SC10
Evaluating the Outcomes of Fat Grafting for Lipoatrophy Defects in MS Patients Treated with Subcutaneous Disease-Modifying Therapies (DMT)
Patients with multiple sclerosis are commonly stabilized on disease modifying therapies (DMT), including glatiramer acetate (Copaxone) or interferon-beta (Betaseron, Rebif, Extavia, Avonex). One of the potential side effects is lipoatrophy at the injection site. This results in the loss of that site for injections and a cosmetically displeasing appearance. We have recruited patients to undergo a fat grafting procedure for lipoatrophy at their injection sites. The procedure is well validated and widely used under local anesthetic to correct contour and soft tissue defects. It involves harvesting fat from an area with ample deposits, a purification process, and injecting the fat for volume augmentation in any subcutaneous plane. Volume outcomes using 3D camera imaging have been used successfully in many areas of plastic surgery. However, there is no report of fat grafting in MS patients who have lipoatrophy secondary to treatment with DMT. This study enrolls MS patients prescribed the procedure as part of their clinical care for lipoatrophy. The study involves imaging the injection site using a 3D scanner before the procedure and at 3, 6, and 12 months after the procedure. The study also collects demographic information, and subjects will complete self-esteem and body image satisfaction questionnaires before the procedure and at 3, 6, and 12 months post operatively.
Objectives:
The primary objective of this study is to evaluate the short and long-term changes in subcutaneous tissue volume following fat grafting for lipoatrophy at DMT injection sites in MS patients. Secondary objectives of this study are to evaluate impact of fat grafting for lipoatrophy on patient-reported self-esteem and body image satisfaction, to correlate self-esteem and body image satisfaction with subcutaneous tissue volume, and have the grafted sites available for potential re-use as injection sites.
Methods:
Enrollment consists of 20 MS patients on DMT who will undergo a fat grafting procedure for lipoatrophy at injection sites. Upon enrollment, subjects will complete a paper-based demographic questionnaire. A 3D scanner (Go!ScanTM manufactured by Creaform) is used to measure subcutaneous volumetric data. The scanner captures images and gives three dimensional volume measurements in the area of interest. The amount of fat injected in each patient will be recorded, and analyzed over time to determine the volume that remains at the measured time points. We also utilize questionnaires to evaluate self-esteem and body image satisfaction. The study will provide cross-sectional and longitudinal data at multiple time points: before the procedure and at 3, 6, and 12 months post operatively.
Results: Pending. The first 6 patients have had the fat grafting procedure and initial imaging done. Awaiting 3 month follow up data.
Conclusions: A novel therapy to treat lipoatrophy defects secondary to DMT injections