Aris Sterodimas

• M.D. MSc ARCS
• Head of Department at Metropolitan General Hospital

Background Facial aging involves complex changes such as volume loss, ligament weakening, and skin quality alterations. The “two-thirds guidelines” emerge as a novel strategy to combat these aging signs, drawing from an extensive analysis of 2800 facial fat grafting procedures conducted over two decades. Methods Guided by facial lipolifting data,...

Background: Liposuction has evolved tremendously over the past three decades and is the most frequently performed aesthetic procedure. Although liposuction has been considered a safe surgical procedure, reports indicate that it can have significant sequelae. The increasing number of liposuction procedures, often performed by inadequately trained ph...

Background Improvements to autologous fat grafting for soft tissue augmentation are needed to overcome the unpredictable volume retention. Approaches such as fat harvesting and processing, injection technique, preparation of the recipient site, and supplemental biologics are topics of ongoing research. Here, an energy-based device was investigated...

Background Fat grafting is commonly utilized in breast surgery, and since it was first described, clinicians and researchers have stridden towards improvement of graft retention. Current advancements include adding adipose-derived mesenchymal stem/stromal cells (MSC(AT)s), which have demonstrated promise for improved graft retention. Objectives Th...

Fat grafting for face and body contouring remains shrouded in the stigma of variable results experienced by most plastic surgeons when they first graft fat. The need of standardization of the autologous fat-grafting technique needs to be done. Numerous clinical reports have been published regarding techniques of fat graft harvesting, preparation, a...

Unlabelled: Enzymatic digestion of extracellular matrix (ECM) from lipoaspirate is the conventional form of harvesting stromal vascular fraction (SVF) called enzymatically digested SVF (E-SVF). Mechanical SVF (M-SVF) isolation has emerged as an alternative method, but it has also some limitations in terms of lower cell viability and diminished cel...

Background Duration and take of gluteal lipografting are unpredictable. More importantly, unsafety of intramuscular lipofilling has been recently proven. Stromal Enriched Lipograft (SEL) is likely to enhance survival of injected fat. The purpose of this study is to describe the use of SEL for gluteal augmentation through injection into the subcutan...

The rejuvenation of the hand has received increased attention recently. The aged hand is characterized by cutaneous and dermal atrophy, with deep intermetacarpal spaces, prominent bones and tendons, and bulging reticular veins. We are presenting the results of a series of patients using Stromal Enriched Lipograft (SEL) for hand rejuvenation. In SEL...

According to recent data, augmentation gluteoplasty continues to gain popularity in the United States and globally, especially in procedures involving fat grafts. However, serious concerns about its safety have been raised over the past 2 years. Patient safety is a priority, and preventive measures should improve safety because appropriate patient...

The current most practiced technique of breast augmentation is the silicone gel implant. Over the last 30 years there has been a constant interest for the use of autologous fat transplantation for breast reconstructive and cosmetic purposes. The main concerns are the unique associated risks of breast implants such as capsular contracture, delayed-o...

Fat tissue (FT) has been used for many years in regenerative surgery as a bioactive material through the lipofilling/fat graft (F-GRF)–nano-fat technique, as a bioactive scaffold when it was enriched with adipose-derived mesenchymal stem cells (AD-MSCs) contained in the stromal vascular fraction (SVF), and as a direct source of AD-MSCs used in woun...

Gluteal augmentation with fat grafting is increasing in demand. Since its introduction, lipofilling has become increasingly popular; however, its results are variable and unpredictable. Several modifications have been made to the different steps of the procedure, harvesting, processing, and injection. The addition of stromal vascular fraction (SVF)...

Mesenchymal Stem Cells (MSCs), and Adipose-Derived Mesenchymal Stem Cells (AD-MSCs) have been used for many years in regenerative medicine for clinical and surgical applications. Additionally, recent studies reported improved respiratory activity after intravenous administration of MSCs into patients affected by coronavirus disease 2019 (COVID-19)...

Background Fat graft enhanced with adipose-derived stromal vascular fraction cells (FG-SVFs) has been used in regenerative plastic surgery, for aesthetic and reconstructive purposes. The authors present their experience using FG-SVFs obtained by minimal manipulation, in face rejuvenation. Objectives The aim of this study was to evaluate the safety...

Background: Face rejuvenation is increasingly challenging because patients request minimally invasive surgery; rapid surgical course and recovery; and fast, tangible, and long-term results. Rejuvenation of face often requires surgery to multiple areas, that is, the lateral face, the midface, the neck, and periorbital areas, in addition to the emer...

Stromal vascular fraction (SVF) containing adipose stem cells (ASCs) has been used for many years in regenerative plastic surgery for autologous applications, without any focus on their potential allogenic role. Allogenic SVF transplants could be based on the possibility to use decellularized extracellular matrix (ECM) as a scaffold from a donor th...

Background: Implant-assisted breast augmentation is among the most performed surgeries performed by plastic surgeons today. This prospective study evaluated the patient satisfaction and complication rates using high-profile round silicone implant alone (traditional breast augmentation) Group A versus the high-profile round silicone implant assisted...

A recent and interesting study reported improved respiratory activity after intravenous administration of mesenchymal stem cells (MSCs) into patients affected by coronavirus disease 2019 (COVID-19). These outcomes displayed that intravenous infiltration of MSCs is a safe and efficacy treatment for COVID-19 pneumonia, a severe acute respiratory illn...

Developing cartilage constructs with injectability, appropriate matrix composition, and persistent cartilaginous phenotype remains an enduring challenge in cartilage repair. Fourteen patients with minor contour deformity were treated with fluid cartilage filler gently injected as autologous fluid graft in deep planes of defect of the nose that were...

Introduction: Abdominoplasty is one of the most popular body-contouring procedures. Despite its popularity, classic abdominoplasty is still associated with a significant rate of complaints from patients such as: fullness of flanks and epigastric areas, lack of a posterior lumbar curve, hanging skin over the incision line, and visible scars over th...

Gigantomastia is a condition characterized by massive breast enlargement during adolescence or pregnancy. There are different types of techniques that have been used to achieve aesthetically acceptable results after reduction mammoplasty of gynecomastia patients in order to avoid distortion and ischaemia of the nipple-areolar complex (NAC). In case...

Pectus excavatum is the most frequent anterior thoracic wall congenital malformation. Autologous fat tissue transfer represents a filling material with ideal properties for soft tissue augmentation. Stromal Enriched Lipograft (SEL) technique which was firstly described by the author and his team, is based on autologous fat grafting enriched with ad...

Background: Liposuction has evolved tremendously over the past three decades and is the most frequently performed aesthetic procedure. Although liposuction has been considered a safe surgical procedure, reports indicate that it can have significant sequelae. The increasing number of liposuction procedures, often performed by inadequately trained ph...

Breast ptosis may be caused by several factors, including significant weight loss, pregnancy, long breastfeeding periods, and involution of the postmenopausal breast tissue. The authors performed a prospective study to evaluate patient satisfaction and the rate of complications after modified round block mastopexy versus traditional round block mas...

Background Numerous studies have provided data on the efficacy of ADSCs, supporting their use in current and future clinical applications. This is the first study to our knowledge, which aims at comparing the cell viability and the absolute number of mesenchymal stem cells and ADSCs from three different approaches of preparing adipose tissue for au...

Background: Tissue engineering has the potential to provide ear-shaped cartilaginous constructs in the near future. Previous attempts to engineer human ear-shaped constructs mimicked human shape and characteristics but were done in immunocompromised animal models. Objectives: The authors design and evaluate a novel, 3-dimensional (3D) cell-copolyme...

Initial, variably successful attempts of fat sculpting date back to the beginning of the 20th Century, but Gerard Illouz was the first to introduce the modern, safe, widespread method of liposuction. Preoperative injection of local anaesthesia, saline, distilled water, adrenaline and hyaluronidase, defined wet technique, established as a safe and e...

The shape of the calf is determined by the development of the soleus and gastrocnemius muscles, the length and orientation of the crural bones, and the distribution of subcutaneous fat. Some people have a naturally thin or underdeveloped calf that remains small despite exercise. Calf augmentation is indicated for cosmetic reasons or for reconstruct...

Recent years have seen an almost unprecedented excitement about medical research. It was well caught by Aristotle 2500 years ago in the opening line of his Metaphysics, when he wrote that “all men by nature desire to know,” and broadened by Francis Bacon in the sixteenth century to encompass the power of science to improve the human condition.

Adipose tissue is unique in the body for its plasticity of growth and regression throughout life. Transplantation of adipose tissue is now being explored as a possible tool to promote the beneficial metabolic effects of subcutaneous white adipose tissue and brown adipose tissue specialized in thermogenesis, as well as adipose-derived stem cells whi...

Several techniques for lipoinjection have been described in the literature. Recently, the role of adult stem cells in adipose tissue has gained interest. The authors compare autologous fat transplantation to adipose-derived stem cell-enriched lipografts. A group of 20 patients with congenital or acquired facial tissue defects were included in this...

Human adipose tissue is an ideal source of autologous cells that is both plentiful and easily obtainable in large quantities through the simple surgical procedure of liposuction. Adipose-derived stem cells (ADSCs) have a great potential for use in tissue repair and regeneration in the field of plastic and reconstructive surgery. The current human a...

In many countries, liposuction is the most frequently performed aesthetic procedure. Although liposuction has been considered a safe surgical procedure, reports indicate that it can have significant sequelae. Irregularities ranging from "oversuctioning" to bumpy skin and asymmetries result from inadequate experience of the surgeon. A total of 57 co...

In the past 25 years, several different techniques of lipoinjection have been developed. The authors performed a prospective study to evaluate the patient satisfaction and the rate of complications after an autologous gluteal lipograft among 351 patients during January 2002 and January 2008. All the patients included in the study requested gluteal...

After massive weight loss (MWL), patients are known to experience significant improvement in obesity-associated comorbid conditions and metabolic disturbances, but almost two-thirds of them require reconstructive body-contouring surgery. The authors present an anatomic study of surgical pieces obtained from 28 patients (17 women and 11 men) during...

Plastic, reconstructive, and cosmetic surgery refers to a variety of operations performed in order to repair or restore body parts to look normal or to enhance a certain structure or anatomy that is already normal. Several ethical considerations such as a patient's right for autonomy, informed consent, beneficence, and nonmalfeasance need to be giv...

Adipose tissue represents an abundant and accessible source of adult stem cells with the ability to differentiate along multiple lineage pathways, including cardiac, neural, cartilage, muscle, and bone tissue. The therapeutic potential of the use of adipose stem cells in regenerative medicine has been increasingly recognized, and in recent years co...

A growing number of men with massive weight loss are seeking improvement of arm deformity extending through the axilla and on to the chest. Although contouring techniques addressing the male arm and anterior chest deformities as separate entities have been described, when a combination of those techniques is performed, the surgical outcomes may lea...

Morbid obesity in the United States has reached startling proportions, with serious physical and psychosocial ramifications. In parallel, bariatric surgery has been increasingly utilized as a method of treatment. As a result, obese patients undergo massive weight loss (MWL), and the resulting skin excess can lead to both functional problems and pro...

Adipose tissue is believed to constitute an ideal source of uncultured stromal stem cells. By optimizing the harvesting, storage, and transplantation of adipose tissue, long-lasting results can be obtained. Cell-assisted lipotransfer (CAL) is a novel approach to autologous fat transplantation in which adipose-derived stem cells are attached to the...

Pectus excavatum is the most common congenital deformity of the anterior wall of the chest producing a caved-in or sunken appearance of the chest. Its mild form is considered to be of cosmetic nature, while the moderate to severe form, can impair cardiac and respiratory function. The authors have introduced a new method for transplantation of autol...

The ability to bring aesthetic harmony back into the ageing face requires the blending of surgical technique, anatomic knowledge and artistic sensitivity to individualise the surgical approach for each given patient. Since the advent of endoscopic techniques for facial rejuvenation, there has been an increase in the number of patients who seek alte...

Soft-tissue loss presents an ongoing challenge in plastic and reconstructive surgery. Standard approaches to soft-tissue reconstruction include autologous tissue flaps, autologous fat transplantation and alloplastic implants. All of these approaches have disadvantages, including donor-site morbidity, implant migration and absorption and foreign bod...

The importance of residents' training in aesthetic surgery and the need for acquiring confidence in performing cosmetic procedures is an established knowledge. A survey was done in two different training systems to evaluate the experience of junior plastic surgeons in performing four common aesthetic surgery procedures at the end of their residency...

During the last decades transaxillary breast augmentation (TBA) has gained worldwide acceptance. Breast augmentation via transaxillary access endoscopically assisted in the subglandular, subfascial, and submuscular planes has been previously described. Although TBA is a well-studied procedure, few reports exist concerning the subfascial plane of im...

Over the last 30 years there has been interest in the use of autologous fat transplantation for breast reconstructive and cosmetic purposes. Up until now injection of adipose tissue into the breast has been subject to two limiting factors. First, fat injection into the breast could result in fat necrosis, cyst formation, and indurations that could...

Infection after breast augmentation is uncommon, occurring in 1-3% of cases. They are typically caused by bacterial skin flora, specifically Staphylococcus aureus and the coagulase-negative staphylococci. There have been infrequent reports of breast implant infection caused by the atypical mycobacteria. This report summarizes the case of a female p...

Aesthetic surgery of the thoracoabdominal region is one of the most frequently performed surgical procedures in plastic surgery. The combination of circumferential liposuction, autologous fat grafting of the buttocks and/or lower limbs, and the modified transverse abdominoplasty as an adjuvant procedure all done in a single surgical procedure is no...

This article provides an up-to-date review of the strategies used in auricular cartilage engineering. The currently available options in stem cell, biomaterial and bio-molecules and the crucial issues for the auricular cartilage engineering are presented. Researchers have demonstrated that neo-cartilage can be constituted in a predetermined shape a...

Tissue engineering is an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function. This field has enjoyed tremendous growth in the past 10 years fuelled by its potential role in regenerating new tissues and naturally heali...

Authors' clinical and surgical experience in correction of the radial polydactyly in its various degrees of severity is presented. Nineteen patients were operated due to thumb duplication in a 10-year period from 1996 to 2006. The cases were classified according to Wassel 7-type classification. The surgical techniques adopted were the Bilhaut-Cloqu...

Silks are naturally occurring polymers and fibroin, its filament core protein, has been shown to support stem cell differentiation in vitro, and promote tissue repair in vivo. The aim of this study is to develop a biomaterial based on silk-fibroin fibers that can be associated with mesenchymal progenitor cells from human perichondrium in vitro, in...

Progressive facial hemiatrophy or Parry-Romberg syndrome is characterised by slowly progressive atrophy of one side of the face, primarily involving the subcutaneous tissue and fat. The restoration of contour and symmetry is the main challenge in patients affected by this syndrome. We describe the case of a patient with stabilised mild hemifacial a...

In many countries, liposuction is the most frequently performed aesthetic procedure. The procedure is promoted as a safe, easy-to-learn, outpatient procedure. The increasing number of liposuction procedures, often performed by inadequately trained physicians, has led to a growing number of iatrogenic postliposuction contour deformities and skin irr...

The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The "sensuous triangle" is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive liposucti...

Rehabilitation and reanimation of the paralyzed face remains a challenge. A variety of autografts and allografts have been used for static facial suspension. We report two cases of long-standing partial facial paralysis treated with 3C triple-convergence polypropylene thread. A 39-year-old woman with right-sided partial facial paralysis underwent a...

Pectus excavatum is a common type of congenital chest wall abnormality. The defect ranges in severity from mild to severe, and can lead to cardiopulmonary impairment caused by the caved-in chest. The case of a 27-year-old woman with mild pectus excavatum and a diagnosis of scleroderma is reported. Cosmetic correction of pectus excavatum malformatio...

In recent years, lumpectomy combined with breast irradiation and chemotherapy, as a part of conservation therapy for breast cancer, has well-established results. Little has been published on reduction mammoplasty for breast-irradiated patients. These patients have increased risks of nipple necrosis, wound complications, and delayed healing. Breast...

To present a type of silicone implant for the treatment of Poland's syndrome chest wall deformity. An axillary surgical approach was used in order to introduce the textured, rectangular-shaped silicone implant that was fabricated in three different sizes. Since 2001, eight male patients have received silicone implants. Implant displacement occurred...

We present a case of a delayed seroma with a fibrous capsule formation after insertion of a textured silicone gel-filled implant for the surgical correction of Poland syndrome, in spite of an uneventful intraoperative and early postoperative course. The result achieved after treatment of the seroma without reinsertion of an implant was aestheticall...

Blushing can be a disabling condition that causes sufferers great distress. It causes patients to become socially isolated, frequently being labelled as "shy". Any referral to their condition is embarrassing; even a discussion with a health care professional requires a great deal of courage. Even then, the information from non-specialists is often...

Neck and anterior chest wall flushing can be a social handicap to the sufferer and current treatment options are often unsatisfactory. We report the case of a 48-year-old woman with severe flushing of the anterior neck and anterior chest wall which resolved after three treatments of intracutaneous botulinum toxin A injections. We believe that this...