BIOLOGICAL MANIPULATIONS CAN IMPROVE THE RESULTS OF AUTOLOGOUS FAT TRANSFER FOR FACIAL REJUVENATION AND LIPOATROPHY
Clinical Problem : Irregular fat resorption and adipocyte apoptosis after autologous fat transfer ( lipofilling) for lipoatrophy may result in variable results and compromised rejuvenation.
Strategies and methods to improve engraftment results : BOLANDCELL has addressed the following negative factors.
- Donor site pre-treatment to amplify preadipocyte population before cell harvest: This can be considered and includes small injections of glucose, fatty acids or low dose, short-acting insulin.
- Laboratory validation of fat injectate ( T3 receptor and PREF-1 receptor ) after cell isolation/separation/centrifugation and before injection (costly and not freely available).
- Extraction of fat : Syringe aspiration or liposuction?
- Co-mixture of fat injectate with REGENLAB platelet rich plasma (and containing PDGF, TGF, EGF, and VEGF ) to facilitate engraftment, healing and cell-take in the recipient site.
- Application of stromal cultured adipocytes rather than lobular white fat, that have a diminished propensity to cell division.
The newer innovations to improve the rejuvenation are thus by application of donor site fat amplification , reconsidering less traumatic cell harvesting technique, modified isolation of fat cells and admixture with platelet derived growth factors from PRP , prior to reimplantation.
PLATELET RICH PLASMA : COSMETIC APPLICATION. This form of facial and cosmetic/aesthetic rejuvenation is available in Cape Town. Rejuvenation of the chronological and photoaged face can also be achieved by dermal injection of PRP via a mesotherapy technique or Mesogun. This can be used as a stand alone procedure without fat or with fat transfer. In the latter case, a volumetric effect is utilised to address lipoatrophy. In the former case, no volumetric effect is really achieved and regeneration of dermal and subdermal mesenchymal stem cells is the proposed theory. As a potential client or recipient of platelet rich plasma for cosmetic facial rejuvenation make sure of the following consent points:
- Your health care provider is well qualified and authorised in the art of platelet rich plasma usage.
- You have no exclusion criteria
- You have sat and had a sensible discussion with an expert in the field. Ask him to provide before and after pictures and to give his personal experience ( and where he or she was trained and by whom)
- Your health care provider is well schooled in the art and practice of the application of platelet derived GF. Is he/she knowledgeable?
- Your health care provider is well schooled in the art of facial mesotherapy technique especially when it comes to the neck and décolleté ( knowledge of applied facial anatomy is required). If not, get a second opinion from a trained specialist and there are academic experts that will gladly do so .
- You have read the PRP instruction brochure found on this website. This will provide you with gratis information, formulated by an international expert in the field and use of biologics, that will allow you to make an informed decision. You will then feel more comfortable.
- Pretreatment of the skin is performed and post procedural interventions explained.
- You have had a skin analysis, preferably with the SKIN EVIDENCE PRO , anew device that is available in Bellville, Cape Town . This gives excellent information about your skin morphology, hydration, sebum content etc. You get a print-out that you can use for later evaluation.
CONCLUSIONS: These new biological strategies to improve engraftment of autologous fat transfer for natural rejuvenation need consideration and verification by further studies. Admixture of the fatty injectate with PLATELET RICH PLASMA may well enhance engraftment of the adipocytes in the recipient and thus improve cell retention.
BOLANDCELL ACADEMIC REFERENCES
- Witort EJ et al. Autologous lipofilling: co-enzyme Q10 can rescue adipocytes from stress-induced apoptotic death. Plast Reconstr Surg 2007:119;1191-9.
- Coleman WP. Fat transplantation. Dermatol Clin 1999 17:891-8.
- Bertossi D et al. Lipofilling of the lips. Arch Facial Plast Surg 2003:5;392-8.
Adipocytes are carefully harvested from subdermal fat (aspirate or liposuction) and used for autologous fat transfer.
Biotechnology: Preadipocytes derived by TC from stroma and placed in PRP vehicle and biocomposite scaffold prior to transfer.
Lobular white fat. Reabsorpsion is inevitable if admixture with PRP is omitted.