (n=8), fatigue (n=5), thromboembolic events (n=4), peripheral neuropathy (n=3), dehydration (n=2), anemia (n=3), thrombocytopenia (n=2), febrile neutropenia (n=2) and myalgias (n=2). Among 26 patients who have received at least one cycle of NabP-Gem, ten dose reductions and four dose delays were seen. To date, 11 patients have begun the Consolidation regimen with mFOLFIRINOX. Conclusions: The induction NabP-Gem regimen shows preliminary evidence of substantial activity similar to published reports (JCO.29:4548-54: 2011). Study will now evaluate the safety, efficacy and feasibilty of the Consolidation regimen with mFOLFIRINOX. Supported by the Seena Magowitz Foundation. Clinical trial information: NCT01488552.

scholarly journals Treatment of “En Coupe De Sabre “ Linear Scleroderma. Soft Tissue Augmentation and Regeneration by Autologous Fat Transfer

2021 ◽  
pp. 30
Author(s):  
◽  
Keyword(s):  
Stem Cells ◽  
Soft Tissue ◽  
Fat Grafting ◽  
Soft Tissue Augmentation ◽  
Congenital Deformity ◽  
Autologous Fat Grafting ◽  
Fat Transfer ◽  
Autologous Fat ◽  
Autologous Fat Transfer ◽  
Linear Scleroderma

Aim: Frontal linear scleroderma, also known as ‘‘en coup de sabre,’’ is a congenital deformity characterized by atrophy and furrowing of the skin of the front parietal area above the level of the eyebrows. In most cases it occurs as a single paramedian line that may be associated with hypoplasia of underlying structures and facial hemiatrophy. In case of a wide lesion many reconstructive strategies have been proposed. The modern approach is aimed at augmentation of the tissue deficiency by using lipostructure and tissue regeneration. Autologous fat transfer (AFT) seems to be an effective strategy to restore the normal volume and contour of the face while providing a source of adipose-derived stem cells (ADSCs) with a multilineage differentiation potential. Methods: In this report, we present a rare case of linear scleroderma en coupe de sabre which was successfully managed with three stages of autologous fat grafting. Conclusion: The proposed uses for ADSCs in tissue repair and regeneration are quite impressive. Recent works on ADSCs would suggest that adult cells may prove to be an equally powerful regenerative tool in treating congenital and acquired maxillofacial disorders. More importantly, physicians, researchers and international associations need to cooperate in informing clinicians about what practices are based on evidence and to encourage support of additional research. There is increasing interest in a possible therapeutic effect of ADSCs from processed lipoaspirate for a wide spectrum of clinical applications in the facial and craniofacial area. AFT can be used in any facial area where soft tissue is lacking or where there is scarring, producing natural and long-lasting results. Mesenchymal stem cells represent a great tool in regenerative medicine. However, more definitive studies are needed to answer specific questions regarding the best technique to be used and the role of ADSCs. Autologous fat grafting provides a safe and easy approach for the treatment of linear scleroderma en coup de sabre, long-term clinically satisfactory results can be obtained.

scholarly journals Indocyanine Green Near-Infrared Fluorescence Imaging-Guided Laparoscopic Heminephrectomy for Left Ureteral Cancer in Patient with Horseshoe Kidney

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Takao Natsuyama ◽  
Yozo Mitsui ◽  
Masato Uetani ◽  
Shigeyuki Ohta ◽  
Shin-ichi Hisasue
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
Imaging System ◽  
Left Kidney ◽  
Horseshoe Kidney ◽  
Near Infrared Fluorescence ◽  
Nirf Imaging ◽  
Novel Approach ◽  
The Right ◽  
Near Infrared Fluorescence Imaging

Laparoscopic surgery for patients with a horseshoe kidney is challenging because of the location, aberrant vasculature, and difficulty with division of the isthmus with adequate hemostasis. We herein report performance of a laparoscopic heminephrectomy for left ureteral cancer in a patient with a horseshoe kidney under guidance from near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG). A 62-year-old male was referred to our hospital for treatment of left ureteral cancer associated with a horseshoe kidney. We performed a laparoscopic left nephroureterectomy and bladder resection in June 2017. During the operation, the NIRF imaging system was used to evaluate the border of the kidney parenchyma isthmus after ligation of the left kidney vasculature supply. Interestingly, the dominant region of the right kidney showed strong ICG fluorescence as compared to the left kidney region. With the assistance of ICG-based NIRF imaging, isthmus division was performed with monopolar scissors and adequate hemostasis was obtained by electrocautery coagulation. This is the first report of use of an ICG-based NIRF imaging system and this novel approach can help to demarcate the left moiety isthmus from right one with more certainty.

Novel Stable Approach with Probability Distribution for Multi-Criteria Decision-Making Problems of Multi-Valued Neutrosophic Sets

2020 ◽  
Vol 19 (05) ◽  
pp. 1271-1292
Author(s):  
Xu Libo ◽  
Li Xingsen ◽  
Cui Honglei
Keyword(s):  
Decision Making ◽  
Probability Distribution ◽  
Dynamic Change ◽  
Distribution Functions ◽  
Transformation Operator ◽  
Decision Makers ◽  
Multi Criteria Decision Making ◽  
Neutrosophic Sets ◽  
Dependent Function ◽  
Novel Approach

In this paper, a novel approach and framework based on interval-dependent degree and probability distribution for multi-criteria decision-making problems with multi-valued neutrosophic sets (MVNSs) is proposed. First, a simplified dependent function and distribution function are given and integrated into a concise formula, which is called the interval-dependent function and contains interval computing and probability distribution information in an interval. Then a transformation operator is defined and it is shown how to convert MVNSs into an interval set. Subsequently, the interval-dependent function with the probability distribution of MVNSs is deduced. Finally, an example and comparative analysis are provided to verify the feasibility and effectiveness of the proposed method. In addition, uncertainty analysis, which reflects the dynamic change of the ranking result with decision-makers’ preferences, is performed by setting different distribution functions, which increases the reliability and accuracy of the proposed method.

scholarly journals Masculinized Male Chest Contouring: Creating the Armor Plate

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Arian Mowlavi ◽  
Waleed Rashid ◽  
Mariam Berri ◽  
Armin Talle
Keyword(s):  
Body Image ◽  
Fat Grafting ◽  
Armor Plate ◽  
Novel Approach ◽  
Male Patients

Abstract Male patients are routinely consulted regarding dislike of their chest appearance. To date, majority of patients have desired elimination of their feminine-appearing breast, termed gynecomastia. These patients have associated their overweight body image, with the femininity of their breasts as presented by fullness and roundedness of their breasts and subsequently have desired maximal flattening of their breast. We present a new set of patients who desire a more muscular-appearing chest than a gynecomastia repair that is interposed on a chiseled abdominal contour. In contrast to the former set of patients, these patients desire bulking of their breasts with a bolder-appearing armor plate look. We present an alternative to traditional gynecomastia repair which involves a novel approach to chest contouring creating a flat, yet bold, pentagonal-shaped breast with linear borders utilizing both fat and gland removal as well as strategic fat grafting back into the chest. We present a novel protocol to create an armor plate male chest appearance as an alternative to traditional gynecomastia contouring. All patients treated to date demonstrate a muscular-appearing chest that is harmonious on an interposed masculine-appearing abdomen.

scholarly journals Evaluation of a new adipose tissue processing method for breast and buttock fat grafting procedures

2020 ◽  
Author(s):  
Eric Auclair ◽  
Massimo Gianfermi
Keyword(s):  
Patient Satisfaction ◽  
Processing Technique ◽  
Fat Grafting ◽  
Processing Method ◽  
Study Cohort ◽  
Level Of Evidence ◽  
Fat Transfer ◽  
Autologous Fat Transfer ◽  
Therapeutic Study ◽  
Fat Processing

Abstract Background There is still some debate about the best adipose processing method for autologous fat transfer procedures. This article reports a series of 66 fat grafting procedures using a novel fat processing technique that involves washing, “micronization,” and decantation. Methods We retrospectively reviewed the files of all patients operated on over a 2-year period by the two investigators. They underwent breast or buttock surgery that employed the novel fat processing technique for fat transfer. Complications and patient satisfaction were recorded, and fat resorption was qualitatively assessed based on clinical examination and photographs. Results Data were retrieved from a total of 66 procedures performed on 43 patients: 17 breast augmentations, 8 buttock augmentations, and 41 breast reconstructions. Five patients also underwent concomitant facial fat grafting. The complications were one case of transient liponecrotic cyst in the breast, one case of transient areolar sensitivity reduction, and two cases of infection. The infections were reported in patients from the breast reconstruction cohort who had a history of radiotherapy. There was no complication associated with facial fat grafting. Patient satisfaction was achieved in 82.4 to 92.5% of cases depending on the study cohort. Fat resorption was graded as minimal to moderate in 95% of all cases. Conclusions This retrospective study supports the safety and effectiveness of this novel fat processing method in breast and buttock surgeries. Further controlled studies are needed to compare its performance with that of other techniques. Level of evidence: Level III, therapeutic study

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