Objectives: Evaluate the efficacy of Acellular Adipose Matrix (AAM) in temple volume correction. Assessment of mean change and improvement from baseline of validated Midface Volume Scale (MMVS). Photographic Imaging. General Aesthetic Improvement Scale (GAIS). Patient Reported Outcomes. Pain immediately post injection using a VAS and patient questionnaire. Biopsy proven generation of new adipocytes and collagen in a non autologous fat graft from adipocellular matrix.
Comparison of new tech in harvesting and injecting with a 100-hole microcannula and filtering mechanism without centrifuge or collagenase.
Introduction: Use of autologous fat grafting (AFG) and adipocellular matrix (AAM) has exponentially increased, for applications, aesthetic and reconstructive. They have shown efficacy in scar revision or mid-face, to breast or buttocks. Graftin longevity and results depend on harvesting, refinement, and placement. AFG and AAM have characteristics of an ideal filler: biocompatibility, versatility, stability, duration, appearance and biostimulation. They have profound benefits beyond contouring; skin over grafts has been noted to improve wrinkling, pigmentation, radiation damage and reduce pore size.
Materials / method: Four centers with 22 patients were injected with AAM in the temple after dilution in 1.4cc of saline. Patients were followed with photography, biopsy, investigator and patient satisfaction surveys. Another group of patients were injected in the malar eminence with AFG harvested with a novel 100-hole (micro) cannula with laser cut smooth edges that minimized cellular destruction on microscopy. Without centrifugation or enzymatic degradation, injections were achieved after passage through a diamond cut laser-drilled filter that has been shown to preserve SVF and live cells (live transfer).
Results: In the AAM group, standard photography, a subject and investigator grading scale showed volume retention up to twelve months. Biopsy results with perilipin stain showed new adipocyte generation. Collagen IV specific staining showed new collagen formation. Patient satisfaction was high. In the AFG group, similar analysis was performed without biopsy results. The new 100-hole harvesting cannula showed more uniform adipocytes, minimal cellular debris, preservation of "stromal vascular tissue" and a filtering mechanism consistent with improved volume retention and minimal bruising and edema.
Conclusion: AAM is a new option in autologous soft tissue augmentation that has most of the characteristics of autologous fat, including multiple growth factors. However, it's major advantage is being "off the shelf fat." Laser drilling technology has the potential advantage of improved survivability of cells and predictability of final volume, preservation of tissues and consistency in technique in AFG. Laser, diamond cut filtering can eliminate the requirement for centrifugation and enzymatic degradation with the potential for comparable results as the traditional , gold standard AFG (Coleman) method.
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Эта работа представлена благодаря поддержке: Musculoskeletal Transplant Foundation suported this work. I own shares in Millenium Medical Technologies, manufacturer of the harvesting cannulae and filters.
