title: Autologous Fat Grafting in Severe Lower Extremity Asymmetries: Report of Four Cases.
abstract: BACKGROUND
  Lower extremity asymmetries are challenging problems in plastic and aesthetic surgery practice. Regardless of their origin, atrophies and asymmetries can be extremely varied and difficult to solve with simple techniques.
  
  
  OBJECTIVE
  The author reports his experience in the treatment of four patients suffering from severe lower extremity atrophy and asymmetry of different etiologies with autologous fat grafting.
  
  
  METHODS
  A total of four cases are presented. Patient selection was based on the severity of atrophy and asymmetry. Two patients were treated with two sessions of simple fat grafting and two patients with one session of cell-enriched fat grafting. The end point in each session was determined by tension/blanching of soft tissues. All patients were followed up for at least 12 months after the last session. During the postoperative follow-up, variables, such as objective volume improvement, objective girth loss, return to daily activities, and patient satisfaction, were analyzed.
  
  
  RESULTS
  The initial analysis of postoperative results showed a good patient satisfaction rate with no relevant complications and an early return to daily activities. Estimated mean volume improvement for simple fat grafting cases was estimated as 44% after two treatments. Mean volume improvement in cell-enriched fat grafting cases was estimated as 25% after only one treatment.
  
  
  CONCLUSIONS
  Autologous fat grafting is a safe, effective, and reliable technique to perform aesthetic and reconstructive reshaping of a lower extremity in cases of atrophy or severe asymmetry. Depending on the preoperative soft tissue compliance, cell-assisted fat grafting will play an important role in reducing the number of sessions to perform.
authors.affiliation: Plastic Surgery, Hospital Moncloa.
authors.forename: Juan
authors.initials: J
authors.lastname: Monreal
keywords: fat grafting; human adipose tissue; lower extremity reconstruction; mesenchymal stem/stromal cells; reconstruction; stromal vascular fraction
references.citation: Plast Reconstr Surg. 2007 Apr 15;119(5):1409-22; discussion 1423-4
references.pmid: 17415234
references.citation: Aesthetic Plast Surg. 1996 Sep-Oct;20(5):409-16
references.pmid: 8849433
references.citation: Ann Plast Surg. 2016 Jun;76 Suppl 4:S359-63
references.pmid: 26545225
references.citation: Aesthetic Plast Surg. 2012 Jun;36(3):704-13
references.pmid: 22069062
references.citation: Microsurgery. 1999;19(5):227-31
references.pmid: 10413788
references.citation: Plast Reconstr Surg. 1972 Mar;49(3):351-3
references.pmid: 4551240
references.citation: Aesthetic Plast Surg. 2008 Jan;32(1):48-55; discussion 56-7
references.pmid: 17763894
references.citation: Aesthet Surg J. 2016 Feb;36(2):211-20
references.pmid: 26333990
references.citation: Aesthetic Plast Surg. 1997 Jan-Feb;21(1):55-7
references.pmid: 9204170
references.citation: Tissue Eng. 2006 Dec;12(12):3375-82
references.pmid: 17518674
references.citation: Plast Reconstr Surg. 2005 Jul;116(1):295-305; discussion 306-7
references.pmid: 15988281
references.citation: Ann Plast Surg. 2008 Nov;61(5):537-43
references.pmid: 18948782
references.citation: Plast Reconstr Surg. 2008 Jun;121(6):2127-33
references.pmid: 18520905
references.citation: Aesthet Surg J. 2003 May;23(3):213-6
references.pmid: 19336080