0011-1375 Erol
Erol OO.
Facial autologous soft-tissue contouring by adjunction of tissue cocktail injection (micrograft and minigraft mixture of dermis, fascia, and fat).
Plast Reconstr Surg. 2000 Nov;106(6):1375-87; discussion 1388-9. PMID: 11083572
Comment in:
Plast Reconstr Surg. 2001 Oct;108(5):1441.
Department of Plastic and Reconstructive Surgery at Kadir Has University, and
Vehbi Koc Foundation American Hospital of Istanbul, Turkey. onep@onep.com.tr
Facial aging is both a physiologic and anatomic process characterized by changes
in the skin and supporting tissues. The aging process produces an outer envelope
that gradually expands while its contents gradually involute and the underlying
structure weakens. This process results in an excess of skin that tends to
create folds, grooves, and deepening furrows. Contour augmentation and filling
depressions with autologous tissue or heterogeneous materials are widely used in
face rejuvenation as an adjunctive procedure. There is unanimous agreement on
the advantages of autogenous tissue grafts over alloplastic materials and
heterogeneous transplants. It is also well known that the revascularization of a
small graft (fat, dermis, and/or composite graft) is better than a large graft.
For this reason, fat injections consisting of small particles have recently
become popular. According to different authors, a graft take may vary from 30 to
50 percent. Nevertheless, it has been thoroughly documented that a graft
consisting of dermis or fascia is superior to a fat graft in both the graft take
rate and quality of the tissue. Strips of dermal graft have been used
successfully for several years to fill lip contour and nasolabial folds.
However, the main disadvantage of this technique is that utilization is
restricted only to certain areas where there is a need for a small incision. To
overcome this obstacle, the author developed a simple technique to obtain an
injectable mass from a mixture of dermis, muscle strips, fat tissue, and fascia
to use in body contouring (especially in the facial region) in large areas. The
author describes the use of the technique in 450 patients. Follow-up in these
patients from 6 months to 10 years showed that the application of the "tissue
cocktail" procedure in select patients improved the author's results and created
a marked increase in the number of satisfied patients with no complaints. The
take and durability of this kind of graft were superior to the author's results
using fat grafts. The tissue cocktail graft remained stable for several years,
as effectively seen in the chin region. The sole complication from the procedure
was some bruising, which was resolved in several days. No single infection or
inclusion cyst was observed in this series.
|
