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Fat Chance

The Rejuvenation of Irradiated Skin

Borrelli, Mimi R., MBBS, MSc*; Patel, Ronak A., BS*; Sokol, Jan, BS*; Nguyen, Dung, MD; Momeni, Arash, MD*; Longaker, Michael T., MD, MBA*,†; Wan, Derrick C., MD*

Plastic and Reconstructive Surgery – Global Open: February 5, 2019 - Volume Latest Articles - Issue - p
doi: 10.1097/GOX.0000000000002092
Latest Articles: PDF Only

Summary: Radiotherapy (RT) helps cure and palliate thousands of patients with a range of malignant diseases. A major drawback, however, is the collateral damage done to tissues surrounding the tumor in the radiation field. The skin and subcutaneous tissue are among the most severely affected regions. Immediately following RT, the skin may be inflamed, hyperemic, and can form ulcers. With time, the dermis becomes progressively indurated. These acute and chronic changes cause substantial patient morbidity, yet there are few effective treatment modalities able to reduce radiodermatitis. Fat grafting is increasingly recognized as a tool able to reverse the fibrotic skin changes and rejuvenate the irradiated skin. This review outlines the current progress toward describing and understanding the cellular and molecular effects of fat grafting in irradiated skin. Identification of the key factors involved in the pathophysiology of fibrosis following RT will inform therapeutic interventions to enhance its beneficial effects.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

From the *Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Plastic and Reconstructive Surgery Division, Stanford University School of Medicine, Stanford, Calif.

Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, Calif.

Published online 5 February 2019.

Received for publication August 29, 2018; accepted October 10, 2018.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was waived.

Derrick C. Wan, MD, Department of Surgery, Stanford University Medical Center, 257 Campus Drive, Stanford, CA 94305, E-mail:

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.