Background: Autologous fat grafting (AFG) has emerged as a useful technique in breast reconstruction. Utilizing a patient\'s own fat from areas like the abdomen or thighs, AFG serves various reconstruction needs. Nevertheless, the oncological safety of AFG in breast cancer patients has become a contentious issue. Concerns about its influence on cancer recurrence and detention have led to significant clinical debate and the need for thorough investigation. Methods: To determine the impact of autologous fat grafting (AFG) on loco-regional recurrence (LRR) in breast cancer survivors undergoing reconstruction, a comprehensive search of databases including PubMed, Medline, Web of Science, and Cochrane libraries was conducted from November 2023 through March 2024. This search adhered to the PRISMA guidelines and aimed to identify all the relevant studies on AFG in the context of breast reconstruction post cancer treatment. A meta-analysis was performed. Results: Out of the studies reviewed, 40 met the inclusion criteria, with a total patient cohort of 14,078. The analysis revealed that AFG had no significant association with increased rates of LRR. Conclusions: According to the available literature, AFG is a safe reconstructive option for breast cancer patients and does not increase the risk of loco-regional recurrence. Nevertheless, further well-structured long-term prospective studies are required, since heterogeneity of available studies is high and requires standardization.

The forehead is the cranial part of the forehead, and represents an important component of facial esthetics. The deformations linked to craniosynostoses are characterized by modifications in height, width, and angulation. Their surgical correction during childhood is based on well-established techniques of remodeling using resorbable osteosynthesis. Today, distraction and springs allow less invasive procedures with good outcomes. Sequellae mainly correspond to hypotrophies of the temporal region, corrected with fat grafting. The presence of a mutation increases the risk of reoperation in the first six years of life.

BACKGROUND: Breast reconstruction after cancer surgery through lipomodeling can be performed alone or in combination with a flap. Our objective is to describe the proportion of techniques used on patients who underwent autologous reconstructive surgery after tumorectomy or mastectomy in Franche-Comté.
METHODS: A bicentric retrospective observational study was conducted between October 2017 and December 2021 (NCT06101732), including three groups: those who underwent exclusive lipomodeling reconstruction after mastectomy (1) or in addition to a flap (2), and those who underwent exclusive lipomodeling reconstruction after tumorectomy (3). Socio-demographic, medical, and surgical data were collected and recorded in a specially designed software.
RESULTS: Two hundred and fifty-one lipomodeling procedures were performed on 91 patients. In group 1, the average transferred volume was 1191mL with an average number of sessions of 4.4 spreads over 19.4months. In group 2, the average transferred volume was 676mL with an average operative time of 2.5 spread over 16.1months. In group 3, the average transferred volume was 223mL with an average number of sessions of 1.5 spreads over 6.2months. Regarding postoperative complications, 11% had cysts of fat necrosis, 4.4% had infections, and 2.2% had hematomas.
CONCLUSIONS: Lipomodeling is a technique that has clearly established itself in the field of breast reconstructive surgery. It results in a few complications and improves the final aesthetic outcome whether used exclusively or in addition to a flap.

BACKGROUND: Velopharyngeal insufficiency (VPI) is a known complication of transoral surgery, with a reported incidence of 8.1%. The main factor related to VPI is the split of the soft palate. However, dead space resulting from transoral decompression may play a pivotal role in the pathogenesis of the dysfunction. In our experience, functionally significant dead space is almost constantly present after transoral decompression. This is probably due to malformation in children and postoperative scarring, thus configuring a nosological entity that we could define as \"syndrome of the nasopharyngeal dead space.\" Palatal prosthesis and pharyngoplasty have been proposed, though these surgical procedures are technically tricky and with possible complications, such as OSA symptoms, snoring, and nasopharyngeal stenosis.
METHODS: We proposed an effortless and minimally invasive procedure to treat this condition based on lipofilling the nasopharynx posterior wall endoscopically. To test the procedure\'s functional result, the submucosa of the nasopharynx posterior wall was initially filled with resorbable material, namely fibrin glue and autologous blood. The result was optimal but regressed after one month. Then, we repeated the procedure by lipofilling with autologous abdominal fat, resulting in a more stable anatomical and functional outcome at six months follow-up.
RESULTS: The patient had a prompt significant improvement of his complaints (rhinolalia and oronasal regurgitation) and a correct projection of the nasopharynx posterior wall, with correct closure during phonation and absence of oronasal reflux.
CONCLUSIONS: The \"syndrome of the nasopharyngeal dead space\" should be correctly identified after transoral surgery. It can be effectively treated with lipofilling of the posterior nasopharyngeal wall, a simple and minimally invasive procedure.

BACKGROUND: Breast lipofilling, a popular cosmetic and reconstructive procedure, involves the transplantation of autologous fat to enhance breast volume and contour. Despite its widespread use, cell processing and the aftertreatment remain controversial. This study investigates the pressure applied by a compression bra and reports in vitro stress tests of processed and unprocessed fat cells.
METHODS: Clinical bra pressure measurements were conducted on a cohort of 45 patients following lipofilling, reduction mammoplasties and DIEP flaps. Laboratory analysis included cell vitality testing using Resazurin assays of processed and unprocessed fat cells after exposure to mechanical or hyperbaric pressure.
RESULTS: Our findings show a mean overall pressure value of the compression bra for all patients of 6.7 ± 5.7 mmHg (range 0-35). Cell processing is superior to sedimentation only regarding fat cell vitality. However, neither mechanical pressure within the specified range nor hyperbaric oxygen exposure significantly affected fat graft survival as measured by Resazurin assays.
CONCLUSIONS: The in vitro measurements showed that it was impossible to harm fat cells with external pressure during lipofilling procedures, regardless of their processing. In the clinical context, the compression bra applied pressure values deceeding the perfusion pressure and may therefore not diminish oxygen supply nor harm the transplanted cells. Therefore, we recommend the use of a compression bra for all lipofilling procedures around the breast.
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 Table of Contents or online Instructions to Authors www.springer.com/00266.

Burn-related chronic neuropathic pain can contribute to a decreased quality of life. When medical and pharmacologic therapies prove ineffective, patients should undergo evaluation for surgical intervention, consisting of a detailed physical examination and elective diagnostic nerve block, to identify an anatomic cause of pain. Based on symptoms and physical examination findings, particularly Tinel\'s sign, treatments can vary, including a trial of laser therapies, fat grafting, or nerve surgeries (nerve decompression, neuroma excision, targeted muscle reinnervation, regenerative peripheral nerve interfaces, and vascularized denervated muscle targets). It is essential to counsel patients to establish appropriate expectations prior to treatment with a multidisciplinary team.

BACKGROUND: The correction of tuberous breast deformity with fat grafting has gained popularity in recent years, but it remains unclear whether this new technique can produce patient satisfaction levels comparable to those achieved with implant-based correction.
METHODS: This study aimed to compare patients\' satisfaction and quality of life using the BREAST-Q questionnaire after correction of tuberous breast deformity with fat grafting and implants. Twenty-four patients (36 breasts) were included in our study. Thirteen patients (15 breasts) had a correction with lipofilling (mean 2.67 interventions) and 11 patients (21 breasts) had an implant-based correction (mean 1 intervention).
RESULTS: Both fat and implant treatments showed statistically significant improvements in breast satisfaction (p value=0.001, 0.002, respectively), psychosocial (p value=0.003, 0.003, respectively), and sexual satisfaction (p value=0.008, 0.002, respectively) between the pre-treatment and post-treatment stages. However, the only statistically significant differences between the treatments were observed in the physical condition pre-treatment (p value=0.008) and sexual condition post-treatment (p value=0.030). The outcome of both treatments was not statistically different. Furthermore, the outcome exhibited a statistically significant positive linear relationship with breast satisfaction for both treatments.
CONCLUSIONS: This study suggests that lipofilling can achieve breast and outcome satisfaction comparable to that of implants, although this parity in results comes at the cost of more interventions. These preliminary results lend support to the notion that, as surgeons have access to two equally effective techniques, it is crucial to provide appropriate guidance to patients to ensure their satisfaction.
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 .

UNASSIGNED: Fat transfer has been widely used after breast conservative surgery (BCS) where it aims to recover shapes as a simple, inexpensive, biocompatible method but the technique is not without complications. Platelet Rich Plasma (PRP) is a promising approach to enhance fat graft survival and subsequently improve the outcome. The aim of this study was to evaluate the effect of enriching fat graft with PRP for delayed correction of deformities after conservative surgery for breast cancer regarding esthetic outcome and incidence of complications.
UNASSIGNED: The current study included 50 female patients who were scheduled for delayed lipofilling for correction of deformities after conservative surgery for breast cancer. The studied patients were randomly allocated into 2 groups: Group I (G I) included 25 patients scheduled for PRP enriched lipoinjection and Group II (G II) included 25 patients scheduled for lipoinjection without PRP as a control group.
UNASSIGNED: Number of sessions of lipoinjection was significantly less in G I in comparison to G II (P = 0.024). During the 2nd session; the amounts of fat injected and harvested were significantly less in G I in comparison to G II (P = 0.049 and 0.001 respectively). Recipient site complications were significantly more evident in G II in comparison to G I (P = 0.01). Surgeon and patient satisfactions were significantly more evident in GI in comparison to G II (P = 0.005 and 0.029 respectively).
UNASSIGNED: The addition of PRP to fat grafts is a simple, cost-effective and safe method to improve esthetic outcome and decrease complications.

UNASSIGNED: Tuberous breast is a rare anomaly affecting the development of mainly the female breast. It presents with varying degrees of hypoplasia in the breast base and skin. In some cases, herniation and widening of the areola is observed. The condition constitutes a great challenge for the reconstructive surgeon. In this study, the surgical cascades of implant and lipofilling corrections were compared with a focus on the need for re-interventions.
UNASSIGNED: In total, 129 patients whose treatment regimen started between January 2010 and October 2020 were included in this study. Patients were categorized into two groups based on the volume correction method used (lipofilling versus implant).
UNASSIGNED: In 35 (27%) patients (41 breasts), breast volume increasement was executed with an implant, while 94 (73%) patients (169 breasts) underwent volume increasement with lipofilling. The mean number of operations during the primary correction process was 1.2 (range 1-5) for the implant group and 2.4 (range 1-5) for the lipofilling group. When assessing the need for re-operations within 5 years after completing the primary correction, 46% of patients in the implant group needed further surgeries, while the corresponding proportion for the lipofilling group was 21% (p = 0.04). There were six major complications, all of them in the implant group.
UNASSIGNED: Implant-based reconstruction is associated with more revision surgeries and major complications compared to autologous lipofilling corrections. Lipofilling offers a more durable result with less re-operations over time despite initial sequential primary surgeries.

UNASSIGNED: Nasolabial folds are a common sign of aging, accompanied by various manifestations such as skin and tissue loosening, wrinkles, lip corner drooping, mandibular angle loss, platysmal bands, and skin pigmentation changes. Limited research has explored Nanofat injection methods. this study was done with the aim of comparing the effect of fat injection by two methods, conventional and Nanofat, in nasolabial folds.
UNASSIGNED: The study conducted in 2020-2021 at the skin clinic in Ilam, western Iran was a case-control study. Participants were divided into two groups, and lipofilling procedures were performed using conventional and nanofat methods with autologous fat. Data collection utilized a researcher-made questionnaire and radiographic results. Follow-up visits occurred on the 30th, 90th, and 180th days to assess complications and recovery rates. After 6 months, participant\'s photographs were taken and compared with pre-intervention photographs using the GIAS criteria. Data analysis was conducted using SPSS22 version software.
UNASSIGNED: The average age of the participants was 37.80±8.30 yr. The treatment response in the conventional fat injection group was significantly better than the nanofat group (P<0.05). Both groups were satisfied with the treatment methods, but high satisfaction was reported in the conventional group, but there was no statistically significant difference between the groups.
UNASSIGNED: Both methods of improving wrinkles were effective, but the improvement and response to treatment in the conventional method was better than the Nanofat method, and its effect was felt by the participants for an average period of 3 months.