Fat grafting for facial scleroderma is a technique to improve the degree of fibrosis, improve skin quality and to improve areas where loss of volume and depressions in the face have occurred.
Fat grafting techniques have advanced in recent years with the advent of Nanofat and adipose-derived stem cell injection techniques. These techniques allow the preparation of fat which has a higher concentration of stem cells which aid the process of repair in scleroderma . The nanofat which contains the stem cells can be directly injected into the skin or by a process of microneedling.
How is Fat transfer for scleroderma performed ?
The surgery is performed under general anaesthetic as a day case procedure.
Firstly, a small amount of liposuction is performed to obtain the fat. This fat is then filtered into exteremely fine fat particles called nanofat. The fat is then centrifuged at high speed to allow the seperation of the various cellular components including the stem cells. The stem cell layer is extracted and then mixed with the nanofat. This achieves an extremely finely processed constituent of fat which contains a high density of stem cells.
The nanofat is then injected into the face with a fine cannula under the skin and into deeper soft tissue to improve depressions and the overall contour. It can then also be injected into the skin wth a microneedling technique.
What is the recovery ?
The recovery is approximately 2 weeks where brusing and swelling to variable degree is present. The surgery is not very painful and any discomfort is easily controlled with mild painkillers.
How long does it take to achieve benefit ?
It is important to understand that the results after treatment are not immediate. The tissues have to undergo a repair process which can take at least 6 months. At the same time the degree of improvement can be variable. In many cases a second treatment is beneficial to augment the overall repair process in the skin and provide a second boost with the stem cell injections.
What are the benefits ?
The benefits of the treatment are:
- improvement in skin quality
- reduced fibrosis
- improvement in contour defects
- improved mouth opening
What are the risks ?
The risks are minimal since the procedure does not involve open surgery. It is mainly an ijection technique to harvest the fat , prepare the fat and then re-inject it. Although infections are a risk this is extremely rare and can be covered with antibiotics. The main risk is the fact that fat transfer techniques have an intrinsic failure rate where the fat grafts fail to heal when transferred to the face. The overall failure rate is approximately 20 percent. This is the reason a second treatment may be required either if a faiulre has occurred or if a further imnprovement is pursued.
Where is the treatment undertaken ?
The treatment is undertaken in London by Mr Chana, a Consultant Plastic and Reconstructive Surgeon with over 25 years of experience in fat transfer techniques. His experience extends to the use of fat transfer for both reconstructive surgery but also aesthetic surgery where the same fat transfer techniques are routinely used for anti-ageing purposes.
Mr Chana does not work in the NHS and therefore the treatment is carried out in a private hospital where fees are incurred
This is a new technque - How do I know this is scientifically proven?
There have been several scientific publications reporting good outcomes from this technique as cited below.
If you are interested in finding out more please contact the office and a Consultation can be arranged by telephone on the number above or by filling out the contact form at the bottom of this webpage.
Published evidence for the benefit of fat transfer for facial scleroderma:
Aesthetic and therapeutic outcome of fat grafting for localized Scleroderma treatment: From basic study to clinical application.
Wang HC, Dong R, Long X, Wang X.
J Cosmet Dermatol. 2021 Sep;20(9):2723-2728. doi: 10.1111/jocd.13941. Epub 2021 Jan 23.
Supportive Use of Adipose-Derived Stem Cells in Cell-Assisted Lipotransfer for Localized Scleroderma.
Chen B, Wang X, Long X, Zhang M, Huang J, Yu N, Xu J.
Plast Reconstr Surg. 2018 Jun;141(6):1395-1407. doi: 10.1097/PRS.4386.
Fat Grafting Subjectively Improves Facial Skin Elasticity and Hand Function of Scleroderma Patients.
Strong AL, Adidharma W, Brown OH, Cederna PS.
Plast Reconstr Surg Glob Open. 2021 Jan 25;9(1):e3373. doi: 10.10973373. eCollection 2021 Jan.
Regenerative Approach to Scleroderma with Fat Grafting.
Magalon G, Daumas A, Sautereau N, Magalon J, Sabatier F, Granel B.
Clin Plast Surg. 2015 Jul;42(3):353-64, viii-ix. doi: 10.1016/j.cps.2015.03.009.