University College London Hospitals, UK
Niroshan Sivathasan completed his bachelor’s and medical degrees at the age of 23 from King’s College London and University College London, respectively. His postgraduate qualifi cations in surgery and aesthetic medicine were also gained in London. He has published 30 articles, and is a reviewer and editorial committee-member for various medical journals. He has a particular interest in cosmesis, and is about to commence a fellowship in cosmetic surgery in Australia.
There is great importance attached to the youthful appearance of the neck and décolletage. Aft er irradiation to these areas, and particularly when in combination with surgery, fi brosis of the skin and underlying tissues occurs. Additionally, function, healing, and repair are signifi cantly impaired, which may result in considerable morbidity. Tissues typically have an unhealthy appearance, and may fuse to produce constrictive and unsightly bands. Fixed-posturedeformities may result, which together with aesthetic compromise may greatly aff ect the quality of life. Patients who had oncosurgical intervention more than fi ve years previously with self-reported dissatisfaction had standard Coleman fat-graft ing performed on them. Objective evaluation of tissue-quality was assessed pre-operatively and at 3-months post-operatively. Th ere was improvement in all measured indices and reported improvement in subjective measures such as pain and quality-of-life scores. Patient-satisfaction was high and there were no donor-site complications. Autologous lipotransfer addresses the aforementioned problems by functioning as a fi ller to address contour discrepancies to improve aesthetics, and by providing a lubricating interface between tissues to improve function. Th e delivery of pluripotent mesenchymal adipose-derived stem cells may enhance angiogenesis to cause regeneration and rejuvenation of ischaemic tissues. Th is surgical modality for aesthetic- and functional-improvement has proven utility in various other anatomical sites. Our results support its use within the determined criteria in the head and neck areas.