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Kawakibi et al. Plast Aesthet Res 2023;10:48 Plastic and
DOI: 10.20517/2347-9264.2022.120
Aesthetic Research

Commentary Open Access

Novel indications for autologous fat grafting in
reconstruction: scleroderma

Abed Rahman Kawakibi , Alexander N. Khouri, Paul S. Cederna, Amy L. Strong

Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI 49109, USA.
Correspondence to: Dr. Amy L. Strong, MD, PhD, MPH, Section of Plastic Surgery, Department of Surgery, University of
Michigan, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109, USA. E-mail: amstrong@med.umich.edu

How to cite this article: Kawakibi AR, Khouri AN, Cederna PS, Strong AL. Novel indications for autologous fat grafting in
reconstruction: scleroderma. Plast Aesthet Res 2023;10:48. https://dx.doi.org/10.20517/2347-9264.2022.120

Received: 26 Oct 2022 First Decision: 19 Jul 2023 Revised: 25 Jul 2023 Accepted: 21 Aug 2023 Published: 1 Sep 2023

Academic Editor: Karol A. Gutowski Copy Editor: Dan Zhang Production Editor: Dan Zhang

Abstract
Scleroderma is a chronic connective tissue disease characterized by inflammation, vascular injury, and progressive
skin fibrosis, resulting in significant aesthetic and functional impairments for patients. Current therapies are limited
and insufficiently treat the cutaneous manifestations of scleroderma. Autologous fat transfer (AFT) is a surgical
technique that has been utilized for many decades for facial rejuvenation. The adipose stem cells (ASCs) present in
fat grafts have also shown significant promise for their anti-inflammatory and regenerative properties. Recently,
AFT has been repurposed to treat the skin manifestations of systemic sclerosis and localized scleroderma. Studies
suggest that AFT in scleroderma patients improves mouth and hand functions, Raynaud’s symptoms, and digital
ulcerations. AFT is a safe procedure with rare postoperative complications, making it a promising intervention for
the treatment of scleroderma. Further studies are required to better characterize the influence of fat grafts on the
recipient site and to establish standards for fat transfer in fibrotic skin diseases.

Keywords: Scleroderma, systemic sclerosis, localized scleroderma, AFT

INTRODUCTION
Scleroderma is a rare heterogeneous autoimmune connective tissue disorder characterized by widespread
inflammation, vascular damage, and fibrosis . Scleroderma has a variety of clinical manifestations in the
[1]
face, hand, and body that vary based on subtype. The two main clinical subtypes include localized

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
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