Iberoamerican Journal of Medicine
https://www.iberoamjmed.com/article/doi/10.53986/ibjm.2023.0028
Iberoamerican Journal of Medicine
Review

Use of stem cell-enriched fat grafts in facial reconstruction: have they demonstrated superiority over autologous fat grafting?

Uso de injertos de grasa enriquecidos con células madre en la reconstrución facial: ¿han demostrado superioridad sobre los injertos de grasa autólogos?

Gerardo Jesus Farley Reina Gonzalez, Maria Daniela del Pilar Zambrano Arenas, Daniel Hernandez Cabarcas, German Daniel Matiz, Wilmer Giovanny Galvis Ballesteros, Miguel Andres Montalvo Clavijo, Rodrigo Alberto Caicedo, Michael Gregorio Ortega-Sierra

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Abstract

Since the 1990s, big strides have been made in plastic and reconstructive surgery, thanks to the implementation of new techniques and resources for its execution. In cases where restoration is sought for small defects, biosurgery, involving the utilization of stem cells, biomaterials, chemical engineering, and tissue engineering, can be employed. The potential to stimulate the innate regenerative capacity of tissue and generate a persistent response over time, minimizing surgical trauma and re-interventions, lies in stem cell transplantation. However, the evidence published on this matter is very scarce, leading to divergence of opinions, suggestions, and recommendations. The aim of this review is to analyze the most recent evidence concerning the outcomes of using fat grafts enriched with stem cells in facial reconstruction, as compared to autologous fat grafts. The review of the literature demonstrates a marked trend suggesting that fat grafts enriched with stem cells may be superior to autologous grafts in facial reconstruction, with potential benefits in medium-term volume retention and faster attainment of results.

Keywords

Transplants; Stem cells; Face; Plastic surgery procedures

Resumen

La cirugía plástica y reconstructiva, ha dado pasos agigantados desde la década de los años 90, con la implementación de nuevas técnicas y recursos para su realización. En los casos de defectos pequeños donde se busca la restauración, se puede hacer uso de la biocirugía, que involucra el uso de células madre, biomateriales, ingeniería química y de tejidos. El trasplante de células madre, tiene el potencial de estimular la capacidad innata regenerativa del tejido, así como de generar una respuesta persistente a lo largo del tiempo, minimizando el trauma quirúrgico y la reintervención. A pesar, de la ventaja plausible, la calidad y cantidad de la evidencia publicada al respecto es muy escasa, ocasionando divergencia de opiniones, sugerencias y recomendaciones. Con base en lo anterior, el objetivo de esta revisión consiste en realizar un análisis de la evidencia más reciente sobre los resultados en el uso de injertos de grasa enriquecidos con células madre en la reconstrucción facial, comparado a los injertos de grasa autólogos. A través de la revisión de la literatura, se pudo evidenciar que, aunque la evidencia es heterogénea a la fecha, existe una tendencia marcada en que el uso de injertos de grasa enriquecidos con células madre, podría ser superior a los injertos autólogos en la reconstrucción facial, con potenciales beneficios en la retención de volumen a mediano plazo y mayor celeridad en la obtención de resultados.

Palabras clave

Trasplante; Células madre; Cara; Procedimientos cirugía plástica

References

1. Menick FJ. Facial reconstruction with local and distant tissue: the interface of aesthetic and reconstructive surgery. Plast Reconstr Surg. 1998;102(5):1424-33. doi: 10.1097/00006534-199810000-00015.
2. Wallace CG, Wei FC. The current status, evolution and future of facial reconstruction. Chang Gung Med J. 2008;31(5):441-9.
3. Degner DA. Facial reconstructive surgery. Clin Tech Small Anim Pract. 2007;22(2):82-8. doi: 10.1053/j.ctsap.2007.03.009.
4. Guntinas-Lichius O, Genther DJ, Byrne PJ. Facial Reconstruction and Rehabilitation. Adv Otorhinolaryngol. 2016;78:120-31. doi: 10.1159/000442132.
5. Elegbede A, Mermulla S, Diaconu SC, McNichols C, Liang Y, Liang F, et al. Patient-reported Outcomes in Facial Reconstruction: Assessment of FACE-Q Scales and Predictors of Satisfaction. Plast Reconstr Surg Glob Open. 2018;6(12):e2004. doi: 10.1097/GOX.0000000000002004.
6. Zeiderman MR, Pu LLQ. Contemporary reconstruction after complex facial trauma. Burns Trauma. 2020;8:tkaa003. doi: 10.1093/burnst/tkaa003.
7. Jaiswal R, Pu LL. Reconstruction after complex facial trauma: achieving optimal outcome through multiple contemporary surgeries. Ann Plast Surg. 2013;70(4):406-9. doi: 10.1097/SAP.0b013e3182853f45.
8. Rose EH. Aesthetic reconstruction of the severely disfigured burned face: a creative strategy for a "natural" appearance using pre-patterned autogenous free flaps. Burns Trauma. 2015;3:16. doi: 10.1186/s41038-015-0014-8.
9. Klimczak J, Helman S, Kadakia S, Sawhney R, Abraham M, Vest AK, et al. Prosthetics in Facial Reconstruction. Craniomaxillofac Trauma Reconstr. 2018;11(1):6-14. doi: 10.1055/s-0037-1603459.
10. Mao JJ, Stosich MS, Moioli EK, Lee CH, Fu SY, Bastian B, et al. Facial reconstruction by biosurgery: cell transplantation versus cell homing. Tissue Eng Part B Rev. 2010;16(2):257-62. doi: 10.1089/ten.TEB.2009.0496.
11. Karam M, Abul A, Wood B, Kahlar N, Naik A, Tay J, et al. Stem Cell-Enriched Fat Grafts Versus Autologous Fat Grafts for Facial Reconstruction: A Systematic Review and Meta-analysis. Ann Plast Surg. 2023;90(5):487-93. doi: 10.1097/SAP.0000000000003553.
12. Salibian AA, Widgerow AD, Abrouk M, Evans GR. Stem cells in plastic surgery: a review of current clinical and translational applications. Arch Plast Surg. 2013;40(6):666-75. doi: 10.5999/aps.2013.40.6.666.
13. McArdle A, Senarath-Yapa K, Walmsley GG, Hu M, Atashroo DA, Tevlin R, et al. The role of stem cells in aesthetic surgery: fact or fiction? Plast Reconstr Surg. 2014;134(2):193-200. doi: 10.1097/PRS.0000000000000404.
14. Nayar HS, Caplan AL, Eaves FF, Rubin JP. The Ethics of Stem Cell-Based Aesthetic Surgery: Attitudes and Perceptions of the Plastic Surgery Community. Aesthet Surg J. 2014;34(6):926-31. doi: 10.1177/1090820X14539971.
15. Atiyeh BS, Ibrahim AE, Saad DA. Stem cell facelift: between reality and fiction. Aesthet Surg J. 2013;33(3):334-8. doi: 10.1177/1090820X13478944.
16. Atiyeh B, Ghieh F, Oneisi A. Nanofat Cell-Mediated Anti-Aging Therapy: Evidence-Based Analysis of Efficacy and an Update of Stem Cell Facelift. Aesthetic Plast Surg. 2021;45(6):2939-47. doi: 10.1007/s00266-021-02353-w.
17. Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013;132(4):1017-26. doi: 10.1097/PRS.0b013e31829fe1b0.
18. Rigotti G, Charles-de-Sá L, Gontijo-de-Amorim NF, Takiya CM, Amable PR, Borojevic R, et al. Expanded Stem Cells, Stromal-Vascular Fraction, and Platelet-Rich Plasma Enriched Fat: Comparing Results of Different Facial Rejuvenation Approaches in a Clinical Trial. Aesthet Surg J. 2016;36(3):261-70. doi: 10.1093/asj/sjv231.
19. Dwivedi S, Sharma P. Stem Cell Biology: A New Hope in Regenerations and Replenishments Therapy. Indian J Clin Biochem. 2018;33(4):369-71. doi: 10.1007/s12291-018-0792-4.
20. Tran DK, Phuong TNT, Bui NL, Singh V, Looi QH, Koh B, et al. Exploring the Potential of Stem Cell-Based Therapy for Aesthetic and Plastic Surgery. IEEE Rev Biomed Eng. 2023;16:386-402. doi: 10.1109/RBME.2021.3134994.
21. Bourne DA, Egro FM, Bliley J, James I, Haas GL, Meyer EM, et al. Stem Cell Therapy Enriched Fat Grafting for the Reconstruction of Craniofacial Deficits. Plast Reconstr Surg Glob Open. 2023;11(6):e5056. doi: 10.1097/GOX.0000000000005056.
22. Bourne DA, Bliley J, James I, Donnenberg AD, Donnenberg VS, Branstetter BF 4th, et al. Changing the Paradigm of Craniofacial Reconstruction: A Prospective Clinical Trial of Autologous Fat Transfer for Craniofacial Deformities. Ann Surg. 2021;273(5):1004-11. doi: 10.1097/SLA.0000000000003318.
23. Sasaki GH. The Safety and Efficacy of Cell-Assisted Fat Grafting to Traditional Fat Grafting in the Anterior Mid-Face: An Indirect Assessment by 3D Imaging. Aesthetic Plast Surg. 2015;39(6):833-46. doi: 10.1007/s00266-015-0533-5.
24. Rasmussen BS, Lykke Sørensen C, Vester-Glowinski PV, Herly M, Trojahn Kølle SF, Fischer-Nielsen A, et al. Effect, Feasibility, and Clinical Relevance of Cell Enrichment in Large Volume Fat Grafting: A Systematic Review. Aesthet Surg J. 2017;37(suppl_3):S46-S58. doi: 10.1093/asj/sjx008.
25. Sterodimas A, de Faria J, Nicaretta B, Boriani F. Autologous fat transplantation versus adipose-derived stem cell-enriched lipografts: a study. Aesthet Surg J. 2011;31(6):682-93. doi: 10.1177/1090820X11415976.
26. Yin Y, Li J, Li Q, Zhang A, Jin P. Autologous fat graft assisted by stromal vascular fraction improves facial skin quality: A randomized controlled trial. J Plast Reconstr Aesthet Surg. 2020;73(6):1166-73. doi: 10.1016/j.bjps.2019.11.010.
27. Picard F, Hersant B, La Padula S, Meningaud JP. Platelet-rich plasma-enriched autologous fat graft in regenerative and aesthetic facial surgery: Technical note. J Stomatol Oral Maxillofac Surg. 2017;118(4):228-31. doi: 10.1016/j.jormas.2017.05.005.
28. Bashir MM, Sohail M, Bashir A, Khan FA, Jan SN, Imran M, et al. Outcome of Conventional Adipose Tissue Grafting for Contour Deformities of Face and Role of Ex Vivo Expanded Adipose Tissue-Derived Stem Cells in Treatment of Such Deformities. J Craniofac Surg. 2018;29(5):1143-7. doi: 10.1097/SCS.0000000000004367.
29. Krastev TK, Beugels J, Hommes J, Piatkowski A, Mathijssen I, van der Hulst R. Efficacy and Safety of Autologous Fat Transfer in Facial Reconstructive Surgery: A Systematic Review and Meta-analysis. JAMA Facial Plast Surg. 2018;20(5):351-60. doi: 10.1001/jamafacial.2018.0102.
30. Moltaji S, Alkhatib AH, Liu H, Murphy J, Gallo L, Karpinski M, et al. Introducing Knowledge Translation to Plastic Surgery: Turning Evidence into Practice. Plast Reconstr Surg. 2018;142(5):760e-769e. doi: 10.1097/PRS.0000000000004891.
31. Mason W, Levin AM, Buhl K, Ouchi T, Parker B, Tan J, et al. Translational Research Techniques for the Facial Plastic Surgeon: An Overview. Facial Plast Surg. 2023. doi: 10.1055/a-2113-5023.
32. Dedhia R, Hsieh TY, Tollefson TT, Ishii LE. Evidence-based Medicine in Facial Plastic Surgery: Current State and Future Directions. Facial Plast Surg Clin North Am. 2016;24(3):265-74. doi: 10.1016/j.fsc.2016.03.005.
33. Dreher R, Blaya C, Tenório JL, Saltz R, Ely PB, Ferrão YA. Quality of Life and Aesthetic Plastic Surgery: A Systematic Review and Meta-analysis. Plast Reconstr Surg Glob Open. 2016;4(9):e862. doi: 10.1097/GOX.0000000000000833.
34. Del Rio A, Rinaldi R, Napoletano S, di Luca NM. Cosmetic surgery for children and adolescents. Deontological and bioethical remarks. Clin Ter. 2017;168(6):e415-e420. doi: 10.7417/T.2017.2044.
35. Shimizu Y, Ntege EH, Sunami H. Current regenerative medicine-based approaches for skin regeneration: A review of literature and a report on clinical applications in Japan. Regen Ther. 2022;21:73-80. doi: 10.1016/j.reth.2022.05.008.
36. Bashiri Z, Rajabi Fomeshi M, Ghasemi Hamidabadi H, Jafari D, Alizadeh S, Nazm Bojnordi M, et al. 3D-printed placental-derived bioinks for skin tissue regeneration with improved angiogenesis and wound healing properties. Mater Today Bio. 2023;20:100666. doi: 10.1016/j.mtbio.2023.100666.


Submitted date:
07/27/2023

Reviewed date:
08/23/2023

Accepted date:
09/10/2023

Publication date:
09/16/2023

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