Can autologous fat transfer treat Kawasaki lines?

  To explore the treatment of Kawasaki lines where specific endotoxin injections are ineffective and skin lift surgery is not appropriate. METHODS: Subdermal autologous fat injections were performed in the area of skin involved in Kawasaki lines to elevate local skin tension, resulting in stretching and flattening of the wrinkled skin. RESULTS: Of the 8 patients with Kawasaki lines, there was no local flattening and no recurrence of Kawasaki folds at 3 months of autologous fat grafting; within 6 months, there was only 1 recurrence of Kawasaki lines. Conclusion: For this specific type of Kawasaki lines, local autologous fat grafting can fill and support the skin where the folds occur, and this means is easy and safe to operate and can obtain good results.  The evolution of the development of Kawasaki lines goes through a process of change from power wrinkles to gravitational wrinkles. The treatment of mild power wrinkles can be done by Botox injection to reduce the contraction force of the frown muscle, while the treatment of severe gravitational wrinkles can be done by surgery to raise the skin tension to achieve initial completion or complete disappearance.  In our clinical work, we have observed a type of Kawasaki wrinkles between power wrinkles and gravitational wrinkles, which can be called static Kawasaki wrinkles, and it is characterized by local frowning and even mild depression when not frowning; local skin laxity, but not yet reaching the kind of skin sagging of gravitational Kawasaki wrinkles. This type of Sichuan lines usually occurs between the eyebrows of middle-aged people around forty years old, often after several repeated Botox injections with insignificant results, but without meeting the indications for skin lifting surgery.  In recent years, fat granule injection grafting has gained popularity due to its advantages such as less damage, lower cost, no rejection and easy acceptance by patients. Although there is still a lot of controversy regarding the lack of specific research data on the survival rate, absorption rate and regression after fat grafting, small doses of fat grafting in the face with good blood flow are recognized and widely used in the treatment of hemifacial atrophy and localized facial depressions.  The area and volume of the body surface between the eyebrows is small, requiring very little fat grafting. At the same time, the subcutaneous blood supply in this area is very rich and very conducive to vascularization after fat grafting, which fully meets the basic requirements for fat grafting of the recipient area. The subcutaneous fat grafting between the eyebrows (filling fat in the mildly sagging subcutaneous area where Kawasaki lines occur) can expand the tissue volume and raise the local skin tension, so that the local folds and depressed skin can be stretched and straightened; at the same time, the thickened subcutaneous fat tissue can increase the load of the frowning muscles, so that the skin is not easily folded, thus preventing the occurrence of Kawasaki lines and achieving the therapeutic effect, so local fat Therefore, local fat injection is especially suitable for the treatment of static Kawasaki lines. The one-year follow-up observation of our group of 8 cases of Kawasaki lines proves that fat grafting is certainly effective in the treatment of static Kawasaki lines if the patients are properly selected.  The key points of fat injection for the treatment of Kawasaki lines are: 1, the indications for treatment must be correct. 2, the local skin of Kawasaki lines and subcutaneous to ensure the correct level of peeling, must form a good cavity, do not damage the local blood vessels or nerves. 3, fat grafting should be timely, fat tissue should not be left outside the body for a long time, so as to ensure the vitality of fat tissue. 4, the amount of fat injection should not be too much, to the affected area slightly above the normal skin surface It is better to have less than 4ML in this group of cases. Based on the follow-up observation of this group of cases, we believe that: local fat injection can be used to treat Kawasaki lines between mild power and heavy gravity, both the static Kawasaki lines we described above. Since botulinum toxin enhances the effect of fat grafting, we hypothesize that local fat injections can be combined with botulinum toxin injections for the treatment of Kawasaki lines, as clinical studies are still ongoing.  Compared to other various and diverse tissue fillers, small amounts of autologous fat grafting have clear results, are easy to perform, are inexpensive, and are the safest because they are the most histocompatible.