自體脂肪移植的過程，應用及效果

摘要：

通過文獻系統回顧自體脂肪移植的方法，應用及效果。

結果：

自從自體脂肪移植誕生後，就一直受到青睞，但其效果各異且不可控。從脂肪採集，到加工，最後注射這幾個關鍵步驟有過幾次修正，採集脂肪過程中，外科切除和使用大口徑套管做低負壓吸引來盡量減少對脂肪細胞的損傷，「濕法」獲得脂肪指用液體注入供區，加速脂肪抽吸以減少疼痛和出血淤青。對於脂肪的處理，相對高速離心過濾，重力分離及過濾，低速離心過濾效果更好。對於脂肪受區注射，採用小套管，多次扇形注射好過一次性注射。由於脂肪中幹細胞的再生潛能，所以脂肪移植不僅僅是注射填充的作用，它可以在胸部重建後改善胸部輪廓，改善疤痕疼痛與攣縮，用來治療燒傷疤痕和放射性皮炎。脂肪填充也用做美容的治療，比如面部和手部年輕化，鼻部填充，胸部和臀部填充塑形。併發症主要有淤青，水腫，疼痛，感染，壞死和鈣化。

結論：

自體脂肪移植低風險，可以用來矯正面部，軀幹，肢端的軟組織缺陷，病人不適感低。

1016/j.amsu.2017.06.059. eCollection 2017 Aug.

Procedure, applications, and outcomes of autologous fat grafting.

OBJECTIVE:

To systematically review the procedure, applications, and outcomes of autologous fat grafting, a promising technique with various clinical applications.

PATIENTS AND METHODS:

Literature review of publications concerning autologous fat grafting.

RESULTS:

Since its introduction, lipofilling has become increasingly popular; however, its results are variable and unpredictable. Several modifications have been made to the procedures of fat harvesting, processing, and injecting. Surgical excision and low negative-pressure aspiration with large-bore cannulas minimize adipocyte damage during fat harvesting. The "wet" method of fat harvesting involves fluid injection at the donor site and facilitates lipoaspiration while minimizing pain and ecchymosis. For fat processing, centrifugation at a low speed is preferable to high-speed centrifugation, gravity separation or filtration. Fat injection at the recipient site should be performed using small-gauge cannulas in a fanning out pattern over multiple sessions, rather than a single session. Fat grafts exhibit not only dermal filler properties but also regenerative potential owing to the presence of stem cells in fat tissue. Thus, the clinical applications of autologous fat grafting include correction of secondary contour defects after breast reconstruction, release of painful scar contractures, and treatment of burn scars and radiodermatitis. Lipofilling is also used in aesthetic surgery, such as facial and hand rejuvenation, augmentation rhinoplasty, and breast and gluteal augmentation. The complications of lipofilling are minimal and include bruising, swelling, pain, infection, necrosis, and calcification.

CONCLUSIONS:

Lipofilling is a low-risk procedure that can be used to correct soft-tissue defects in the face, trunk, and extremities, with minimal discomfort for patients.

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