Application of shuffling fat in the treatment of eyelid cicatricial depression and atrophy due to stick-bone scar
10.3760/cma.j.cn114453-20200511-00283
- VernacularTitle:乳糜脂肪在眼睑贴骨瘢痕性凹陷萎缩畸形治疗中的应用
- Author:
Xiaonan YANG
1
;
Qiuni GAO
;
Zhenyu YANG
;
Zhen ZHAI
;
Panxi YU
;
Xiaolei JIN
;
Zuoliang QI
Author Information
1. 中国医学科学院北京协和医学院整形外科医院整形十六科 100144
- Keywords:
Adipose tissue;
Adipocytes;
Autologous fat grafting;
Volume, eyelid;
Cicatrix, stick-bone
- From:
Chinese Journal of Plastic Surgery
2020;36(8):828-833
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect and reasonable strategy of shuffling fat in the treatment of eyelid stick-bone scar cicatricial depression and atrophy.Methods:A retrospective analysis consisted of patients admitted in Plastic Surgery Hospital, CAMS from March 2017 to May 2019, and the inclusion criteria was depressive and atrophic deformities caused by eyelid stick-bone scar. By performing subcutaneous liposuction on the abdomen, the harvested fat was further mechanically refined into shuffling fat. Single serialized shuffling fat injection with a 3-month interval was performed in the orbital region. Approximately 3 months after fat transplantation, symptomatic treatment was performed due to complications of upper eyelid ptosis or ectopic, and fat injection combined with the orbicularis oculi muscle flap was carried out to repair the lower eyelid atrophic deformity. Follow up regularly after the operation to observe the occurrence of complications. Six months after the end of treatment, the patient and observer scar assessment scale (POSAS) was used to assess scars, and the doctor-patient comprehensive score was used to assess patient satisfaction.Results:A total of 6 patients with stick-bone scar in the eyelid area were enrolled including 4 males and 2 females, aged 24-53 years old, with an average of 37 years old. The causes of defects included 4 cases of trauma, 2 cases after maxillary osteomyelitis treatment. Duration of disease ranged 1.5-50.0 years, average 14.2 years. Scars were located in the regions of upper eyelid in 4 cases and lower eyelid in 2 cases. Area of depressed region ranged 0.5 cm×2.0 cm-1.5 cm×3.0 cm. After mechanical refinement, the fat texture was more delicate and even. Injection of shuffling fat with the single volume of 0.6 to 1.3 ml was performed 3 to 4 times (average 3.25 times) on the upper eyelid and average 2 times on the lower eyelid, respectively. During the post-operative 6 months, the appearance of all patients was significantly improved, the volume of soft tissues of the eyelid was significantly increased, the pliability and elasticity of the scar tissue was ameliorated, and no complications occurred. The scores of patient scar assessment scale (PSAS) and observer scar assessment scale (OSAS) were (7.0±1.0) and (6.7±1.1), respectively, and the doctor-patient comprehensive score was 4-5 (average 4.5).Conclusions:For upper eyelid, shuffling fat injection has a good therapeutic effect on depressive and atrophic deformity caused by the stick-bone scar by increasing the tissue volume; for lower eyelid, it is necessary to combine the orbicularis oculi myocutaneous flap on the basis of shuffling fat transplantation to further increase the support structure for better appearance.
