Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation
Identifieur interne : 001A26 ( Pmc/Checkpoint ); précédent : 001A25; suivant : 001A27Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation
Auteurs : Fabio Nicoli [Italie, Taïwan] ; Ram M. Chilgar [Taïwan] ; Stamatis Sapountzis [Taïwan] ; Davide Lazzeri [Italie] ; Matthew Yeo Sze Wei [Taïwan] ; Pedro Ciudad [Taïwan] ; Marzia Nicoli [Italie] ; Seong Yoon Lim [Taïwan] ; Pei-Yu Chen [Taïwan] ; Joannis Constantinides [Taïwan, Royaume-Uni] ; Hung-Chi Chen [Taïwan]Source :
- Archives of Plastic Surgery [ 2234-6163 ] ; 2014.
Abstract
Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF). We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.
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DOI: 10.5999/aps.2014.41.5.588
PubMed: 25276654
PubMed Central: 4179366
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University of Rome "Tor Vergata", Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A3">Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A4">Department of Immunology, University of Rome "La Sapienza", Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Department of Immunology, 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wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Pathology, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Constantinides, Joannis" sort="Constantinides, Joannis" uniqKey="Constantinides J" first="Joannis" last="Constantinides">Joannis Constantinides</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="A6">Department of Plastic and Reconstructive Surgery, St. Thomas' Hospital, London, UK.</nlm:aff><country xml:lang="fr" 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Reconstructive Surgery, University of Rome "Tor Vergata", Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="A3">Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Chilgar, Ram M" sort="Chilgar, Ram M" uniqKey="Chilgar R" first="Ram M." last="Chilgar">Ram M. Chilgar</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Sapountzis, Stamatis" sort="Sapountzis, Stamatis" uniqKey="Sapountzis S" first="Stamatis" last="Sapountzis">Stamatis Sapountzis</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Lazzeri, Davide" sort="Lazzeri, Davide" uniqKey="Lazzeri D" first="Davide" last="Lazzeri">Davide Lazzeri</name><affiliation wicri:level="3"><nlm:aff id="A3">Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Sze Wei, Matthew Yeo" sort="Sze Wei, Matthew Yeo" uniqKey="Sze Wei M" first="Matthew Yeo" last="Sze Wei">Matthew Yeo Sze Wei</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Ciudad, Pedro" sort="Ciudad, Pedro" uniqKey="Ciudad P" first="Pedro" last="Ciudad">Pedro Ciudad</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Nicoli, Marzia" sort="Nicoli, Marzia" uniqKey="Nicoli M" first="Marzia" last="Nicoli">Marzia Nicoli</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A3">Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A4">Department of Immunology, University of Rome "La Sapienza", Rome, Italy.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Italie</country><wicri:regionArea>Department of Immunology, University of Rome "La Sapienza", Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Lim, Seong Yoon" sort="Lim, Seong Yoon" uniqKey="Lim S" first="Seong Yoon" last="Lim">Seong Yoon Lim</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Pei Yu" sort="Chen, Pei Yu" uniqKey="Chen P" first="Pei-Yu" last="Chen">Pei-Yu Chen</name><affiliation wicri:level="1"><nlm:aff id="A5">Department of Pathology, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Pathology, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author><author><name sortKey="Constantinides, Joannis" sort="Constantinides, Joannis" uniqKey="Constantinides J" first="Joannis" last="Constantinides">Joannis Constantinides</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="A6">Department of Plastic and Reconstructive Surgery, St. Thomas' Hospital, London, UK.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, St. Thomas' Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung</wicri:regionArea><wicri:noRegion>Taichung</wicri:noRegion></affiliation></author></analytic><series><title level="j">Archives of Plastic Surgery</title><idno type="ISSN">2234-6163</idno><idno type="eISSN">2234-6171</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF). We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Shih, Yc" uniqKey="Shih Y">YC Shih</name></author><author><name sortKey="Xu, Y" uniqKey="Xu Y">Y Xu</name></author><author><name sortKey="Cormier, Jn" uniqKey="Cormier J">JN Cormier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, N" uniqKey="Liu N">N Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, Nf" uniqKey="Liu N">NF Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, Nf" uniqKey="Liu N">NF Liu</name></author><author><name sortKey="Zhang, Lr" uniqKey="Zhang L">LR Zhang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coleman, Sr" uniqKey="Coleman S">SR Coleman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Salgado, Cj" uniqKey="Salgado C">CJ Salgado</name></author><author><name sortKey="Mardini, S" uniqKey="Mardini S">S Mardini</name></author><author><name sortKey="Spanio, S" uniqKey="Spanio S">S Spanio</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rohrich, Rj" uniqKey="Rohrich R">RJ Rohrich</name></author><author><name sortKey="Ghavami, A" uniqKey="Ghavami A">A Ghavami</name></author><author><name sortKey="Crosby, Ma" uniqKey="Crosby M">MA Crosby</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lam, Sm" uniqKey="Lam S">SM Lam</name></author><author><name sortKey="Glasgold, Ra" uniqKey="Glasgold R">RA Glasgold</name></author><author><name sortKey="Glasgold, Mj" uniqKey="Glasgold M">MJ Glasgold</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pinski, Ks" uniqKey="Pinski K">KS Pinski</name></author><author><name sortKey="Roenigk, Hh" uniqKey="Roenigk H">HH Roenigk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Keyhan, So" uniqKey="Keyhan S">SO Keyhan</name></author><author><name sortKey="Hemmat, S" uniqKey="Hemmat S">S Hemmat</name></author><author><name sortKey="Badri, Aa" uniqKey="Badri A">AA Badri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Levi, B" uniqKey="Levi B">B Levi</name></author><author><name sortKey="Glotzbach, Jp" uniqKey="Glotzbach J">JP Glotzbach</name></author><author><name sortKey="Sorkin, M" uniqKey="Sorkin M">M Sorkin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alghoul, M" uniqKey="Alghoul M">M Alghoul</name></author><author><name sortKey="Mendiola, A" uniqKey="Mendiola A">A Mendiola</name></author><author><name sortKey="Seth, R" uniqKey="Seth R">R Seth</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Andre, P" uniqKey="Andre P">P Andre</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, N" uniqKey="Liu N">N Liu</name></author><author><name sortKey="Shao, L" uniqKey="Shao L">L Shao</name></author><author><name sortKey="Xu, X" uniqKey="Xu X">X Xu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aschen, S" uniqKey="Aschen S">S Aschen</name></author><author><name sortKey="Zampell, Jc" uniqKey="Zampell J">JC Zampell</name></author><author><name sortKey="Elhadad, S" uniqKey="Elhadad S">S Elhadad</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="brief-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Arch Plast Surg</journal-id><journal-id journal-id-type="iso-abbrev">Arch Plast Surg</journal-id><journal-id journal-id-type="publisher-id">APS</journal-id><journal-title-group><journal-title>Archives of Plastic Surgery</journal-title></journal-title-group><issn pub-type="ppub">2234-6163</issn><issn pub-type="epub">2234-6171</issn><publisher><publisher-name>The Korean Society of Plastic and Reconstructive Surgeons</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25276654</article-id><article-id pub-id-type="pmc">4179366</article-id><article-id pub-id-type="doi">10.5999/aps.2014.41.5.588</article-id><article-categories><subj-group subj-group-type="heading"><subject>Idea and Innovations</subject></subj-group></article-categories><title-group><article-title>Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nicoli</surname><given-names>Fabio</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Chilgar</surname><given-names>Ram M.</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Sapountzis</surname><given-names>Stamatis</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Lazzeri</surname><given-names>Davide</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Sze Wei</surname><given-names>Matthew Yeo</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Ciudad</surname><given-names>Pedro</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Nicoli</surname><given-names>Marzia</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Lim</surname><given-names>Seong Yoon</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Chen</surname><given-names>Pei-Yu</given-names></name><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Constantinides</surname><given-names>Joannis</given-names></name><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Chen</surname><given-names>Hung-Chi</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome, Italy.</aff><aff id="A2"><label>2</label>Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.</aff><aff id="A3"><label>3</label>Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.</aff><aff id="A4"><label>4</label>Department of Immunology, University of Rome "La Sapienza", Rome, Italy.</aff><aff id="A5"><label>5</label>Department of Pathology, China Medical University Hospital, Taichung, Taiwan.</aff><aff id="A6"><label>6</label>Department of Plastic and Reconstructive Surgery, St. Thomas' Hospital, London, UK.</aff><author-notes><corresp>Correspondence: Hung-Chi Chen. Department of Plastic and Reconstructive Surgery, China Medical University Hospital, 2 Yuh-Der Road, Taichung 40447, Taiwan. Tel: +886422052020, Fax: +886422030777, <email>D19722@mail.cmuh.org.tw</email></corresp></author-notes><pub-date pub-type="ppub"><month>9</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>15</day><month>9</month><year>2014</year></pub-date><volume>41</volume><issue>5</issue><fpage>588</fpage><lpage>593</lpage><history><date date-type="received"><day>17</day><month>3</month><year>2014</year></date><date date-type="rev-recd"><day>30</day><month>5</month><year>2014</year></date><date date-type="accepted"><day>14</day><month>6</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 The Korean Society of Plastic and Reconstructive Surgeons</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF). We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.</p></abstract><kwd-group><kwd>Lymphedema</kwd><kwd>Adipose tissue</kwd><kwd>Hyaluronic acid</kwd><kwd>Rejuvenation</kwd><kwd>Esthetics</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label><caption><p>Case 1: Preoperative, intraoperative, and postoperative photographs</p><p>(A) Lymphedema fat graft rejuvenation case: preoperative photograph. (B) Intraoperative photograph of lymphedema fat harvesting. (C) Clinical case at postoperative year 2.</p></caption><graphic xlink:href="aps-41-588-g001"></graphic></fig><fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label><caption><p>Case 2: preoperative and postoperative photographs</p><p>(A) Lymphedema fat graft rejuvenation case: preoperative photograph. (B) Photograph at follow-up at postoperative year 1.</p></caption><graphic xlink:href="aps-41-588-g002"></graphic></fig><fig id="F3" orientation="portrait" position="float"><label>Fig. 3</label><caption><p>Pathologic comparison between fat and lymphedema fat</p><p>(A) Histological analysis of abdominal fat: Masson's Trichrome stain on ×40 magnification. (B) Histological analysis of lymphedema fat: Masson's Trichrome stain on ×40 magnification.</p></caption><graphic xlink:href="aps-41-588-g003"></graphic></fig><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Patient summary</p></caption><graphic xlink:href="aps-41-588-i001"></graphic><table-wrap-foot><fn><p>HCC, Hung-Chi Chen; LFG, lymphedema fat graft; LN, lymph node; SCC, squamous cell carcinoma; RRPP, radical reduction with preservation of perforators.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Subjective assessment</p></caption><graphic xlink:href="aps-41-588-i002"></graphic><table-wrap-foot><fn><p>SD, standard deviation.</p><p><sup>a)</sup>Score: minimum, 0; maximum, 10.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Italie</li><li>Royaume-Uni</li><li>Taïwan</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Latium</li></region><settlement><li>Londres</li><li>Rome</li></settlement></list><tree><country name="Italie"><region name="Latium"><name sortKey="Nicoli, Fabio" sort="Nicoli, Fabio" uniqKey="Nicoli F" first="Fabio" last="Nicoli">Fabio Nicoli</name></region><name sortKey="Lazzeri, Davide" sort="Lazzeri, Davide" uniqKey="Lazzeri D" first="Davide" last="Lazzeri">Davide Lazzeri</name><name sortKey="Nicoli, Fabio" sort="Nicoli, Fabio" uniqKey="Nicoli F" first="Fabio" last="Nicoli">Fabio Nicoli</name><name sortKey="Nicoli, Marzia" sort="Nicoli, Marzia" uniqKey="Nicoli M" first="Marzia" last="Nicoli">Marzia Nicoli</name><name sortKey="Nicoli, Marzia" sort="Nicoli, Marzia" uniqKey="Nicoli M" first="Marzia" last="Nicoli">Marzia Nicoli</name><name sortKey="Nicoli, Marzia" sort="Nicoli, Marzia" uniqKey="Nicoli M" first="Marzia" last="Nicoli">Marzia Nicoli</name></country><country name="Taïwan"><noRegion><name sortKey="Nicoli, Fabio" sort="Nicoli, Fabio" uniqKey="Nicoli F" first="Fabio" last="Nicoli">Fabio Nicoli</name></noRegion><name sortKey="Chen, Hung Chi" sort="Chen, Hung Chi" uniqKey="Chen H" first="Hung-Chi" last="Chen">Hung-Chi Chen</name><name sortKey="Chen, Pei Yu" sort="Chen, Pei Yu" uniqKey="Chen P" first="Pei-Yu" last="Chen">Pei-Yu Chen</name><name sortKey="Chilgar, Ram M" sort="Chilgar, Ram M" uniqKey="Chilgar R" first="Ram M." last="Chilgar">Ram M. Chilgar</name><name sortKey="Ciudad, Pedro" sort="Ciudad, Pedro" uniqKey="Ciudad P" first="Pedro" last="Ciudad">Pedro Ciudad</name><name sortKey="Constantinides, Joannis" sort="Constantinides, Joannis" uniqKey="Constantinides J" first="Joannis" last="Constantinides">Joannis Constantinides</name><name sortKey="Lim, Seong Yoon" sort="Lim, Seong Yoon" uniqKey="Lim S" first="Seong Yoon" last="Lim">Seong Yoon Lim</name><name sortKey="Sapountzis, Stamatis" sort="Sapountzis, Stamatis" uniqKey="Sapountzis S" first="Stamatis" last="Sapountzis">Stamatis Sapountzis</name><name sortKey="Sze Wei, Matthew Yeo" sort="Sze Wei, Matthew Yeo" uniqKey="Sze Wei M" first="Matthew Yeo" last="Sze Wei">Matthew Yeo Sze Wei</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Constantinides, Joannis" sort="Constantinides, Joannis" uniqKey="Constantinides J" first="Joannis" last="Constantinides">Joannis Constantinides</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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