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CC BY-NC 4.0 · Arch Plast Surg 2018; 45(02): 128-134
DOI: 10.5999/aps.2017.00997
Original Article

Volumetric lipoinjection of the fronto-orbital and temporal complex with adipose stem cells for the aesthetic restoration of sequelae of craniosynostosis

Yanko Castro-Govea 
Plastic Surgery Service, Hospital Universitario “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
,
Amin Vela-Martinez
Plastic Surgery Service, Hospital Universitario “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
,
Luis Alberto Treviño-Garcia
Plastic Surgery Service, Hospital Universitario “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
› Author AffiliationsThe authors thank Sergio Lozano-Rodriguez, M.D. and Alejandro Quiroga-Garza, M.D. for their help in translating the manuscript. We also thank the graphic designer, Ricardo Vela, for his help in making the images presented in this paper.
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Background Non-syndromic craniosynostosis causes craniofacial asymmetry and may persist after cranioplasty. These postoperative asymmetries are primarily depressions. In some cases, patients may be subjected to pranks and harassment by their peers, affecting their psychosocial development. We propose lipoinjection enriched with adipose stem cells (ASCs) to treat the sequelae of craniosynostosis in the fronto-orbital and temporal complex in cranioplasty patients, with the goal of improving the appearance of the upper third of the face.

Methods Twelve children (four boys and eight girls) between 4 and 8 years of age (mean age, 6 years) in the postoperative period after treatment for plagiocephaly, brachycephaly, and trigonocephaly were included, with a follow-up period of 1 to 18 months. Fat tissue was obtained from the lower abdomen, and ASCs were isolated using the Yoshimura technique. Lipoinjection was performed using several mini-approaches to ensure adequate distribution.

Results Two different scales were used to evaluate the aesthetic outcomes. At 6 months, three plastic surgeons independent of the study classified the results using a Likert scale. The patients’ parents categorized the results using a visual analog scale at 6, 9, and 18 months. R esults were favorable on both scales, as the patients’ facial appearance improved and they reported increased happiness and self-esteem due to their remodeled facial appearance.

Conclusions We suggest that lipoinjection enriched with ASCs is a good alternative for correcting asymmetry of the fronto-orbital and temporal contour in patients with sequelae of craniosynostosis. This treatment will help boost patients’ self-esteem starting at an early age.

Keywords

Craniosynostoses - Transplants - Frontal bone - Adipose tissue - Stem cells


Publication History

Received: 23 May 2017

Accepted: 13 December 2017

Article published online:
22 May 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Anderson PJ, David DJ. Late results after unicoronal craniosynostosis correction. J Craniofac Surg 2005; 16: 37-44
    CrossrefPubMedGoogle Scholar
  • 2 Sgouros S, Goldin JH, Hockley AD. et al. Surgery for unilateral coronal synostosis (plagiocephaly): unilateral or bilateral correction?. J Craniofac Surg 1996; 7: 284-9
    CrossrefPubMedGoogle Scholar
  • 3 Joly A, Pare A, Sallot A. et al. Long-term assessment of suturectomy in trigonocephaly and anterior plagiocephaly. J Craniofac Surg 2016; 27: 627-30
    CrossrefPubMedGoogle Scholar
  • 4 Persing JA. MOC-PS(SM) CME article: management considerations in the treatment of craniosynostosis. Plast Reconstr Surg 2008; 121 4 Suppl 1-11
    PubMedGoogle Scholar
  • 5 Lovegrove E, Rumsey N. Ignoring it doesn’t make it stop: adolescents, appearance, and bullying. Cleft Palate Craniofac J 2005; 42: 33-44
    CrossrefPubMedGoogle Scholar
  • 6 Aspinall CL. Anticipating benefits and decreasing burdens: the responsibility inherent in pediatric plastic surgery. J Craniofac Surg 2010; 21: 1330-4
    CrossrefPubMedGoogle Scholar
  • 7 Versnel SL, Plomp RG, Passchier J. et al. Long-term psychological functioning of adults with severe congenital facial disfigurement. Plast Reconstr Surg 2012; 129: 110-7
    CrossrefPubMedGoogle Scholar
  • 8 Laurent F, Capon-Degardin N, Martinot-Duquennoy V. et al. Role of lipo-filling in the treatment of sequelae in craniosynostosis surgery. Ann Chir Plast Esthet 2006; 51: 512-6
    CrossrefPubMedGoogle Scholar
  • 9 Tanikawa DY, Aguena M, Bueno DF. et al. Fat grafts supplemented with adipose-derived stromal cells in the rehabilitation of patients with craniofacial microsomia. Plast Reconstr Surg 2013; 132: 141-52
    PubMedGoogle Scholar
  • 10 Matsumoto D, Sato K, Gonda K. et al. Cell-assisted lipotransfer: supportive use of human adipose-derived cells for soft tissue augmentation with lipoinjection. Tissue Eng 2006; 12: 3375-82
    CrossrefPubMedGoogle Scholar
  • 11 Rigotti G, Marchi A, Sbarbati A. Adipose-derived mesenchymal stem cells: past, present, and future. Aesthetic Plast Surg 2009; 33: 271-3
    CrossrefPubMedGoogle Scholar
  • 12 Eto H, Suga H, Matsumoto D. et al. Characterization of structure and cellular components of aspirated and excised adipose tissue. Plast Reconstr Surg 2009; 124: 1087-97
    CrossrefPubMedGoogle Scholar
  • 13 Castro-Govea Y, De La Garza-Pineda O, Lara-Arias J. et al. Cell-assisted lipotransfer for the treatment of parry-romberg syndrome. Arch Plast Surg 2012; 39: 659-62
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Yoshimura K, Sato K, Aoi N. et al. Cell-assisted lipotransfer for facial lipoatrophy: efficacy of clinical use of adipose-derived stem cells. Dermatol Surg 2008; 34: 1178-85
    PubMedGoogle Scholar
  • 15 Chen X, Yan L, Guo Z. et al. Adipose-derived mesenchymal stem cells promote the survival of fat grafts via crosstalk between the Nrf2 and TLR4 pathways. Cell Death Dis 2016; 7: e2369
    CrossrefPubMedGoogle Scholar
  • 16 Zhu M, Zhou Z, Chen Y. et al. Supplementation of fat grafts with adipose-derived regenerative cells improves long-term graft retention. Ann Plast Surg 2010; 64: 222-8
    CrossrefPubMedGoogle Scholar
  • 17 Coleman SR. Structural fat grafts: the ideal filler?. Clin Plast Surg 2001; 28: 111-9
    CrossrefPubMedGoogle Scholar
  • 18 Horl HW, Feller AM, Biemer E. Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging. Ann Plast Surg 1991; 26: 248-58
    CrossrefPubMedGoogle Scholar
  • 19 Eremia S, Newman N. Long-term follow-up after autologous fat grafting: analysis of results from 116 patients followed at least 12 months after receiving the last of a minimum of two treatments. Dermatol Surg 2000; 26: 1150-8
    CrossrefPubMedGoogle Scholar
  • 20 Meier JD, Glasgold RA, Glasgold MJ. Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg 2009; 11: 24-8
    CrossrefPubMedGoogle Scholar
  • 21 Knize DM. Limited-incision forehead lift for eyebrow elevation to enhance upper blepharoplasty. Plast Reconstr Surg 1996; 97: 1334-42
    CrossrefPubMedGoogle Scholar
  • 22 Castro-Govea Y, Garza-Pineda Ode L, Salazar-Lozano A. Mini-temporal and perilobular approach to facelift: mini-TAPA-facelift. Facial Plast Surg 2013; 29: 244-52
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Lorot-Marchand A, Guerreschi P, Pellerin P. et al. Frequency and socio-psychological impact of taunting in school-age patients with cleft lip-palate surgical repair. Int J Pediatr Otorhinolaryngol 2015; 79: 1041-8
    CrossrefPubMedGoogle Scholar