Arch Plast Surg.  2018 Mar;45(2):128-134. 10.5999/aps.2017.00997.

Volumetric lipoinjection of the fronto-orbital and temporal complex with adipose stem cells for the aesthetic restoration of sequelae of craniosynostosis

• Castro-Govea Y
• Vela-Martinez A
• Treviño-Garcia LA

• KMID: 2409456
• DOI: http://doi.org/10.5999/aps.2017.00997

Abstract

BACKGROUND
Non-syndromic craniosynostosis causes craniofacial asymmetry and may persist after cranioplasty. These postoperative asymmetries are primarily depressions. In some cases, patients may be subjected to pranks and harassment by their peers, affecting their psychosocial development. We propose lipoinjection enriched with adipose stem cells (ASCs) to treat the sequelae of craniosynostosis in the fronto-orbital and temporal complex in cranioplasty patients, with the goal of improving the appearance of the upper third of the face.
METHODS
Twelve children (four boys and eight girls) between 4 and 8 years of age (mean age, 6 years) in the postoperative period after treatment for plagiocephaly, brachycephaly, and trigonocephaly were included, with a follow-up period of 1 to 18 months. Fat tissue was obtained from the lower abdomen, and ASCs were isolated using the Yoshimura technique. Lipoinjection was performed using several mini-approaches to ensure adequate distribution.
RESULTS
Two different scales were used to evaluate the aesthetic outcomes. At 6 months, three plastic surgeons independent of the study classified the results using a Likert scale. The patients' parents categorized the results using a visual analog scale at 6, 9, and 18 months. R esults were favorable on both scales, as the patients' facial appearance improved and they reported increased happiness and self-esteem due to their remodeled facial appearance.
CONCLUSIONS
We suggest that lipoinjection enriched with ASCs is a good alternative for correcting asymmetry of the fronto-orbital and temporal contour in patients with sequelae of craniosynostosis. This treatment will help boost patients' self-esteem starting at an early age.

Keyword

Craniosynostoses; Transplants; Frontal bone; Adipose tissue; Stem cells

MeSH Terms

Abdomen
Adipose Tissue
Child
Craniosynostoses*
Depression
Follow-Up Studies
Frontal Bone
Happiness
Humans
Parents
Plagiocephaly
Plastics
Postoperative Period
Stem Cells*
Surgeons
Visual Analog Scale
Weights and Measures
Plastics