Regenerative plastic surgery for facial treatmentPietro Gentile MD, Phd
Facial Lipofilling with adipose tissue graft with SVF and PRP: which are the application fields?
Year after year the application of Stromal Vascular Fraction (SVF) resulted in numerous advantages, together with Platelet Rich Plasma (PRP) and using fat tissue as lipofilling or facial treatment. This procedure is applied in reconstructive field, starting from burn sequelae, outcomes scar, facial hemiatrophy and Romberg Syndrome, to cosmetic field to enhance facial recontouring as lips augmentation and skin rejuvenation. Regenerative Plastic Surgery has become a revolution in terms of medical treatments and social outcomes. What has been revolutionized is the contemporary thinness concept, the stereotype that runs a no holds barred war against fat that, nowadays, not only has been reevaluated but also treasured as a precious resource. Body adipose tissue can be considered as a source of beauty and wellness from which obtain Stromal Vascular Fraction cells containing adult stem cells. Our organs and tissues have got the richest level of adult stem cells, called ASC -Adipose Derived Stem Cells. We can extract adipose tissue through liposuction and, thanks to mechanical filtration method, separate SVF cell population by centrifugation and subsequent filtration of the solution. SVF cells will be added to adipose tissue and then grafted on deficit areas. In this way we apply autologous cells and tissue not only to fill in, as in the case of face or breast, but also to enhance skin quality. The application of this technique on the face can be performed by considering patient’s eligibility based on exclusion criteria already explained in the breast section. This procedure, in fact, is not suitable for every patient. In some cases a second intervention had to be performed as to achieve the desired volume.
Lipofilling and lipostructure with adipose tissue graft with SVF and PRP: what is it?
The increasingly use of autologous adipose tissue added to SVF -Stromal Vascular Fraction Cells and/or to PRP Platelet Rich Plasma for facial treatment, is the result of the growing demand for skin rejuvenation and soft tissue augmentation.
The immediate gratification and the absence of prosthesis are the main reasons why patients require this kind of intervention. During the last five years, a growing number of scientific publications have described this subject. Stromal vascular fraction cells and adipose tissue fields of application are: outcomes of radiotherapy in breast cancer reconstruction, breast augmentation, outcomes of breast reconstruction after mastectomy, prosthesis removal outcomes. Nowadays, stromal vascular fraction can be obtained through minimal manipulation of adipose tissue, by using fat centrifugation procedures and mechanical filtration of it. SVF cell population contains adipose-derived stem cells called Adipose Derived Stem Cells (ASC). ASC improve vascularization and adipose tissue survival by secreting various growth factors. In recent years we have published numerous scientific studies, after years of researches, regarding SVF, ASC and PRP mixed with adipose tissue for facial treatment (see scientific publication section).
The aim of the studies was to evaluate the fat engraftment in the breast through objective evaluation and long-term follow up. Preoperative and postoperative evaluation in our studies included complete clinical examination, photograph evaluation, nuclear magnetic resonance (NMR), breast ultrasound.
Procedure explanation available in the video on the right.
Lipofilling and lipostructure with adipose tissue graft with SVF and PRP: what are its limits?
The procedure is not suitable for every patient. First of all, it is necessary to carefully evaluate the tumor, its progression and the illness follow up in patients with breast cancer reconstruction outcomes.
Exclusion criteria have to be considered for this treatment. The exclusion criteria are divided into 2 categories: systemic and local. The systemic criteria include platelet disorders, thrombocytopenia, anti-aggregating therapy, bone marrow aplasia, uncompensated diabetes, sepsis, and cancer. The local criteria include cancer loss of substance. In the case of breast hypoplasia, that is a less developed breast in terms of volume, it is necessary to careful evaluate during the medical examination whereas there are areas of the body with enough adipose tissue to be taken trough liposuction (abdomen, flank, thigh most commonly).
It is necessary to evaluate patient’s real needs and expectations, explaining him/her that there will be an adipose tissue resorption especially during the first six months. In some cases it is necessary to repeat the procedure as to achieve the adequate volume. The benefits will be a natural breast feeling to the touch and to the view.
Lipofilling and lipostructure with adipose tissue graft with SVF and PRP: what outcomes could be supposed?
A higher fat engraftment percentage at facial level than traditional methods applied. Adipose tissue graft with SVF and PRP is a promising alternative to prosthesis or other procedures as fillers. SVF and PRP, in fact, improve autologous adipose tissue viability.