Regenerative Cells For Facial Surgery: Biofilling and Biocontouring
Regenerative Cells For Facial Surgery: Biofilling and Biocontouring
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DOI：
10.1093/asj/sjx078
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发表时间：
2017-07-01
影响因子：
2.9
通讯作者：
Saad, Ahmad
中科院分区：
文献类型：
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作者：
Cohen, Steven R.;Hewett, Sierra;Saad, Ahmad
Zuk 等人于 2001 年在脂肪基质血管部分中发现了干细胞和再生细胞。在临床前研究中，这些细胞似乎可以刺激血管生成并减少炎症，此后不久，随着 Rigotti、Coleman、Mojallal、我们小组和其他人等研究人员证明脂肪可用于治疗和美容适应症，基质血管成分 (SVF) 的临床应用不断发展。脂肪及其含量对面部美观的再生作用已在组织学和细胞水平上得到证实。据报道，弹性蛋白和胶原纤维的再生以及毛细血管密度的改善和炎症的减少。我们回顾了目前在面部手术中使用再生细胞和不同类型脂肪移植的方法。脂肪移植物从再生的角度以及可以根据治疗的区域和状况修改为不同组织特征的组织产品进行分类。对富含 SVF 的脂肪、毫脂肪、微脂肪和纳米脂肪移植物以及复合脂肪移植物的临床应用进行了综述。根据迄今为止的临床经验和证据，在美容手术中使用 SVF 的再生效果似乎不大，但似乎有明确的再生组织学发现。当将富含细胞的脂肪移植物与单独的脂肪移植物进行比较时，这些改善对于患者来说可能在临床上并不明显。然而，组织学中看到的微妙变化可能会随着时间的推移而累积。定义了三种类型的脂肪移植物： 毫脂肪（块大小 2.4
Zuk et al in 2001 identified stem and regenerative cells within the stromal vascular fraction of fat. In preclinical studies, these cells appeared to stimulate angiogenesis and reduce inflammation, and soon thereafter, clinical use of stromal vascular fraction (SVF) evolved as researchers such as Rigotti, Coleman, Mojallal, our group, and others demonstrated that fat can be used for both therapeutic and aesthetic indications. The regenerative effects of fat and its contents on facial aesthetics have been shown at the histologic and cellular level. Regeneration of elastin and collagen fibers as well as improvement in capillary density and reduction of inflammation have been reported. We review our current approach to the use of regenerative cells and different types of fat grafts in facial surgery. The fat graft is classified, both from a regenerative point of view as well as a tissue product that can be modified into different tissue characteristics, depending on the area and condition treated. Clinical use of SVF enriched fat, millifat, microfat, and nanofat grafts as well as composite fat grafts are reviewed. Based on clinical experience and evidence to date, it appears that the regenerative effects seen with the use of SVF in aesthetic surgery are modest, but there appear to be definite histologic findings of regeneration. These improvements may not be clinically apparent to a patient when cell enriched fat grafts are compared to fat grafts alone. However, the subtle changes seen in histology may be cumulative over time. Three types of fat grafts are defined: millifat (parcel size 2.4