BACKGROUND: The prevalence of cancer is growing daily. Oral cancer, which is primarily triggered by tobacco use, can have detrimental effects on facial appearance. Despite significant advances in the molecular underpinnings of cancer, surgery, chemotherapy and radiotherapy have become standard cancer treatment methods. These treatments remove the tumor but can significantly alter patient\'s appearance, which can impact their physical and mental wellbeing. The soft tissue augmentation technique of autologous fat grafting (AFG), commonly referred to as lipofilling, is frequently used in cosmetic and reconstructive surgery to promote facial rejuvenation and body form remodeling. The advantages of AFG include its biocompatibility, low immunogenicity and allergenicity, as well as its capability to heal wounds.
OBJECTIVE: To explore the advantages of and patient satisfaction with the AFG technique as a potential facial restoration procedure in oral cancer patients.
METHODS: We examined the effects of facial AFG in cosmetic surgery patients and investigated the prevalence of postoperative problems. Patient satisfaction and potential complications after autologous fat filling in different areas of the facial space were investigated using clinical evaluations, patient-reported outcomes and photographic assessments.
RESULTS: All of the patients were satisfied with the results in terms of improved facial shape, skin glossiness, skin elasticity, ptosis, and facial expressions. More than 80% of the patients and surgeons reported overall satisfaction.
CONCLUSIONS: Based on these findings, we hypothesize that the AFG approach may be beneficial as a reconstructive therapy for patients with oral cancer following treatment. This technique will improve the patient\'s physical appearance, confidence and mental wellbeing.

BACKGROUND: Age-related changes to the face pertinent anatomy and important aspects of autologous fat grafting have been widely applied in facial rejuvenation. Various types of autologous fat products (Macrofat, Microfat, SEFF, nanofat, and SVF-gel) with different properties and applicabilities have been introduced and available for surgeons.
METHODS: Key differences between common techniques for fat processing and infiltration. Develop a plan for patients based on site-specific facial anatomical zones, we suggested a pyramidal multiple-theory (multi-type, multi-method and multi-layer) for facial fat grafting. Based on the complicated mechanism of the face decrepitude in different layers of facial soft tissue, autologous fat products with various particle sizes and components into different layers.
RESULTS: Fifty-eight patients underwent this facial fat grafting strategy from June 2020 to Jan 2022. All achieved cosmetic improvements, with higher patients\' satisfaction, and minor complications. Our facial fat grafting strategy takes advantage of different fat products and is able to address the physiological tissue changes during aging, more properly and targetedly, than the traditional facial fat grafting.
CONCLUSIONS: Fat grafting to the face aids in volume restoration and rejuvenation, thereby addressing soft-tissue atrophy associated with the aging face, acquired conditions, or congenital malformations. The technique described as \"lipo-tumescence\" has been successfully used in the breast and other regions of the body that have radiation damage and is discussed in this article specifically for the face and neck.

UNASSIGNED: The resection of tumors in small breasts or in areas such as the upper and inner parts of the breast may have disabling cosmetic results. Tumor resection reduces the volume of the breast and may result in asymmetry or distortion of the nipple-areola complex. Autologous fat transfer/grafting has been shown to be a reliable technique for improving these poor cosmetic results. This study aimed to evaluate the feasibility, complications, and cosmetic outcomes of immediate autologous fat grafting during breast-conserving surgery (BCS) in Chinese patients with early-stage breast cancer.
UNASSIGNED: This retrospective study included 58 patients with early breast cancer treated by the same surgical team from October 2016 to May 2017. The patients were divided into two groups: BCS with lipofilling (experiment group, n=30) and BCS without lipofilling (control group, n=28). All patients received the recommended breast cancer treatment with complementary radiotherapy. The follow-up period after the completion of radiotherapy ranged from 36-44 months. The resected and grafted volumes, complications, esthetic results, patient satisfaction, and recurrence rate within 3 years were compared between the groups.
UNASSIGNED: The average resected and grafted volumes in the lipofilled group were 47 and 74 mL, respectively, with only one seroma and no other complications. Regarding physician evaluation, BCS with lipofilling resulted in better cosmetic outcomes than BCS without lipofilling (33% versus 15%, respectively). Poor responses occurred in only 7% of patients with lipofilling, compared with 15% without lipofilling. Regarding patient self-evaluation, Breast-Q scores including patient satisfaction with their breasts and psychosocial well-being, were significantly higher in patients who received lipofilling compared with non-lipofilled patients. Regional recurrence occurred in one patient (case 21) (3.7%) in the lipofilling group and systemic recurrence occurred in one patient (case 12) (3.8%) in the control group.
UNASSIGNED: Immediate autologous fat grafting is a promising, effective, and convenient technique for partial breast reconstruction after BCS, with potentially higher levels of patient and physician satisfaction compared with traditional BCS.
UNASSIGNED: Chinese Clinical Trial Registry ChiCTR-ONN-17010514. Registered 24 January 2017.

Lipofilling is a popular technique for soft tissue augmentation, limited by unpredictable graft survival. This study aimed at exploring the effect of hydrogel from acellular porcine adipose tissue (HAPA) on angiogenesis and survival of adipose tissue used for lipofilling. The effect of HAPA on adipose-derived stem cells (ADSCs) proliferation, adipogenic differentiation, and vascular endothelial growth factor (VEGF) secretion were evaluated in hypoxia and normoxiain vitro. For thein vivostudy, adipose tissue with phosphate buffered saline, ADSCs, and HAPA (with or without ADSCs) were co-injected subcutaneously into nude mice. HAPA-ADSCs mixture (tissue engineering adipose tissue) was also grafted. Gross observation, volume measurement, and ultrasound observation were assessed. For histological assessment, hematoxylin and eosin, perilipin, cluster of differentiation 31 (CD31), Ki67, and transferase-mediated d-UTP nick end labelling (TUNEL) staining were performed. HAPA improved ADSCs proliferation, VEGF secretion, and adipogenic differentiation under normoxia and hypoxia conditionsin vitrostudy. For thein vivostudy, HAPA showed improved volume retention and angiogenesis, and reduced cell apoptosis when compared to ADSCs-assisted lipofilling and pure lipofilling. In conclusion, HAPA could maintain ADSCs viability and improve cell resistant to hypoxia and might be a promising biomaterial to assist lipofilling.

OBJECTIVE: To investigate the effect of hydrogel from acellular porcine adipose tissue (HAPA) on the survival of transplanted adipose tissue.
METHODS: For in vitro study, adipose tissue and HAPA-adipose tissue complex were cultured in normoxia and hypoxia atmospheres for 24 and 72 hours. TUNEL and Perilipin immunofluorescence staining were performed to observe the effect of HAPA on apoptosis and survival of adipocities. For in vivo study, 42 healthy male nude mice (4-6 weeks old) weighing 15-18 g were randomly divided into adipose group (group A), 10%HAPA group (group B), 20%HAPA group (group C), 30%HAPA group (group D), 40%HAPA group (group E), and 50%HAPA group (group F) according to different HAPA/adipose tissue volume ratio ( n=7). For each group, 1 mL adipose tissue or HAPA-adipose tissue complex was injected subcutaneously into the dorsum of the nude mice. At 4 weeks after transplantation, 7 nude mice in each group were sacrificed and grafts were harvested, gross observation, volume measurement, ultrasound examination, and histologic staining (HE staining, CD31 and Perilipin immunofluorescence stainings) were applied.
RESULTS: Hypoxia showed a tendency of promoting adipose tissue necrosis and apoptosis, while HAPA exhibited an obvious effect of inhibiting cell apoptosis in vitro study ( P<0.05). For in vivo study, grafts of all groups had intact fibrocapsule. No obvious signs of infection and necrosis were observed at 4 weeks. Volume shrinkage was observed in all groups, however, the groups A-D had significantly higher volume retention rate than groups E and F ( P<0.05). Ultrasound examination showed that there were no significant difference in the number and volume of liquify area of the grafts in each group ( P>0.05). With the increase of HAPA\'s volume ratio, HE staining proved an improved fat integrity while a gradually decreased vacuoles and fibrosis. CD31 immunohistochemical staining showed that the number of neo-vascularisation in groups E and F were significantly higher than those in groups A-D ( P<0.05). Perilipin immunofluorescence staining showed that with the increase of HAPA volume ratio, the number of living adipocytes increased gradually, and more new adipocytes could be seen in the field of vision.
CONCLUSIONS: As the volume ratio of HAPA gradually increased, the survival of transplanted adipose tissue also increased, but the volume retention rate decreased gradually. 30%HAPA was considered the relative optimal volume ratio for its superior adipose tissue survival and volume retation rate.
UNASSIGNED: 探讨猪脂肪源基质水凝胶（hydrogel from acellular porcine adipose tissue，HAPA）对游离移植脂肪存活的影响。.
UNASSIGNED: 体外实验中，将脂肪及 HAPA-脂肪复合物分别于常氧、低氧条件下培养，24 h 后行 TUNEL 染色，24、72 h 后行围脂肪蛋白免疫荧光染色，观察 HAPA 对移植脂肪凋亡及存活的影响。体内实验中，取 4～6 周龄雄性裸鼠 42 只（体质量 15～18 g），按植入不同体积比 HAPA-脂肪复合物，将裸鼠随机分为脂肪组（A 组）、10%HAPA 组（B 组）、20%HAPA 组（C 组）、30%HAPA 组（D 组）、40%HAPA 组（E 组）、50%HAPA 组（F 组），每组 7 只。分别于各组裸鼠背部皮下注射脂肪或对应 HAPA-脂肪复合物 1 mL。术后 4 周处死裸鼠，取出移植物，行大体观察、体积测量、超声检查及组织学染色（HE 染色、CD31 免疫组织化学染色、围脂肪蛋白免疫荧光染色）。.
UNASSIGNED: 体外实验显示，低氧环境具有促进移植脂肪坏死及细胞凋亡的趋势，而 HAPA 在体外低氧条件下具有明显抑制脂肪凋亡的效果（ P<0.05）。体内实验中，术后 4 周取材时，各组移植物包膜完整，移植物均无明显感染坏死表现。各组移植物体积均较注射时缩小，E、F 组移植物体积显著低于 A～D 组（ P<0.05）。超声检查示，各组移植物的液化坏死区个数及体积比较均无明显差异。HE 染色示随着移植物中 HAPA 体积比的提高，移植物内部的结构完整性逐渐提高，液化坏死形成的囊泡区逐渐减少，纤维化程度逐渐降低。CD31 免疫组织化学染色示 E、F 组新生血管数量显著多于 A～D 组（ P<0.05）。围脂肪蛋白免疫荧光染色示，随着 HAPA 体积比的增加，活脂肪细胞逐渐增加，且视野内可见较多新生脂肪细胞。.
UNASSIGNED: 随着 HAPA/脂肪体积比逐渐提高，移植脂肪存活程度也相应提高，但体积保留率逐渐下降。30%HAPA 辅助脂肪移植可达到游离移植脂肪存活和总体体积保留率相对最佳的状态。.

BACKGROUND: Adipose-derived stem cell (ADSCs)-assisted and platelet-rich plasma (PRP)-assisted lipofilling aim to enhance angiogenesis and cell proliferation and are promising techniques for lipofilling. This study aimed to compare the outcomes of ADSCs-assisted and PRP-assisted lipofilling.
METHODS: Adipose tissue and human venous blood were obtained from women with early breast cancer. Human ADSCs were isolated and amplified in vitro. PRP was extracted through double centrifugation. The effect of PRP on ADSCs proliferation was evaluated. In the in vivo study, 1 ml of adipose tissue with saline (control group), PRP (PRP group), or ADSCs (ADSCs group) was injected subcutaneously into the dorsum of nude mice. At 2, 4, 8, and 12 weeks after injection, tissues were assessed for volume retention and ultrasound abnormality. For histological assessment, hematoxylin and eosin staining were performed.
RESULTS: Cytokines in PRP and blood were comparable. Regarding the in vitro assay, PRP significantly improved ADSCs proliferation, and the effect was dose-dependent. Concerning the in vivo study, for each time point, ADSCs-assisted lipofilling showed superior volume maintenance. Similarly, the PRP group showed improved angiogenesis and fat survival, as compared with the control group. The angiogenic effect of PRP was inferior to that of ADSCs at most time points. No significant difference was observed at 12 weeks after lipofilling. Complication rates were comparable between the PRP group and ADSCs group.
CONCLUSIONS: PRP-assisted and ADSCs-assisted lipofilling can significantly improve the cosmetic results of grafted fat. PRP-assisted lipofilling, which is considered convenient and clinically available, is a promising technique to improve neovascularization and fat survival.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .