Adipose Derived Stem Cell Chin Augmentation

One of the key elements of the face with a significant role in facial harmony is the chin. Congenital anomalies, tumors, and trauma can all result in retrognathism in the chin or microgenia. Aufricht et al. first introduced the concept of chin augmentation in 1934. They utilized the obtained osseocartilaginous hump from a combined rhinoplasty to complete their augmentation surgery. It was not until 1953 that Brown et al. reported the use of implantable alloplastic materials for chin augmentation. Silicone-based implants are synthetic and can cause patients’ tissues to have multiple inflammatory and noninflammatory reactions. For decades, osteotomy, silicone implants, and the combination of these two techniques were the most utilized methods for chin augmentation. The introduction of fillers, specifically hyaluronic acid (HA) fillers, completely changed how plastic surgeons approached facial reconstructive and/or esthetic procedures. Needless to say, chin augmentation was not an exception in this revolution. However, as successful and popular as these procedures (i.e., genioplasty, silicone implants, and HA fillers) have been, neither of them carries any kind of osseocartilaginous regenerative properties with them. Hence, applications of various autologous grafts have been investigated in facial reconstructive and esthetic procedures. Much of the executed research and available published literature on regenerative autologous therapy for chin augmentation and other facial cosmetic/reconstructive procedures is in its infancy. Even though there are varied sources of stem cells with remarkable proliferative and regenerative potentials (e.g., amniotic fluid stem cells, Wharton jelly, umbilical cord stem cells), adipose-derived stem cells (ASCs) and bone marrow mesenchymal stem cells (BMMSCs) are still superior and preferred for clinical applications due to their high cell availability. ASCs can be obtained from large quantities of adipose tissues via a standard wet liposuction procedure. ASCs have been found to stimulate the recruitment of the endogenous stem cells and promote their differentiation into much-needed cells in sites of injury. Furthermore, ASCs entail antioxidant properties that mitigate inflammation and wound healing. Both ASCs and stromal vascular fraction (SVF) can increase and enhance vascularization and the secretion of varied growth factors. It has been suggested by some investigators that the preadipocytes and macrophages present in SVF confer regenerative properties through removal of dying cells or enhanced immune responses, eventually leading to tissue remodeling.