Surgical Aesthetics

JAN-FEB 2014

For plastic surgery and cosmetic surgery trends, techniques and equipment, plastic and cosmetic surgeons turn to Surgical Aesthetics for the latest on breast augmentation, liposuction, rhinoplasty and more.

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Cutting Edge ASCs Improve Nerve Regeneration Mastopexy Simulation Software Canfield Imaging Systems has developed a new mastopexy module for its 5.3 VECTRA 3D software system, which allows patients to see the expected results of their mastopexy procedures, with or without adding implants, prior to surgery. The surgeon selects the incision type, adjusts the position, if necessary, and VECTRA completes the process. Implants can be added by selecting the desired brand, type and size from VECTRA's extensive implant library. Additional features include automatic cropping, skin cloning and animation templates, and an assessment mode to aid in the visualization of breast asymmetries. For more information, visit canfieldsci.com. 6 Surgical Aesthetics ❘ January/February 2014 PRP-Enriched Gluteal Augmentation Platelet rich plasma (PRP)-enriched autologous fat transfer is a safe and effective option for gluteal augmentation, though patient satisfaction is mixed. Researchers Joep C.N. Willemsen and Nicole Lindenblatt of the Bergman Clinics, The Hague, The Netherlands, performed 24 bilateral gluteal augmentations with PRP-enriched autologous fat (the mean amount of fat transferred was 481cc for both sides) that included liposuction to adjacent zones for contouring. The patients were followed for a mean of 44 months after treatment. Postoperative complications were recorded and patient satisfaction was measured via questionnaire. The study, "Results and Long-Term Patient Satisfaction After Gluteal Augmentation With Platelet-Rich Plasma-Enriched Autologous Fat," was published in the European Journal of Plastic Surgery (December 2013). The researchers reported no incidence of seroma or hematoma formation, infection or liponecrosis. And most patients recovered quickly, returning to work within 10 days of the procedure. Patient satisfaction, in general, increased from baseline to three months postoperatively and declined slightly in the long-term, though it varied among the individual patients. Willemsen and Lindenblatt write, "PRP-enhanced lipofilling of the buttocks proved to be a safe procedure, including a low complication rate and consistent results. However, subjective patient expectations have to be taken into account when choosing the indication." © ISTOCKPHOTO.COM Differentiated adipose-derived stem cells (dASC) produce a level of nerve growth factors and brain-derived neurotrophic factor in skin flaps comparable to Schwann cells (SC). Researchers Koichi Tomiat, MD, PhD, et al, of the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan, bilaterally elevated microvascular island groin flaps in 32 Lewis rats. The epigastric nerve was resected and ligated (noninnervated flap) on the right flap. The nerve was crushed (innervated flap) on the left flap. The dermal and hypodermal layers of the flaps were simultaneously injected with either adipose-derived stem cells (ASCs), dASCs, SCs or vehicle. The reinnervation pattern of the flap was assessed immunohistochemically, using a neuronal marker, PGP9.5 at 20 weeks. The researchers found that dASC cultures produced significantly higher amounts of nerve growth factor and brain-derived neurotrophic factor compared with ASC cultures (P < 0.01), and note that the level was comparable to that of SC cultures. The dASC and SC-injections also increased reinnervation density in the periphery of both types of flaps (P < 0.05). The effect was more pronounced in noninnervated flaps, though long-term survival of the transplanted cells was not found. The authors posit, "dASCs could improve flap reinnervation by two mechanisms: First, neurotrophic factors produced by dASCs facilitated regrowth of cutaneous axons from the surroundings of flap. Second, nerve growth factor released by dASCs induced the collateral sprouting of undamaged axons in adjacent tissues." The study, "Differentiated Adipose-derived Stem Cells Promote Reinnervation of Rat Skin Flaps," was published in Plastic & Reconstructive Surgery (June 2013).

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