Title : Long Term Effect of Stem Cell Enriched Adipose Tissue Grafting on Contour Deformities with Pigmentary Changes of Face
Introduction: Contour deformities of the face requiring soft tissue augmentation are usually associated with hyper pigmentation of overlying skin. These deformities often result from a variety of conditions like trauma, infection and certain acquired diseases like Rhomberg’s disease. Conventionally, such contour problems are treated by using allogenic fillers, implants, major flap surgery, lasers and other cosmetic options but with certain limitations. Flap surgery, Implants and Allogenic Fillers deal contours but do not improve hyper-pigmentation. Similarly, Lasers and de-pigmentary creams improve pigmentation but have nothing to do with contour correction. Therefore, innovative strategies are required that can simultaneously heal contour deformities and also resolve the skin hyper-pigmentation permanently. Fat is an ideal source of autologous tissue for regenerative medicine applications in plastic surgery and cosmetology. Fat grafting is recognized as a promising and novel technique for volume restore and skin rejuvenation due to its regenerative properties. In the current study we aim to evaluate the effect of autologous fat grafting for contour deformities related hyper-pigmentation.
Methods: A prospective study conducted in the Departments of Plastic & Reconstructive Surgery and Tissue Engineering and Regenerative Medicine Laboratory, Department of Biomedical Sciences, King Edward Medical University/Mayo Hospital, Lahore from February 2017 to January 2019. Adipose tissue was harvested from lower part of abdomen. Mesenchymal Stem cells were isolated and cultured. In the next sitting, more fat harvested, enriched with stem cells and grafted at the contour defect. Serial photographs of the recipient area were taken every three months till one year under standard settings and camera make and pigmentation compared.
Results: One hundred patients, 63 % females and 37% males with mean age of 27.33+ 7.25 years. The volume of injected fat was having mean of 9.73+ 5.21 ml. Most of the patients (43%) required one session while 37% required two sessions of fat grafting and in 20% patients three sessions repeated after an interval of three months were adequate to get satisfactory results. Improvement in pigmentation measured by difference ICD was having mean of 1.08x106± 464745.535. Thirty seven percent patients were highly satisfied while 52% were satisfied and 11% patients were unsatisfied with the improvement in pigmentation of the overlying skin.
Conclusion: Stem Cells enriched adipose tissue grafting is a magnificent treatment option for contour deformities of face with pigmentary changes.
Key Words: Mesenchymal Stem Cells, Contour defects, Pigmentary changes, Adipose tissue, Integrated Color Density