Autologous Fat Transfer in Craniofacial Surgery

FACE Pub Date : 2024-03-11 DOI:10.1177/27325016241238441
Tatevik Malisetyan, Joshua L. Harrison, S. Shahriari, Tegan N. Clarke, Elizaveta V. Rogol, Gregory L. Borah
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Abstract

Over the past two decades, autologous fat transfer has garnered significant recognition and widespread adoption within esthetic and reconstructive surgical domains. In craniofacial surgery, fat transplantation is frequently employed to address soft tissue volumetric deficiencies and asymmetries that influence facial contours. While adipose tissue (AT) is widely regarded as an optimal choice for augmentation due to its abundant availability and biocompatibility, the unpredictability and heightened resorption rates observed with traditional lipofilling techniques present a challenge for clinicians. Adipose-derived stem cells (ASCs) housed within the grafted tissue play a pivotal role in graft survival and offer avenues for tissue repair due to their angiogenic, anti-inflammatory, and immunosuppressive properties. Micro Fragmentation of Adipose Tissue (MFAT), utilized in several FDA-approved processing devices, has demonstrated promising outcomes in treating osteoarthritic joints, with success primarily attributed to enhanced paracrine function of ASCs via preservation of the perivascular niche. Currently, its application for treating bone or articular defects in the craniofacial region, including abnormalities of the temporomandibular joint, remains limited. This scarcity underscores the need for further investigation prior to its widespread integration into clinical practice.
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颅颌面手术中的自体脂肪移植
在过去的二十年里,自体脂肪移植在美容和整形外科领域获得了广泛的认可和采用。在颅面部手术中,脂肪移植经常被用来解决影响面部轮廓的软组织体积不足和不对称问题。虽然脂肪组织(AT)因其丰富的可用性和生物相容性而被广泛认为是增量的最佳选择,但传统脂肪填充技术的不可预测性和较高的吸收率给临床医生带来了挑战。移植组织中的脂肪源性干细胞(ASCs)因其血管生成、抗炎和免疫抑制特性,在移植存活中发挥着关键作用,并为组织修复提供了途径。美国食品和药物管理局(FDA)批准的几种加工设备都采用了脂肪组织微碎裂技术(MFAT),该技术在治疗骨关节炎方面取得了可喜的成果,其成功主要归功于通过保留血管周围龛位增强了间充质干细胞的旁分泌功能。目前,该技术在治疗颅面部骨骼或关节缺损(包括颞下颌关节异常)方面的应用仍然有限。这种稀缺性凸显了在将其广泛应用于临床实践之前进行进一步研究的必要性。
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