Lipotransfer Improves Mouth Function, Appearance, Quality of Life, Study Says

Lipotransfer Improves Mouth Function, Appearance, Quality of Life, Study Says

Lipotransfer — a procedure in which fat tissue is injected into facial scar tissue — improved mouth function, appearance, and quality of life for people with scleroderma, a study says.

The study, “Stem cell enriched lipotransfer reverses the effects of fibrosis in systemic sclerosis,” was published in the journal PLOS ONE.

Scleroderma is characterized by the appearance of thick scar tissue in the skin and internal organs. One of the main concerns of people with scleroderma is the appearance of fibrosis in the face, which affects their mouth function, appearance, and quality of life, and leads to isolation and psychological distress.

However, there is no medical alternative to improve facial fibrosis, as most treatments focus on the disease manifestations in internal organs.

Autologous lipotransfer is a reconstructive procedure that consists of extracting fat tissue from areas different from the face, like the abdomen or thighs, and injecting it in the face. The treatment reshapes the face, and reverses the effects of fibrosis.

The procedure has been successful in people with scleroderma, burns, and radiation-induced fibrosis. Additionally, it is minimally invasive and has almost no secondary adverse events.

The mechanisms by which lipotransfer reverses fibrosis are not fully understood. But they are thought to be associated with adipose-derived stem cells (ADSCs), a type of cell present in fat tissue, which has anti-inflammatory and immunoregulatory properties.

Researchers in the U.K. have now assessed the impact of lipotransfer, enriched with ADSCs, in patients with scleroderma. Their goal was to reveal the mechanisms by which the procedure reverses fibrosis.

The study included 62 people with scleroderma with signs of facial fibrosis. Participants were between 18 and 65 years old, with a mean age of 56 years, and 98% were female.

Researchers assessed mouth function using the Mouth Handicap in Systemic Sclerosis Scale (MHISS). Quality of life was assessed using physiological indexes that evaluate distress over physical appearance, anxiety and depression, and perceived negative judgment from others before and after the procedure.

Results showed that the treatment overall was well-tolerated. Adverse events included bruising and swelling in the area where fat tissue was removed, which disappeared after two weeks. There was one case of infection in the face, which was solved with oral antibiotics.

Lipotransfer significantly improved the MHISS scores in all categories, including mouth opening, aesthetic, and dry mouth. After the treatment, patients reported having more volume in the mouth and lips, fewer wrinkles, and better color in the lips. Positive effects also were perceived in the cheeks and nose.

Patients who underwent three or more lipotransfer sessions showed better results in all the categories analyzed.

The treatment also significantly improved scores on all psychological measurements.

“We found that the psychological health of the patients in this study was significantly improved,” the researchers said. “In contrast to previously published reports, our study was not limited to treating only the perioral [mouth] area but also the cheeks, chin, nasolabial folds [commonly known as laugh lines], and nose. This approach allowed for a better aesthetic outcome in terms of volume and facial elasticity that may have contributed to the psychological improvement in these patients.”

Researchers observed no significant differences between patients taking immunosuppressors and those who were not, which suggests that the mechanism of action of lipotransfer is not related to the immune system.

“In this study, we demonstrated a significant clinical improvement in orofacial fibrosis in [scleroderma], previously regarded as a disease manifestation without effective therapy,” the researchers said.

The team also cultured scleroderma-derived fibroblasts — the cells responsible for skin fibrosis — together with ADSCs extracted from patients. The goal was to better understand the action of lipotransfer.

They observed that the fibroblasts survived and divided less when cultured along with the ADSCs, than when cultured alone. They also produced fewer markers of fibrosis, and turned off genes involved in fibrosis.

The team concluded that “lipotransfer may reduce dermal fibrosis through the suppression of fibroblast proliferation and key regulators of fibrogenesis [fibrosis development].”

“Autologous stem cell-enriched lipotransfer offers a potentially effective regenerative option to treat oro-facial fibrosis in [scleroderma] that operates independently of immunosuppression and disease subset,” they added.

The team plans to further validate the findings in a controlled trial.

Alejandra has a PhD in Genetics from São Paulo State University (UNESP) and is currently working as a scientific writer, editor, and translator. As a writer for BioNews, she is fulfilling her passion for making scientific data easily available and understandable to the general public. Aside from her work with BioNews, she also works as a language editor for non-English speaking authors and is an author of science books for kids.
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Alejandra has a PhD in Genetics from São Paulo State University (UNESP) and is currently working as a scientific writer, editor, and translator. As a writer for BioNews, she is fulfilling her passion for making scientific data easily available and understandable to the general public. Aside from her work with BioNews, she also works as a language editor for non-English speaking authors and is an author of science books for kids.
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7 comments

  1. Bonnie Finn says:

    The only photo with the article appears to be a stock photo of a woman. Photos of the actual patients–before and after–would be appreciated.

  2. L. Arthur says:

    I’d like to know if this is a procedure that would be covered by Medicare if done in a hospital, and how does one become eligible? I live in Montreal, Quebec Canada. I have doctors I see in a hospital that has a Scleroderma research group and clinic.

  3. Carol Wetherell says:

    I have terrible mouth opening problems. All dental work is extremely painful as a result. I would love to also know more particularly how one becomes eligible for the lipotransfer procedure. Even if insurance does not cover it I would self pay for it.

  4. Shawn Lopez says:

    I agree with Bonnie, I would like to see pictures of actual people who have had this procedure done and their personal experiences.

  5. I was diagnosed with SLE at 32, SS at 40 and Scleroderma at 65. I have been very ill for about fifteen months. For over a year I had the white S.S. Tongue, then one day my lips started burning like they were on fire and became twice their size, then these blisters on top of the white tongue appeared as well on the rest of the rest of the inside mouth. Then a red rash around lips. Got prescription for rash, the other comes and goes. Not really painful, but uncontrollable and annoying. I am in the process of trying to find a new Dr. here, there aren’t many and my GP won’t treat me, so I’ve suffered thru with no help.wrong choice. If you have any thoughts please share. Thanks

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