Alopecia Following Deoxycholic Acid Treatment for Submental Adiposity

Alopecia is an increasingly recognized adverse effect of deoxycholic acid treatment. A retrospective review of 66 male patients demonstrated an incidence of alopecia of 15% (8 patients).1 The alopecia was first noticed approximately 4 weeks after injection and in this series, 5 of the 8 patients reported improvement or complete resolution of the alopecia. Review of the literature identified 4 other cases with varying degrees of regrowth observed.24 Herein, we report a case of alopecia following deoxycholic acid treatment.

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Where will your breast implants be placed?

breast implant location

If you are considering breast augmentation there are many questions you will want to have answered by the plastic surgeon before making your final decision.

Among a host of other important questions that you should ask during your breast augmentation consultation is “where the breast implants will be placed?”

Many patients are not aware that there is an option when it comes to the placement of the breast implants. Implants may be placed either over the muscle or under the muscle, and there are several factors which help determine the optimal implant placement for each individual patient, including:

  • Your body type
  • Your current health
  • The actual size (cc’s) of the implants
  • Saline vs silicone implants
  • Your individual goals and desires

Board-certified and experienced plastic surgeons who have performed a high volume of breast augmentation surgeries will be able to direct the best position to determine optimal implant placement, and it is extremely important for breast augmentation patients to understand the pros and cons for the two different placement options.

Subglandular placement

Also known or referred to as “over-the-muscle” placement, the subglandular placement technique is where the implant is positioned between the chest muscle and the existing breast tissue areas. The over the muscle positioning is done so the implant lies below the glands of the breast, thus providing the ability for the patient to breast-feed in the future.

PROS: Patients tend to have less movement of the implants during physical activity, as well as less discomfort immediately following the surgery.

CONS: The appearance can me more artificial. In addition, during mammograms the readings may be less accurate. Also, patients may experience a higher rate of capsular contracture, which occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant.

Submuscular placement

The other option is known as submuscular, or under-the-muscle placement of the breast implant. This technique includes placement of the implant partially under the pectoralis major chest muscle.

PROS: Patients experience more accurate mammograms. In addition, the submuscular placement tends to produce a more natural appearance, and a reduced rate of capsular contracture.

CONS: Some patients experience slightly more discomfort after surgery, with a longer postsurgical recovery.

The role of the chest muscle

The muscles in the chest play an important role in breast augmentation procedures with regards to optimal placement of the implants. Each individual patient will vary in the amount of muscle they have and this could be a factor in determining whether subglandular or submuscular placement is best.

The anatomy of each patient must be factored in. For example, women who have very large or strong chest muscles will be best suited for over-the-muscle positioning of the implants. One reason for this is with larger chest muscles there will be a tendency for distortion of the breasts as the chest muscles move and are flexed. In these cases, subglandular placement is advised.

How much breast tissue is present

In addition to the muscle density and mass, the amount of tissue in the breast area before surgery will also have an impact on where the placement should be for optimal postsurgical results. When there is a significant amount of breast tissue, there will be adequate soft tissue coverage making the pectoralis muscle superfluous in this regard.

As you move through the process of selecting your breast surgeon, and during your consultation about the procedure, you will want to discuss the placement of the breast implants, going over which option – over the muscle or under – will be best for you.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Masseteric Nerve Transfer and Selective Neurectomy for Rehabilitation of the Synkinetic Smile

Key Points

Question  Is masseteric-to-facial nerve transfer combined with selective neurectomy associated with improved synkinetic smile?

Findings  In this case series, 7 patients underwent masseter-to-facial nerve transfer with selective neurectomy for synkinesis. Patients experienced a statistically significant improvement in multiple eFACE domains including smile, dynamic function, synkinesis, midface and smile function, and lower face and neck function at 1-year mean follow-up.

Meaning  Masseteric-to-facial nerve transfer with selective neurectomy may provide significant smile improvement with a long-term decrease in synkinesis for patients.

Importance  Synkinesis is the involuntary movement of 1 area of the face accompanying volitional movement of another; it is commonly encountered in patients affected by facial palsy. Current treatments for synkinesis include biofeedback for muscular retraining and chemodenervation via the injection of botulinum toxin. Chemodenervation is effective in reducing unwanted muscle movement, but it requires a commitment to long-term maintenance injections and may lose effectiveness over time. A permanent solution for synkinesis remains elusive.

Objective  To evaluate masseteric-to-facial nerve transfer with selective neurectomy in rehabilitation of the synkinetic smile.

Design, Setting, and Participants  In this case series, 7 patients at a tertiary care teaching hospital underwent masseteric-to-facial nerve transfer with selective neurectomy for synkinesis between September 14, 2015, and April 19, 2018. The medical records of these patients were retrospectively reviewed and demographic characteristics, facial palsy causes, other interventions used, and changes in eFACE scores were identified.

Intervention  Masseteric-to-facial nerve transfer.

Main Outcomes and Measures  Changes in eFACE scores (calculated via numeric scoring of many sections of the face, including flaccidity, normal tone, and hypertonicity; higher scores indicate better function and lower scores indicate poorer function) and House-Brackmann Facial Nerve Grading System scores (range, 1-6; a score of 1 indicates normal facial function on the affected side, and a score of 6 indicates absence of any facial function [complete flaccid palsy] on the affected side).

Results  Among the 7 patients in the study (6 women and 1 man; median age, 49 years [range, 41-63 years]), there were no postoperative complications; patients were followed up for a mean of 12.8 months after surgery (range, 11.0-24.5 months). Patients experienced a significant improvement in mean (SD) eFACE scores in multiple domains, including smile (preoperative, 65.00 [8.64]; postoperative, 76.43 [7.79]; P = .01), dynamic function (preoperative, 62.57 [15.37]; and postoperative, 75.71 [8.48]; P = .03), synkinesis (preoperative, 52.70 [4.96]; and postoperative, 82.00 [6.93]; P < .001), midface and smile function (preoperative, 60.71 [13.52]; and postoperative, 78.86 [14.70]; P = .02), and lower face and neck function (preoperative, 51.14 [16.39]; and postoperative, 66.43 [20.82]; P = .046). Preoperative House-Brackmann Facial Nerve Grading System scores ranged from 3 to 4, and postoperative scores ranged from 2 to 3; this change was not significant.

Conclusion and Relevance  This study describes the application of masseteric-to-facial nerve transfer with selective neurectomy for smile rehabilitation in patients with synkinesis, with statistically significant improvement in smile symmetry and lower facial synkinesis as measured with the eFACE tool. This technique may allow for long-term improvement of synkinesis and smile. This study is only preliminary, and a larger cohort will permit more accurate assessment of this therapeutic modality.

Level of Evidence  4.

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What type of tummy tuck is right for you?

tummy tuck types

Are you feeling discouraged because exercising isn’t giving you the results you desire? Do you still have a tummy pooch despite eating well? Do you wish your tummy was trim, toned and tight?

It can be difficult to regain your body’s shape after significant changes in your figure (such as pregnancy or major weight loss), and even a healthy lifestyle may not be able to restore your slender midsection. Even if you have lost belly fat, you may still be experiencing a decrease in skin elasticity, which can cause your skin to sag.

A tummy tuck can be an effective solution when your best efforts have not yielded any results in regards to the appearance of your midsection. With multiple procedure options, a tummy tuck can tighten your sagging skin and help you regain subtle tummy contours.

How does a tummy tuck help?

During your tummy tuck surgery consultation, your plastic surgeon will examine the condition of your skin and tissue to determine which of the following types of tummy tuck is best suited for your needs.

Mini tummy tuck

A mini tummy tuck focuses on the area of the tummy that lies below the navel. Your plastic surgeon will make a single incision at the bikini line that is easily concealed under a swimsuit. He will stretch the skin downward as he smooths and adjusts the skin. If you are also in need of muscle tightening to correct a slight pooch, this type of tummy tuck would be appropriate. Women who are wanting to correct the physical changes after pregnancy are ideal candidates for a mini tummy tuck.

Full tummy tuck

This is the most common type of tummy tuck procedure since it focuses on the entire midsection. Your surgeon will make two incisions – one will be located in the lower abdomen and the second is made around the navel. Though scarring is more obvious with this procedure, these incision sites allow your surgeon to remove sagging skin from both the upper and lower abdomen. He will also tighten the abdominal muscles necessary to give you a more toned midsection. Many patients benefit from this type of tummy tuck, including women who are post-pregnancy, have experienced major weight loss and are unhappy with how their bodies have changed due to genetics or aging.

Extended tummy tuck

An extended tummy tuck is most commonly performed for patients who need removal of significant amounts of skin. This typically occurs after a massive weight loss. Your surgeon will make a single incision; it will wrap around the abdomen to reach the hips. Such a large incision allows him to tighten the skin evenly down across the tummy. It can leave a larger scar than the other procedures that may be hard to hide under intimate clothing.

BodyTite™

BodyTite™ is a radiofrequency-assisted liposuction (RFAL) procedure that uses cutting-edge technology to help eliminate stubborn fat for a smoother, slimmer physique. During this procedure, a thin tube, also known as a cannula, is inserted under the skin while an electrode is placed on the outer surface. The radiofrequency waves from the electrode melt the fat, making it easier to remove. These waves heat the skin, which stimulates the production of collagen to tighten the skin. This procedure is used in conjunction with liposuction.

Starting your tummy tuck journey

If you think that tummy tuck surgery might be right for you and your aesthetic goals, be sure to meet with a board-certified plastic surgeon for a consultation. You can use the ASPS Plastic Surgeon Match referral service to find ASPS member surgeons in your area.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Assessing Nasal Soft-Tissue Envelope Thickness for Rhinoplasty

Key Points

Question  How does nasal soft-tissue envelope (STE) thickness vary in our patient population, and can facial plastic surgery clinicians predict nasal STE thickness based on visual examination of the nose?

Findings  This study of 190 patients found that the STE is thickest at the sellion, thinnest at the rhinion, thickened over the supratip and nasal tip, and thinned over the columella; thickness followed a near-normal distribution for each measured subsite, with the majority of patients in a medium thickness range. The 4 study experts accurately predicted nasal STE thickness from clinical photographs, with the highest accuracy at the nasal tip.

Meaning  Experts can accurately predict nasal STE thickness based on visual examination of the nose, which has implications for surgical planning in rhinoplasty.

Importance  Preoperative assessment of nasal soft-tissue envelope (STE) thickness is an important component of rhinoplasty that presently lacks validated tools.

Objective  To measure and assess the distribution of nasal STE thickness in a large patient population and to determine if facial plastic surgery clinicians can predict nasal STE thickness based on visual examination of the nose.

Design, Setting, and Participants  This retrospective review and prospective assessment of 190 adult patients by 4 expert raters was conducted at an academic tertiary referral center. The patients had high-resolution maxillofacial computed tomography (CT) scans and standardized facial photographs on file and did not have a history of nasal fracture, septal perforation, rhinoplasty, or other surgery or medical conditions altering nasal form. Data were analyzed in March 2019.

Main Outcomes and Measures  Measure nasal STE thickness at defined anatomic subsites using high-resolution CT scans. Measure expert-predicted nasal STE thickness based on visual examination of the nose using a scale from 0 (thinnest) to 100 (thickest).

Results  Of the 190 patients, 78 were women and the mean (SD) age was 45 (17) years. The nasal STE was thickest at the sellion (mean [SD]) (6.7 [1.7] mm), thinnest at the rhinion (2.1 [0.7] mm), thickened over the supratip (4.8 [1.0] mm) and nasal tip (3.1 [0.6] mm), and thinned over the columella (2.6 [0.4] mm). In the study population, nasal STE thickness followed a nearly normal distribution for each measured subsite, with the majority of patients in a medium thickness range. Comparison of predicted and actual nasal STE thickness showed that experts could accurately predict nasal STE thickness, with the highest accuracy at the nasal tip (r, 0.73; prediction accuracy, 91%). A strong positive correlation was noted among the experts’ STE estimates (r, 0.83-0.89), suggesting a high level of agreement between individual raters.

Conclusions and Relevance  There is variable thickness of the nasal STE, which influences the external nasal contour and rhinoplasty outcomes. With visual analysis of the nose, experts can agree on and predict nasal STE thickness, with the highest accuracy at the nasal tip. These data can aid in preoperative planning for rhinoplasty, allowing implementation of preoperative, intraoperative, and postoperative strategies to optimize the nasal STE, which may ultimately improve patient outcomes and satisfaction.

Level of Evidence  NA.

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Effect of Vibratory Anesthetic Device on Pain Anticipation and Perception During Dermatologic Surgery

Key Points

Question  Do patients who catastrophize pain, defined as patients who anticipate higher pain levels on the 11-point Numeric Rating Scale (score >4), receive equal benefit from a vibratory stimulus during local anesthetic injection as patient who do not catastrophize pain (Numeric Rating Scale score ≤4)?

Findings  In this randomized clinical trial of 87 patients who experienced 101 unique events, patients who catastrophized pain reported significantly higher Numeric Rating Scale scores during local anesthetic injection than patients who did not. The addition of vibration resulted in a 25.5% reduction of Numeric Rating Scale scores during local anesthetic injection in patients who catastrophized pain and a 79.4% reduction in patients who did not catastrophize pain.

Meaning  Patients who catastrophize pain can be identified in the clinical setting with assessment of anticipation of pain levels (Numeric Rating Scale score >4), and these patients benefit from the addition of vibration during local anesthetic injection.

Importance  Vibration has been shown to decrease injection site pain in patients; however, to date, this effect has not been assessed for patients who catastrophize pain (ie, patients who anticipate a higher pain level). The anticipation of a pain score greater than 4 on the 11-point Numeric Rating Scale (NRS) has been associated with an increase in a patient’s perception of procedural pain.

Objective  To assess the efficacy of vibration during cutaneous anesthetic injection for dermatologic surgery for patients who catastrophize pain (NRS score >4) and patients who do not (NRS score ≤4).

Design, Setting, and Participants  Randomized, parallel-group clinical trial from June 19 to September 4, 2018, at a tertiary dermatologic surgery clinic among 87 adults undergoing cutaneous cancer removal surgery. Patients completed a preprocedural questionnaire detailing their baseline pain, anticipated pain, and drug use. Analysis was performed on an intent-to-treat basis.

Interventions  Use of a vibratory anesthetic device (VAD) on the treatment site prior to anesthetic injection in the on (VAD ON) or off (VAD OFF) mode.

Main Outcomes and Measures  Pain was reported using the 11-point NRS (where 0 indicates no pain and 11 indicates the worst pain imaginable). A minimum clinically important difference of 22% or more and a substantial clinically important difference of 57% or more were used to assess the efficacy of vibration in patient-reported NRS score during anesthetic injection (iNRS score).

Results  A total of 87 patients were included, with 101 unique events reported (among the unique events, 37 were reported in women and 64 were reported in men; mean [SD] age, 66.0 [11.3] years). The mean (confidence level [CL]) iNRS score for patients who catastrophized pain was 2.27 (0.66) compared with 1.44 (0.39) for patients who did not (P = .03). A 38.9% decrease in mean (CL) iNRS score was reported with VAD ON compared with VAD OFF in all participants (1.24 [0.38] vs 2.04 [0.54]). Patients who catastrophized pain reported a 25.5% decrease in mean (CL) iNRS score with VAD ON vs VAD OFF (1.91 [0.99] vs 2.57 [0.98]), and patients who did not reported a 79.4% decrease (1.02 [0.40] vs 1.84 [0.66]). VAD ON was the only statistically significant variable to affect iNRS score (F statistic, 2.741; P = .03).

Conclusions and Relevance  This trial demonstrates that those who catastrophize pain prior to a procedure report a higher perceived level of pain. The application of vibration during local anesthetic injection resulted in a minimum clinically important difference in pain level for patients who catastrophize pain and a substantial clinically important difference in pain level for patients who do not.

Level of Evidence  2.

Trial Registration  ClinicalTrials.gov identifier: NCT03467685

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Association Between Pain and Patient Satisfaction After Rhinoplasty

Key Points

Question  In rhinoplasty surgery is there an association between postoperative pain and perception of surgical success?

Findings  In this prospective case series survey study of 104 patients who underwent cosmetic and/or functional rhinoplasty, a statistically significant negative association was found between perception of pain and perception of outcome (breathing improvement) in purely functional rhinoplasty. In contrast, among patients who underwent rhinoplasty with simultaneous cosmetic changes, no association between pain and perception of surgical success was found.

Meaning  This prospective study highlights important results that may help guide preoperative rhinoplasty counseling because patients who are interested in purely functional improvement (without cosmetic change) may warrant additional pain-specific counseling to optimize patient satisfaction.

Importance  In light of the current opioid crisis, there exists a demonstrated need to balance adequate postrhinoplasty pain control with measured use of narcotics. If pain is inadequately controlled, patients may be unsatisfied with their elective surgical experience.

Objectives  To characterize the association between patient-reported pain outcomes, objective opioid use, and perception of surgical success.

Design, Setting, and Participants  A case series survey study was conducted from July 2018 to January 2019. Consecutive patients who underwent cosmetic and/or functional rhinoplasty by 2 facial plastic surgeons (D.A.S. and L.N.L.) at an academic medical center were surveyed 1 month after surgery.

Main Outcomes and Measures  The number of oxycodone tablets taken, patient-reported pain outcomes, number of narcotic prescription refills, and patient-reported functional and cosmetic outcomes were recorded. Perception of pain, surgical outcome, and oxycodone intake were also evaluated by sex. Demographic information and perception of surgical results were recorded. Statistical analysis was performed using STATA statistical software (version 12.0, STATA Corp). Spearman rank order correlation was used for ordinal, monotonic variables with P < .05 being considered statistically significant.

Results  Overall, 104 patients were surveyed; 6 were lost to follow-up. Of the participants included, 50 were women with a mean (SD) age of 38 (16.0) years and 48 were men with a mean (SD) age of 38 (16.7) years. Although patients were prescribed a range of 10 to 40 tablets of oxycodone, patients took a mean (SD) of 5.2 tablets (range, 0-23). There were no significant sex differences in perception of pain, perception of outcome, or narcotic use. Among patients undergoing purely functional rhinoplasty, a statistically significant negative association between perception of pain and perception of functional outcome (breathing improvement) was evident. Patients who experienced less pain than they expected had a greater perception of functional improvement (rs = −0.62, P = .001). In contrast, among patients who underwent rhinoplasty with cosmetic improvement, no association was found between pain and perception of surgical outcome (rs = 0.05, P = .64).

Conclusions and Relevance  To our knowledge, this is the first study to prospectively evaluate the association between opioid use, patient-reported pain, and perceived surgical success. These data may help guide preoperative counseling because patients who are interested purely in breathing improvement (without cosmetic change) may warrant additional pain-specific counseling to optimize patient satisfaction.

Level of Evidence  3.

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Is weight loss your New Year’s resolution? What’s next when you lose the weight?

weight loss resolution next steps

Body contouring can help put the finishing touches on your 2020 weight loss goal and keep you motivated. Shedding excess weight, whether by diet and exercise or bariatric surgery, improves your health as well as your appearance.

However, major weight loss can result in excess skin and stubborn pockets of fat that no amount of dietary changes or exercise seem to touch. For this, body contouring procedures can help eliminate the excess skin and sculpt your curves, giving you your desired appearance, improving your motivation to keep the weight off and give you the self-confidence you deserve.

What body contouring procedures are available?

Whether to remove or tighten excess skin or help to repair stretched and lax muscles due to years of excessive weight, there are a variety of different surgical body contouring procedures available. These procedures include:

  • Tummy tuck – This procedure can remove excess abdominal skin as well as help to repair stretched and lax abdominal muscles.
  • Breast lifts and augmentation – Breast lifts can improve sagging tissue while augmentation can increase your bust line and breast appearance.
  • Thigh lifts – This procedure addresses sagging and excess skin on the inner thighs.
  • Upper arm lifts – An upper arm lift addresses excess, sagging skin and tissue in the arms.
  • Facelifts – As you lose weight, you may experience sagging in the mid-face, jowls and neck. Facelifts after weight loss can address these issues, giving you a younger, more defined look.
  • Lower body lifts – Lower body lifts address excess skin and sagging in the abdomen, buttocks, and inner and outer thighs.

How to decide if you are ready for body contouring surgery?

When you have lost a large amount of weight, you may be extremely eager to jump into body contouring surgery to help eliminate your excess skin and complete your weight loss journey. However, there are some important things to consider before you take that step.

  1. You need to be at or near your ideal body weight. If you are continuing to lose weight, now is not the time for body contouring. Additional weight loss after a surgical procedure can result in additional excess skin and the need for additional procedures.
  2. Your weight loss needs to be stable. You may have lost a double or even triple-digit number of pounds, but, as you know, weight loss can fluctuate and keeping weight off is often the hardest part of your weight loss journey. Before you are a good candidate for body contouring surgery, you need to be able to maintain your weight loss and show weight stabilization.
  3. You must be healthy enough for surgery. If you have lost weight naturally through diet and exercise, chances are you are already following a healthy diet and lifestyle. If you lost weight through bariatric surgery, you may need time to adjust to your new dietary restrictions and make sure you are meeting nutritional needs before surgery. If you are a smoker, you will be advised to stop smoking as this can impair healing and recovery.

What added benefits does body contouring provide?

Body contouring procedures address physical concerns such as the removal of excess skin and the repair of stretched muscles. But they do far more than that. After all the work you put in to lose the weight, the excess and hanging skin can create a different set of concerns. While you should be celebrating your success, this excess skin and tissue may leave you feeling self-conscious or even uncomfortable.

Many people who have lost significant amounts of weight report discomfort due to their excess skin. It can interfere with normal activity, including exercise necessary to maintain your new weight loss. Excess sagging skin is also prone to ulcers and infections. Body contouring procedures remove this skin, reducing the risk of infection and giving you the ability to get back to life.

What is your next step?

Once you meet the criteria for body contouring surgery, your next step is to consult with a board-certified plastic surgeon that specializes in body contouring procedures. Together, you and your plastic surgeon will determine which procedures will help you achieve your contouring goals and put a surgical plan in action.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Molecular Characterization of Lipoaspirates Used in Regenerative Head and Neck Surgery

Key Points

Question  What is the composition of lipoaspirates used for lipotransfer in the head and neck, and what is their potential for wound healing in vitro?

Findings  In this case series study of lipoaspirate samples obtained from 15 patients, adipose-derived mesenchymal stem cells were found in high purity and were able to multidifferentiate. The adipose-derived stem/stromal cells and their supernatants had proliferation- and immune-modulating properties in vitro.

Meaning  The findings suggest that lipoaspirates contain a concentration of adipose-derived stem/stromal cells that can be used for regenerative head and neck surgical procedures.

Importance  Adipose-derived mesenchymal stem cells (ASCs) have been used commonly in regenerative medicine and increasingly for head and neck surgical procedures. Lipoaspiration with centrifugation is purported to be a mild method for the extraction of ASCs used for autologous transplants to restore tissue defects or induce wound healing. The content of ASCs, their paracrine potential, and cellular potential in wound healing have not been explored for this method to our knowledge.

Objective  To evaluate the characteristics of lipoaspirates used in reconstructive head and neck surgical procedures with respect to wound healing.

Design, Setting, and Participants  This case series study included 15 patients who received autologous fat injections in the head and neck during surgical procedures at a tertiary referral center. The study was performed from October 2017 to November 2018, and data were analyzed from October 2017 to February 2019.

Main Outcomes and Measures  Excessive material of lipoaspirates from subcutaneous abdominal fatty tissue was examined. Cellular composition was analyzed using immunohistochemistry (IHC) and flow cytometry, and functionality was assessed through adipose, osteous, and chondral differentiation in vitro. Supernatants were tested for paracrine ASC functions in fibroblast wound-healing assays. Enzyme-linked immunosorbent assay measurement of tumor necrosis factor (TNF), vascular endothelial growth factor (VEGF), stromal-derived factor 1α (SDF-1α), and transforming growth factor β3 (TGF-β3) was performed.

Results  Among the 15 study patients (8 [53.3%] male; mean [SD] age at the time of surgery, 63.0 [2.8] years), the stromal vascular fraction (mean [SE], 53.3% [4.2%]) represented the largest fraction within the native lipoaspirates. The cultivated cells were positive for CD73 (mean [SE], 99.90% [0.07%]), CD90 (99.40% [0.32%]), and CD105 (88.54% [2.74%]); negative for CD34 (2.70% [0.45%]) and CD45 (1.74% [0.28%]) in flow cytometry; and negative for CD14 (10.56 [2.81] per 300 IHC score) and HLA-DR (6.89 [2.97] per 300 IHC score) in IHC staining; they differentiated into osteoblasts, adipocytes, and chondrocytes. The cultivated cells showed high expression of CD44 (mean [SE], 99.78% [0.08%]) and CD273 (82.56% [5.83%]). The supernatants were negative for TNF (not detectable) and SDF-1α (not detectable) and were positive for VEGF (mean [SE], 526.74 [149.84] pg/mL for explant supernatants; 528.26 [131.79] pg/106 per day for cell culture supernatants) and TGF-β3 (mean [SE], 22.79 [3.49] pg/mL for explant supernatants; 7.97 [3.15] pg/106 per day for cell culture supernatants). Compared with control (25% or 50% mesenchymal stem cell medium), fibroblasts treated with ASC supernatant healed the scratch-induced wound faster (mean [SE]: control, 1.000 [0.160]; explant supernatant, 1.369 [0.070]; and passage 6 supernatant, 1.492 [0.094]).

Conclusions and Relevance  The cells fulfilled the international accepted criteria for mesenchymal stem cells. The lipoaspirates contained ASCs that had the potential to multidifferentiate with proliferative and immune-modulating properties. The cytokine profile of the isolated ASCs had wound healing–promoting features. Lipoaspirates may have a regenerative potential and an application in head and neck surgery.

Level of Evidence  NA.

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The Latest Technology & Inventions

Wolters Kluwer Health

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