Tissue Induction in Plastic and Maxillo-facial Surgery

Tissue induction is defined as the activation of cell regeneration to restore damaged tissue, which involves stimulating cell signaling and modifying the microenvironment. Tissue inducers therefore have the advantage of acting quickly and durably on treated tissues, alone or in combination with surgical procedures, in order to reduce iatrogeny and potentiate surgical results. The aim of this review was to detail the various current techniques for tissue regeneration in the field of plastic and maxillo-facial surgery. We conducted a systematic search on Pubmed, Google Scholar and Science Direct. Articles in English and French, published after 2012 and focusing on facial tissue induction were searched. Only prospective comparative studies assessing as many cases as possible were analyzed. The following keywords were used: “skin rejuvenation”, “skin regeneration”, “collagen induction”, “skin enhancer”, “aging rejuvenation”, “oral mucosa rejuvenation”, “oral mucosa regeneration”, “buccal mucosa rejuvenation”, “buccal mucosa regeneration”, “oral bone regeneration”, “alveolar bone regeneration”. Fifty innovative articles published since 2012 dealing with tissue induction techniques with an interest in plastic and maxillo-facial surgery were identified and then selected. The most effective tissue inducers for skin and mucosal regeneration were lasers, radiofrequency, pulsed light, hyaluronic acid and PRP. Tissue induction allows collagen self-production leading to tissue regeneration. Many techniques can be used for tissue induction that represent an additional tool in the therapeutic arsenal available to plastic and maxillofacial surgeons to improve patient management.These inducers can be used alone or in combination to achieve synergistic effects and better clinical outcomes

Face Transplant: Indications, Outcomes, and Ethical Issues—Where Do We Stand?

Background: The addition of face allotransplantation (FT) to the head and neck reconstructive surgery arsenal has started a true revolution. This study is aimed at providing an extensive analysis of the current practice of composite tissue allotransplantation. Moreover, a thorough description of pre-procedural, intra-operative, and post-procedural settings, indications, contraindications, outcomes, ethical considerations, and future perspectives is provided. Methods: The authors’ experience was supplemented with a literature review performed by using the PubMed, MEDLINE, and Embase databases on 21 February 2022. The search terms used were “face transplantation indications”, “face transplantation complications”, and “face transplantation ethical issues”. Results: The most recent achievements and long-term clinical sequelae of FT are classified and summarized. A large number of records (4435) were identified. Seventy-five articles were assessed for eligibility. Publications without new data and reports with a patient follow-up < 5 years were excluded. Nineteen articles met the criteria for inclusion. Conclusions: The most recent achievements in the field of FT may be combined with cutting-edge regenerative medicine procedures and innovative immunological processing. It is paramount to build strong international networks between the world FT experts in order to achieve higher-level outcomes and reduce the complication rate. Nevertheless, the utmost caution is required in patient selection, clinical assessment, strict follow-up, and rejection management