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Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation
Nicoli, Fabio,Chilgar, Ram M.,Sapountzis, Stamatis,Lazzeri, Davide,Yeo, Matthew Sze Wei,Ciudad, Pedro,Nicoli, Marzia,Lim, Seong Yoon,Chen, Pei-Yu,Constantinides, Joannis,Chen, Hung-Chi Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.5
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 postoperative 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 $7.2{\pm}0.5$, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of $8.5{\pm}0.7$ 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.
Potential Use of Transferred Lymph Nodes as Metastasis Detectors after Tumor Excision
Fabio Nicoli,Pedro Ciudad,Seong Yoon Lim,Davide Lazzeri,Christopher D’Ambrosia,Kidakorn Kiranantawat,Ram M. Chilgar,Stamatis Sapountzis,Bulent Sacak,Hung-Chi Chen 대한성형외과학회 2015 Archives of Plastic Surgery Vol.42 No.4
Due to the fact that it reliably results in positive outcomes, lymph node flap transfer is becoming an increasingly popular surgical procedure for the prevention and treatment of lymphedema. This technique has been shown to stimulate lymphoangiogenesis and restore lymphatic function, as well as decreasing infection rates, minimizing pain, and preventing the recurrence of lymphedema. In this article, we investigate possible additional benefits of lymph node flap transfer, primarily the possibility that sentinel lymph nodes may be used to detect micrometastasis or in-transit metastasis and may function as an additional lymphatic station after the excision of advanced skin cancer.
Potential Use of Transferred Lymph Nodes as Metastasis Detectors after Tumor Excision
Nicoli, Fabio,Ciudad, Pedro,Lim, Seong Yoon,Lazzeri, Davide,D'Ambrosia, Christopher,Kiranantawat, Kidakorn,Chilgar, Ram M,Sapountzis, Stamatis,Sacak, Bulent,Chen, Hung-Chi Korean Society of Plastic and Reconstructive Surge 2015 Archives of Plastic Surgery Vol.42 No.4
Due to the fact that it reliably results in positive outcomes, lymph node flap transfer is becoming an increasingly popular surgical procedure for the prevention and treatment of lymphedema. This technique has been shown to stimulate lymphoangiogenesis and restore lymphatic function, as well as decreasing infection rates, minimizing pain, and preventing the recurrence of lymphedema. In this article, we investigate possible additional benefits of lymph node flap transfer, primarily the possibility that sentinel lymph nodes may be used to detect micrometastasis or in-transit metastasis and may function as an additional lymphatic station after the excision of advanced skin cancer.
Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation
Fabio Nicoli,Ram M. Chilgar,Stamatis Sapountzis,Davide Lazzeri,Matthew Yeo Sze Wei,Pedro Ciudad,Marzia Nicoli,Seong Yoon Lim,Pei-Yu Chen,Joannis Constantinides,Hung-Chi Chen 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5
Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has manyimportant properties. Over the past few years, significant research has been performed toidentify an ideal tissue to implant as a filler. Because of its unique composition, fat harvestedfrom the lymphedema tissue is an interesting topic for investigation and has significantpotential for application as a filler, particularly in facial rejuvenation. Over a 36-monthperiod, we treated and assessed 8 patients with lymphedematous limbs who concurrentlyunderwent facial rejuvenation with lymphedema fat (LF). We conducted a pre- and postoperativesatisfaction questionnaire survey and a histological assessment of the harvested LFfat. The overall mean general appearance score at an average of 6 months after the procedurewas 7.2±0.5, demonstrating great improvement. Patients reported significant improvementin their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. Thisstudy demonstrates that LF as an ideal autologous injectable filler is clinically applicable andeasily available in patients with lymphedema. We recommend the further study and clinicaluse of this tissue as it exhibits important properties and qualities for future applications andresearch.
Lazzeri, Davide,Huemer, Georg M.,Nicoli, Fabio,Larcher, Lorenz,Dashti, Talal,Grassetti, Luca,Li, Qingfeng,Zhang, Yixin,Spinelli, Giuseppe,Agostini, Tommaso Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.1
Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.
Davide Lazzeri,Georg M. Huemer,Fabio Nicoli,Lorenz Larcher,Talal Dashti,Luca Grassetti,Qingfeng Li,Yixin Zhang,Giuseppe Spinelli,Tommaso Agostini 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.1
Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.