Research Article of American Journal of Surgical Research and Reviews
Facial Lipostructure: an Overview
Luigi Clauser, MD, DMD, Maria Elena de Notariis, MD ,Carolina Sannino MD,and Antonio Lucchi, MD, DMD
Unit of Maxillo-Facial Surgery, Istituto Stomatologico Italiano ,Via Pace, 21,20122 Milano,Italy
Aim: Facial lipostructure (FLS) is not a new procedure. In the past, many surgeons steered clear of it because the results were poor and unpredictable . In the 80’s however FLS emerged with precise indications, improved techniques, foreseeable and stable results. Its use has become widespread because it produces natural, long-lasting outcomes with minimal donor site morbidity . FLS usually represents the last procedure or retouch in many reconstructive procedures and protocols. Moreover adipose-derived stems cells (ADSCs) represent a promising source of autologous cells for tissue repair and regeneration.
Methods: In the maxillofacial area, FLS is indicated primarily to restore and rejuvenate the zygomas, periorbital region, cheeks, nose, lips, chin, mandible and jawline. Recently, it has been applied to correct localized tissue atrophy, burns, hemifacial atrophy (Parry-Romberg syndrome, scleroderma, anophthalmic orbit), and loss of substance resulting from trauma, tumor excision, and congenital craniofacial deformity sequelae.
Orthognathic surgery and fat grafting represent a new application and an appropriate indication. It is well known that this surgery moves the skeletal bases (maxilla, mandible, chin) but often this leads to a lack of soft tissue coverage. Some patients, particularly women, complain about this lack of soft tissue volume after bony surgery.
Conclusion: FLS was launched as a means to improve volumes and facial aesthetics. Recently, it has been applied in more complex reconstructive and regenerative procedures. It can especially be used on any facial area lacking soft tissue due to posttraumatic outcomes, post tumor deformities, and as a refinement in for many acquired and congenital maxillofacial deformities. The proposed uses for ADSCs in tissue repair and regeneration are quite impressive. Recent works on ADSCs would suggest that adult cells may prove to be an equally powerful regenerative tool in treating congenital and acquired maxillofacial disorders. More importantly, physicians, researchers and international associations need to work to inform clinicians about what practices are evidence based and to encourage support of additional research. Today tissue engineering and regenerative medicine are a multidisciplinary science that is evolving along with biotechnologic advances.
Keywords: Facial lipostructure; Coleman technique; lipoaspirate; facial fat grafting; facial augmentation; adipose tissue; stem cells; regeneration; engineering; fat grafting research
How to cite this article:
Luigi Clauser, Maria Elena de Notariis, Carolina Sannino, Antonio Lucchi. FACIAL LIPOSTRUCTURE: AN OVERVIEW. American Journal of Surgical Research and Reviews, 2021, 4:20. DOI:10.28933/ajsrr-2021-05-1206
1. Coleman SR. Facial recontouring with lipostructure. Clin Plast Surg, 1997;24(2):347–367 PMID: 9142473
2. Coleman SR. Structural fat grafts: the ideal filler? Clin Plast Surg, 2001;28(1):111–119 PMID: 11248861
3. Coleman SR, ed. Structural Fat Grafting. St. Louis, MO: Quality, Medical Publishing Inc; 200 pp 93-112
4. Rigotti G, Marchi A, Sbarbati A. Adipose-derived mesenchymal, stem cells: past, present, and future. Aesthetic Plast Surg 2009; 33(3):271–273 doi: 10.1007/s00266-009-9339-7
5. Strem BM, Hicok KC, Zhu M, et al. Multipotential differentiation of adipose tissue-derived stem cells. Keio J Med 2005;54(3):132–141PMID: 16237275, doi: 10.2302/kjm.54.132
6. Fraser JK, Wulur I, Alfonso Z, Hedrick MH. Fat tissue: an underappreciated source of stem cells for biotechnology. Trends Biotechnol 2006;24(4):150–154, PMID: 16488036 DOI: 10.1016/j.tibtech.2006.01.010
7. Clauser LC, Tieghi R, Galiè M, Carinci F. Structural fat grafting: facial volumetric restoration in complex reconstructive surgery. J Craniofac Surg 2011;22(5):1695–1701 PMID: 21959415 DOI: 10.1097/SCS.0b013e31822e5d5e
8. Clauser L, Sarti E, Dallera V, Galiè M. Integrated reconstructive strategies for treating the anophthalmic orbit. J Craniomaxillofac Surg 2004;32(5):279–290, PMID: 15458669 DOI: 10.1016/j.jcms.2004.04.010
9. Clauser L et al. Fat grafting in Soft Tissue augmentation, Springer-Verlag London Ltd., part of Springer Nature 2020M. Perry, S. Holmes (eds.), Atlas of Operative Maxillofacial Trauma Surgery, pp 237-250 https://link.springer.com/ book/10.1007%2F978-1-4471-5616-1 , 2020
10. Clauser L optimizing maxillofacial and craniofacial results. In: Coleman SR, Mazzola RF, eds. Fat Injection From Filling to Regeneration. Saint Louis, MO: Quality Medical Publishing Inc; 2009: pp 475–500
11. Yoshimura K,Coleman SR. Complications of fat grafting. How they occur and how to find,avoid,and treat them. Clin Plastic Surg 2015; 42:383 doi: 10.1016/j.cps.2015.04.002.
12. Clauser L, Ferroni L, Gardin C,et al. Selective augmentation of stem cell populations in structural fat grafts for maxillofacial surgery. PLoS One. 2014 Nov 6;9(11) PMC422876, doi:10.1371/journal.pone.0110796
13. Clauser L.,A.Lucchi,I.Tocco-Trussardi et al.Autologous fat transfer for facial augmentation and regeneration.Role of mesenchymal stem cells.In: S.C Bagheri,H.A,Kahan,B.Bohli Editors. Fat grafting for aesthetic facial surgery.Atlas of the Oral and Maxillofacial Surgery Clinics of North America.Elsevier,March 2018.pp 25-32. doi: 10.1016/j.cxom.2017.10.002.
14. Clauser L.,Bertolini F. Facial Fat Grafting in reconstructive maxillofacial surgery. American Journal of Surgical Research and Reviews, 2021; 4:11. doi:10.28933/ajsrr-2020-12-0505
15. Clauser L. Autologous Facial Fat Transfer: Soft Tissue Augmentation and Regenerative Therapy J of Craniofacial Surgery – 31, 7 – October 2020 , 1879 – 1882 doi: 10.1097/SCS.000000 00000 06731.