title: Lymphedema fat graft: an ideal filler for facial rejuvenation.
abstract: Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF). We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome, Italy. ; Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan. ; Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Nicoli
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ram M
authors.initials: RM
authors.lastname: Chilgar
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Stamatis
authors.initials: S
authors.lastname: Sapountzis
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lazzeri
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Matthew Yeo
authors.initials: MY
authors.lastname: Sze Wei
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ciudad
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome, Italy. ; Plastic Reconstructive and Aesthetic Surgery, Villa Salaria Clinic, Rome, Italy. ; Department of Immunology, University of Rome "La Sapienza", Rome, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Nicoli
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Pathology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Chen
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan. ; Department of Plastic and Reconstructive Surgery, St. Thomas' Hospital, London, UK.
authors.forename: Joannis
authors.initials: J
authors.lastname: Constantinides
authors.affiliation: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chen
keywords: Adipose tissue; Esthetics; Hyaluronic acid; Lymphedema; Rejuvenation