简介:自体脂肪是理想的软组织填充物。它很容易接近,生物相容性便宜,它提供了体积增加和皮肤质量改善。自1893年以来一直使用脂肪移植,但自从1980年代Coleman和Illouz发展现代抽脂术以来,它才获得广泛的普及。全世界每年有超过50万例的面部脂肪移植手术被实施,并且这种趋势正在迅速增加。总的来说,假定与面部脂肪移植相关的一般并发症约为2%.材料和方法:在2021年7月之前,对PubMed搜索引擎进行了系统的文献搜索。以下算法用于研究:(脂肪移植或脂肪填充)和面部和并发症。分层应用的排除标准是评论文章,不报告受体部位并发症;不在英语和儿科人群中。文摘由LS手动筛选,GS,JM和PDS分别和随后匹配的准确性。检索和分析了相关的全文文章,并从数据库中提取了数据。文章选择的流程图在系统审查和荟萃分析的优选报告项目(PRISMA)声明之后描述。结果:总的来说,通过PubMed搜索确定了462篇论文。共有359篇被排除在外:38篇论文不是英文的,41篇是评论文章,279篇文章未报告受体部位并发症,1篇未报告人类受试者。平均并发症发生率为1.5%~81.4%。共发现298起不良事件:40次(13.4%)血管内注射,13(4.3%)不对称,57(19.1%)违规行为,22(7.4%)移植物肥大,21(7%)脂肪坏死,73(24.5%)长期水肿,1例(0.3%)感染,6(2%)延长红斑,15例(5%)毛细血管扩张和50例(16.8%)痤疮激活。结论:FFG相关的副作用可以在三个类别中恢复:严重,中度,和未成年人。严重(13.4%)的副作用,如血管内注射或迁移,需要神经或神经外科治疗,通常会导致永久性残疾或死亡。中度(38.3%)副作用,如脂肪肥大,坏死,囊肿形成,不规则和不对称需要润饰操作。轻微(48.3%)的副作用,如长时间的水肿或红斑,不需要手术治疗。尽管假设面部脂肪移植的总体并发症发生率约为2%,面部脂肪移植的真实并发症发生率尚不清楚,原因是缺乏报告,也没有就副作用的定义和鉴定达成共识.需要更多的RCT来进一步确定该手术的实际并发症率。
Introduction: Autologous fat is ideal soft tissue filler. It is easily accessible, biocompatible, cheap, and it provides both volume augmentation and skin quality improvement. Fat grafting has been used since 1893, but it has only gained widespread popularity since the development of modern liposuction by Colemann and Illouz in the 1980s. Every year more than half a million facial fat grafting procedures are carried out worldwide and the trend is rapidly increasing. Overall, general complications associated with facial fat grafting are assumed to be around 2%. Is that true? Material and Methods: Until July 2021, a systematic search of the literature was performed interrogating PubMed search engines. The following algorithm was used for the research: (fat graft OR
lipofilling) AND face AND complications. Exclusion criteria applied hierarchically were
review articles, not reporting recipient site complications; not in English and paediatric population. Abstracts were manually screened by LS, GS, JM and PDS separately and subsequently matched for accuracy. Pertinent full-text articles were retrieved and analysed and data were extracted from the database. The flow chart of article selection is described following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: In total, 462 papers were identified by PubMed search. A total of 359 were excluded: 38 papers were not in English, 41 were
review articles, 279 articles did not report recipient site complications and 1 was not on human subjects. Average complication rate ranged from 1.5% to 81.4%. A total of 298 adverse events were identified: 40 (13.4%) intravascular injections, 13 (4.3%) asymmetry, 57 (19.1%) irregularities, 22 (7.4%) graft hypertrophy, 21 (7%) fat necrosis, 73 (24.5%) prolonged oedema, 1 (0.3%) infection, 6 (2%) prolonged erythema, 15 (5%) telangiectasia and 50 (16.8%) cases of acne activation. Conclusions: FFG related side effects could be resumed in three categories: severe, moderate, and minor. Severe (13.4%) side effects such as intravascular injection or migration require neurological or neurosurgical management and often lead to permanent disability or death. Moderate (38.3%) side effects such as fat hypertrophy, necrosis, cyst formation, irregularities and asymmetries require a retouch operation. Minor (48.3%) side effects such as prolonged oedema or erythema require no surgical management. Despite the fact that the overall general complication rate of facial fat grafting is assumed to be around 2%, the real complication rate of facial fat grafting is unknown due to a lack of reporting and the absence of consensus on side effect definition and identification. More RCTs are necessary to further determine the real complication rate of this procedure.