Browsing by Author "Andjelkov, Katarina (36974991500)"

Background: Facial aging involves complex changes such as volume loss, ligament weakening, and skin quality alterations. The “two-thirds guidelines” emerge as a novel strategy to combat these aging signs, drawing from an extensive analysis of 2800 facial fat grafting procedures conducted over two decades. Methods: Guided by facial lipolifting data, including patient age, fat type (microfat and nanofat), and injection depth, this study devises a systematic framework for multilayer fat rejuvenation and ligament restoration. The two-thirds guidelines advocate injecting two-thirds of the patient’s age for microfat and one-third for nanofat, with specific injection codes for lower, middle, and upper facial regions. Results: A prospective study involving 400 patients confirms the efficacy of the two-thirds guidelines. However, applicability may vary for patients outside SD ranges, particularly concerning facial proportions and body mass index. Patients within the golden ratio range (1.4–1.9) report high satisfaction rates and a 50% fat graft uptake, with minimal complications. For patients outside this range, an artificial intelligence (AI) program was implemented. Conclusions: The two-thirds guidelines offer a comprehensive approach to facial rejuvenation, addressing volume loss, ligament weakening, and skin quality. They are applicable in early aging stages, promising enduring and natural outcomes while mitigating effects of weight fluctuations. These guidelines provide a safe, replicable, and adaptable approach to facial fat grafting, either standalone or in combination with facelift techniques, with minimized overfilling risks. A dataset obtained from 2800 patients serves as the foundation for developing an AI program tailored to aid doctors in diagnosing and treating similar cases. © 2024 The Authors.

Background This study offers objective dimensions of the gastrocnemius muscle and analyzes correlations between dimensional variables, with a view to providing guidance on the proportions of a healthy gastrocnemius muscle for both genders. Methods This anatomical study was conducted at the Institute of Forensic Medicine Faculty of Medicine University of Belgrade, Serbia, from May until November 2014. We included 47 fresh cadavers (up to 12-h postmortem interval) both male and female. The inclusion criteria were absence of any trauma or degenerative findings in lower limbs, normally weighed, and age between 18 and 60 years. The exclusion criteria were significant difference in dimensions between legs and overweighed cadavers. Results After statistical analysis of gathered data, we were able to define the exact shape and average measures of the medial and lateral head of gastrocnemius muscle in male and female. Factors affecting muscle dimensions are also defined in this study. Conclusion The method of dissection that we applied could be recommended for exploration of different anatomical structures of calf region. The reported dimensions and correlations are useful guide in planning cosmetic and reconstructive procedures with high accuracy. © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons

Aim: The aim of this study was to investigate whether the application of nanofat containing stem cells improves continence in women who had previously undergone anal sphincteroplasty with unsatisfactory long-term outcomes. Method: This prospective pilot study included nine women with various degrees of anal incontinence who had previously undergone anal sphincteroplasty due to obstetric trauma. In all patients, the Wexner Incontinence Score (WS) and Faecal Incontinence Quality of Life Score (FIQLS), as well as anal manometry and endoanal ultrasound measurements, were performed before the procedure and during follow-up. In all patients, liposuction was performed and 50 ml of raw lipoaspirate was obtained and processed using a NanoFat Kit device. Approximately 20 ml of the mechanically emulsified and filtrated fat was obtained and the anal sphincter complex was infiltrated with it. Patient follow-up was conducted in person or via telephone 6 and 12 months after the procedure. Results: The squeeze pressure was significantly increased 6 months after the procedure (p = 0.01). The external anal sphincter measured at the 12 o'clock position was significantly thicker (p = 0.04). A significant decrease in the WS was observed both 6 and 12 months after the procedure compared with baseline values (p < 0.05 for both). Conclusion: This study is the first to show that the application of nanofat as an injectable product improves continence in patients with unsatisfactory results after sphincteroplasty, suggesting it to be a promising and effective therapeutic tool. The procedure is safe and can be easily performed as an ambulatory procedure. © 2022 Association of Coloproctology of Great Britain and Ireland.

Hair folliculogenesis and hair growth mediated by the secretory properties of white adipocytes may pave the way for the adipose-derived (AD) regenerative therapy for androgenetic alopecia (AGA). Quantitative and qualitative secretome profiling of AD stem cells (ADSCs) from different zones of hair growth in patients with AGA were analysed. 1-mm punch samples of adipose tissue associated with hair follicles, of three scalp areas (balding, non-balding and transition zones) and one periumbilical sample, were used for ADCS isolation. The ADCS secretome was analysed in conditioned media using a 41plex assay. Among the thirty-five signalling proteins analysed, the levels of VEGF, EGF, IL-6, Eotaxin, MCP-3, IFNγ-inducible protein-10 and MIP-1α were higher in the balding zone compared with the non-balding and periumbilical zones. In contrast, MCP-1 was the lowest in the balding zone in comparison with the other zones. The observed differences in the secretome suggest crosstalk between angiogenic and inflammatory processes underlying AGA aetiology and may prove relevant in both the diagnosis of AGA and the application of ADSC secretome for AGA treatment. © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Hair folliculogenesis and hair growth mediated by the secretory properties of white adipocytes may pave the way for the adipose-derived (AD) regenerative therapy for androgenetic alopecia (AGA). Quantitative and qualitative secretome profiling of AD stem cells (ADSCs) from different zones of hair growth in patients with AGA were analysed. 1-mm punch samples of adipose tissue associated with hair follicles, of three scalp areas (balding, non-balding and transition zones) and one periumbilical sample, were used for ADCS isolation. The ADCS secretome was analysed in conditioned media using a 41plex assay. Among the thirty-five signalling proteins analysed, the levels of VEGF, EGF, IL-6, Eotaxin, MCP-3, IFNγ-inducible protein-10 and MIP-1α were higher in the balding zone compared with the non-balding and periumbilical zones. In contrast, MCP-1 was the lowest in the balding zone in comparison with the other zones. The observed differences in the secretome suggest crosstalk between angiogenic and inflammatory processes underlying AGA aetiology and may prove relevant in both the diagnosis of AGA and the application of ADSC secretome for AGA treatment. © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Autologous fat transfer is one of the most frequently done procedures, either as a single procedure or in combination with other procedures, in aesthetic, reconstructive, and regenerative surgery. Fat grafting is shown to be safe through many studies but it can rarely cause severe complications like fat embolism. Newer reports that studied sudden death after gluteal augmentation with fat showed that fat embolism has two forms depending on the amount of fat that enters the bloodstream, as well as the size of fat droplets: Microscopic (MIFE) and macroscopic (MAFE) fat embolism. MIFE has a clinical presentation that matches the characteristics of the traditionally known fat embolism syndrome, whereas MAFE causes a state that mostly resembles a massive pulmonary thromboembolism and has a poor prognosis. Both forms of fat embolization occur as a result of fat particles entering the blood stream, but their clinical presentations, prevention, treatment and prognoses are completely different. A quick diagnosis and start of treatment are key for a positive outcome. Selection of an eligible patient, the selection of a safe region, correct performing of the procedure and excellent knowledge of anatomy are of great importance in prevention of a fat embolism. © Springer Nature Switzerland AG 2022.

Autologous fat transfer is one of the most frequently done procedures, either as a single procedure or in combination with other procedures, in aesthetic, reconstructive, and regenerative surgery. Fat grafting is shown to be safe through many studies but it can rarely cause severe complications like fat embolism. Newer reports that studied sudden death after gluteal augmentation with fat showed that fat embolism has two forms depending on the amount of fat that enters the bloodstream, as well as the size of fat droplets: Microscopic (MIFE) and macroscopic (MAFE) fat embolism. MIFE has a clinical presentation that matches the characteristics of the traditionally known fat embolism syndrome, whereas MAFE causes a state that mostly resembles a massive pulmonary thromboembolism and has a poor prognosis. Both forms of fat embolization occur as a result of fat particles entering the blood stream, but their clinical presentations, prevention, treatment and prognoses are completely different. A quick diagnosis and start of treatment are key for a positive outcome. Selection of an eligible patient, the selection of a safe region, correct performing of the procedure and excellent knowledge of anatomy are of great importance in prevention of a fat embolism. © Springer Nature Switzerland AG 2022.

[No abstract available]

Background: Herniated or pseudoherniated nipple-areolar complex (NAC), also called protuberant or “domed nipple,” is an entity that can be present both in males and females and represents a therapeutic challenge. It can be an isolated deformity, but in most cases is found within another breast deformity, such as tuberous breast or can appear following pregnancy. Its diagnosis and appropriate treatment become important when patients search for correctional breast surgery. Objective: To review some common techniques for the treatment of tuberous breasts that address the nipple-areola problem as well, but also to present our experience with some newer and less invasive surgical techniques that could be useful for isolated treatment of herniated or pseudoherniated nipple. Method: We performed a retrospective study that included all patients operated from December 2013 to December 2018. We reviewed existing techniques which in addition to our personal experience helped us to create an algorithm to assist surgeons in this matter. Results: A total of 125 patients with herniated or pseudoherniated NAC were treated. There were 87 women and 38 men. The average age of the patients was 30, 8 ± 8.1 years (ranging from 20 to 63). We analyzed the results of four following techniques: periareolar mastopexy (52 patients), release of fibrous tissue in combination with lipofilling (19 patients), resection of herniated breast tissue (23 patients) or controlled electrocoagulation of relaxed erectile muscle (31 patients). The minimum follow-up for all cases was 4 months. Conclusion: The achievement of a successful aesthetic result is possible in a single-stage procedure with initial surgery. It depends on careful individual preoperative evaluation of anatomical features and a surgical approach chosen accordingly. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266. © 2021, Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.

[No abstract available]

Background: Calf augmentation surgery is one of the least popular procedures among plastic surgeons; in contrast, it is by far one of the most gratifying procedures among patients. In this article, the authors present a retrospective analysis of a surgeon's extensive experience with calf implants. Methods: The authors retrospectively analyzed 134 patients having calf augmentation for cosmetic and reconstructive surgery in their practice from 2003 to 2015. All patients were divided into two groups: primary cases and patients who had previously been operated on and who were referred to our service as patients who had complications after calf augmentation surgery. The subfascial approach was the preferred approach by authors for all primary cases. The authors analyzed indications, complication rates, results, and pitfalls. Secondary cases were further divided into three groups according to the origin of the problem and some possible solutions. Results: Subfascial calf augmentation surgery is safe and easy to reproduce, with a short recovery period and a low complication rate (<1 percent). To achieve the best aesthetic results, surgeons should choose appropriate implants for each case. In secondary cases, fat grafting is a powerful tool and can be used alone or in combination with calf implants. Conclusions: There are several groups of patients seeking calf augmentation surgery (e.g., bodybuilders, women, those with reconstructive problems). Therefore, treatment should be planned individually. The development of a new implant is necessary and should be based on detailed anatomical findings and in accordance with surgical techniques. The process is intriguing and rewarding. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V. © Copyright 2017 by the American Society of Plastic Surgeons.

Background: Subcutaneous tissue is an abundant source of adipose-derived regenerative cells. It is readily available and easy to extract by means of liposuction, making it one of the most popular sources for tissue engineering and regenerative medical applications. Methods: The stromal vascular fraction (SVF) cell yield and viability of the lipoaspirate obtained from 43 patients undergoing elective liposuction were examined in correlation with their age, gender, body mass index, smoking status, and physical activity. The lipoaspirate was processed with the Celution® 800/CRS system to isolate the SVF and a few drops of the obtained pellet were used for cell counting with NecleoCounter® NC-100TM. Results: Twenty-eight (65.1%) were men and 15 (34.9%) were women with an average age of 40.7 ± 10.4 years (women) and 38.9 ± 11.8 years (men). Viable SVF cells/g fat was significantly correlated with smoking level (negative correlation, ρ= − 0.312, P < 0.05) and with marginal significance with female gender. Cell viability showed a significant negative correlation with physical activity level (ρ = − 0.432, P < 0.01); borderline significance for correlation of this parameter with smoking level should not be neglected. Other parameters did not influence the cell yield nor the viability of the stromal vascular fraction. Conclusion: Many factors may influence SVF cell yield and viability. Our findings indicate that age and smoking significantly influenced SVF cell yield, age positively while smoking negatively. Increased physical activity had a negative correlation with SVF cell viability. Level of Evidence N/A: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2020, Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.