The Functional Anatomy of the Deep Facial Fat Compartments: A Detailed Imaging-Based Investigation

BACKGROUND Injection of soft-tissue fillers into the facial fat compartments is frequently performed to ameliorate the signs of facial aging. This study was designed to investigate the functional anatomy of the deep facial fat compartments and to provide information on the effects of injected material in relation to age and gender differences. METHODS Forty fresh frozen cephalic specimens of 17 male and 23 female Caucasian body donors (mean age, 76.9 ± 13.1 years; mean body mass index, 23.6 ± 5.3 kg/m(2)) were investigated. Computed tomographic and magnetic resonance imaging procedures were carried out using colored contrast-enhanced materials with rheologic properties similar to commercially available soft-tissue fillers. Anatomical dissections were performed to guide conclusions. RESULTS No statistically significant influences of age or gender were detected in the investigated sample. Increased amounts of injected contrast agent did not correlate with inferior displacement of the material in any of the investigated compartments: deep pyriform, deep medial cheek, deep lateral cheek, deep nasolabial (located within the premaxillary space), and the medial and lateral sub-orbicularis oculi fat. CONCLUSIONS Increasing volume in the deep midfacial fat compartments did not cause inferior displacement of the injected material. This underscores the role of deep soft-tissue filler injections (i.e., in contact with the bone) in providing support for overlying structures and resulting in anterior projection

Adipose-derived Stromal Cell Therapy Combined with a Short Course Non-Myeloablative Conditioning Promotes Long-term Graft Tolerance in Vascularized Composite Allotransplantation

The risks of chronic immunosuppression limit the utility of vascularized composite allotransplantation (VCA) as reconstructive option in complex tissue defects. We evaluated a novel, clinically translatable, radiation-free conditioning protocol that combines anti-lymphocyte serum (ALS), tacrolimus and CTLA4-Ig with adipose-derived stromal cells (ASCs) to allow VCA survival without long-term systemic immunosuppression. Full-mismatched rat hind-limb transplant recipients received tacrolimus (0.5mg/kg) for 14 days and were assigned to four groups: CTRL received no conditioning; ASC-group received CTLA4-Ig (10mg/kg BW s.c. POD 2, 4, 7) and donor ASCs (1x10^6 iv, POD 2, 4, 7, 15, 28); ASC-CYP-group received CTLA4-Ig, ASC plus cyclophosphamide (50mg/kg i.p., POD 3); ASC-ALS-group received CTLA4-Ig, ASCs plus ALS (500µL i.p., POD 1, 5). Banff grade III or 120 days were endpoints. ASCs suppressed alloresponse in vitro. Median rejection-free VCA survival was 28 days in CTRL (n=7), 34 in ASC (n=6) and 27.5 in ASC-CYP (n=4). In contrast, ASC-ALS achieved significantly longer, rejection-free VCA survival in 6/7 animals (86%), with persistent mixed donor-cell chimerism, and elevated systemic and allograft skin T$_{regs}$ , with no signs of acute cellular rejection. Taken together, a regimen comprised of short-course tacrolimus, repeated CTLA4-Ig and ASC administration, combined with ALS, promotes long-term VCA survival without chronic immunosuppression

A swim test for functional assessment of rodent peripheral nerve regeneration

ISSN:0165-0270ISSN:1872-678