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Aesthetic Surgery Journal Sep 2021The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also... (Review)
Review
The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also influencing self-esteem and causing miscommunication of affect based on facial miscues. With this evidence-based paper, the authors aim to provide a comprehensive overview of the latest research on the etiology and progression of facial aging by explaining the aging process from the "inside out," that is, from the bony platform to the skin envelope. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. This is followed by an in-depth analysis of specific aging regions by facial thirds (upper, middle, and lower thirds). This review may help aesthetic physicians in the interpretation of the aging process and in prioritizing and rationalizing treatment decisions to establish harmonious facial balance in younger patients or to restore balance lost with age in older patients.
Topics: Adipose Tissue; Adolescent; Aged; Aging; Esthetics; Face; Humans; Skin Aging
PubMed: 33325497
DOI: 10.1093/asj/sjaa339 -
Indian Journal of Ophthalmology Oct 2020Of the two common techniques of lower blepharoplasty, the transconjunctival approach is limited to young patients with prominent herniation of lower fat pad without skin... (Review)
Review
Of the two common techniques of lower blepharoplasty, the transconjunctival approach is limited to young patients with prominent herniation of lower fat pad without skin excess and the transcutaneous approach to patients requiring skin excision. However, the current trends not only highlight the traditional sculpting of the three orbital fat pads in lower lid blepharoplasty but also additional relocation of the intraorbital fats for correcting the inferior orbital hollowing. The purpose of this review is to analyze the published literature on common types, techniques, indications, and outcomes of the multiple surgical variants of lower lid blepharoplasty often aimed at treating the redundant skin, steatoblepharon, tear trough deformity, lid laxity, and dermatochalasis, thereby to correct the negative vector and inferior orbital hollowing along with effacement of the lid cheek junction. An extensive survey of peer-reviewed literature published in English in electronic databases, as well as bibliographies from cited articles, was conducted. Databases such as MEDLINE PubMed, the Cochrane Library, and Embase were scanned using relevant medical subject heading (MeSH) terms. Clinical studies with a minimum of five study cases were included. Level III evidence, case reports, letters, editorials, and case series with fewer than five eyes were excluded. This article provides a concise overview of available literature and as such no meta-analysis was done due to the narrowed scope of the involved studies and the variety in surgical approaches and techniques of lower lid blepharoplasty.
Topics: Adipose Tissue; Blepharoplasty; Blepharoptosis; Eyelids; Face; Humans; Skin Transplantation
PubMed: 32971612
DOI: 10.4103/ijo.IJO_2265_19 -
Nature Sep 2022Adipose tissues communicate with the central nervous system to maintain whole-body energy homeostasis. The mainstream view is that circulating hormones secreted by the...
Adipose tissues communicate with the central nervous system to maintain whole-body energy homeostasis. The mainstream view is that circulating hormones secreted by the fat convey the metabolic state to the brain, which integrates peripheral information and regulates adipocyte function through noradrenergic sympathetic output. Moreover, somatosensory neurons of the dorsal root ganglia innervate adipose tissue. However, the lack of genetic tools to selectively target these neurons has limited understanding of their physiological importance. Here we developed viral, genetic and imaging strategies to manipulate sensory nerves in an organ-specific manner in mice. This enabled us to visualize the entire axonal projection of dorsal root ganglia from the soma to subcutaneous adipocytes, establishing the anatomical underpinnings of adipose sensory innervation. Functionally, selective sensory ablation in adipose tissue enhanced the lipogenic and thermogenetic transcriptional programs, resulting in an enlarged fat pad, enrichment of beige adipocytes and elevated body temperature under thermoneutral conditions. The sensory-ablation-induced phenotypes required intact sympathetic function. We postulate that beige-fat-innervating sensory neurons modulate adipocyte function by acting as a brake on the sympathetic system. These results reveal an important role of the innervation by dorsal root ganglia of adipose tissues, and could enable future studies to examine the role of sensory innervation of disparate interoceptive systems.
Topics: Adipose Tissue; Adipose Tissue, Beige; Animals; Axons; Energy Metabolism; Ganglia, Spinal; Homeostasis; Hormones; Mice; Organ Specificity; Sensory Receptor Cells; Subcutaneous Fat; Sympathetic Nervous System; Thermogenesis
PubMed: 36045288
DOI: 10.1038/s41586-022-05137-7 -
Journal of Anatomy Aug 2018The infrapatellar pad, a fibro-adipose tissue with peculiar microscopic and mechanical features, is gaining wide attention in the field of rheumatological research. The... (Review)
Review
The infrapatellar pad, a fibro-adipose tissue with peculiar microscopic and mechanical features, is gaining wide attention in the field of rheumatological research. The purpose of this descriptive review is to summarize the most recent published evidence on the anatomic, physiologic and biomechanical inter-relationship between the infrapatellar fat pad and the knee synovial membrane. As an extrasynovial tissue, the infrapatellar fat pad does not directly interact with the articular cartilage; based on its location in close contact with the synovial membrane, and due to the metabolic properties of adipose tissue, it may influence the behavior of the synovial membrane. In fact, considering evidence of macroscopic and microscopic anatomy, the infrapatellar fat pad is the site of insertion of the infrapatellar and medial synovial plicae. Also biochemically, there is much evidence highlighting the interaction among these two structures; in the case of inflammation, the mutual interplay is ascribable to the release of pro-inflammatory mediators stimulating the proliferation of inflammatory cells and promoting tissue modifications in both. All these assumptions could support the emerging idea that the infrapatellar fat pad and the synovial membrane may be considered a morpho-functional unit.
Topics: Adipose Tissue; Humans; Knee Joint; Synovial Membrane
PubMed: 29761471
DOI: 10.1111/joa.12820 -
International Wound Journal Dec 2015There has been much debate concerning the pathologic consequences of diabetes on the plantar fat pad and its subsequent association with the development of a foot ulcer.... (Review)
Review
There has been much debate concerning the pathologic consequences of diabetes on the plantar fat pad and its subsequent association with the development of a foot ulcer. This review article documents two theories regarding pathophysiology in diabetic foot ulcer formation as they are related to the plantar fat pad and discusses current treatment options for this pathophysiological phenomenon. Traditionally, fat pad atrophy in diabetic patients was thought to result as an irregular arrangement of collagen fibrils within the septal walls as a result of glycation as well as diminishing adipocyte size due to thickened septal walls. Contrary to this traditional theory, a model depicting distal fat pad migration from under the metatarsal heads has been described in the diabetic patient. Such pad migration renders the metatarsal heads vulnerable to increased pressure, which, in turn, predisposes to foot ulceration. This migratory fat pad theory plays a significant role in approaches to the prevention of diabetic foot ulceration and subsequent amputation. Various methods of fat pad supplementation and claw toe management are impacted by the pathophysiological changes described and new avenues of therapy may be based on these changes.
Topics: Adipose Tissue; Diabetic Foot; Humans; Metatarsophalangeal Joint
PubMed: 24131727
DOI: 10.1111/iwj.12173 -
Sports Health 2016The infrapatellar fat pad (IFP) is in the anterior knee compartment and may be a major pain generator. (Review)
Review
CONTEXT
The infrapatellar fat pad (IFP) is in the anterior knee compartment and may be a major pain generator.
EVIDENCE ACQUISITION
A PubMed database search using the terms Hoffas fat pad, anterior interval, and infrapatellar fat pad was performed from the years 1970 to 2015.
STUDY DESIGN
Clinical review.
LEVEL OF EVIDENCE
Level 5.
RESULTS
Limited research exists examining the role of the IFP in relation to potential treatment and rehabilitation implications.
CONCLUSIONS
Alterations in IFP mobility, whether the result of postsurgical scarring or faulty movement patterns, result in pain and disability in a variety of patient populations. The majority of treatment approaches are driven by the surgical technique.
Topics: Adipose Tissue; Arthralgia; Biomechanical Phenomena; Cicatrix; Humans; Knee Injuries; Movement; Postoperative Complications
PubMed: 26502189
DOI: 10.1177/1941738115611413 -
BMC Veterinary Research Jan 2023Interpretation of patellar ligament (PL) ultrasonography may be difficult, as hypoechoic or heterogenous echogenicity are common findings. Verifying suspected disease of...
BACKGROUND
Interpretation of patellar ligament (PL) ultrasonography may be difficult, as hypoechoic or heterogenous echogenicity are common findings. Verifying suspected disease of equine PLs by histopathology is also problematic as descriptions of normal PL vascularity and histology are scarce. The current study describes the PL and infrapatellar fat pad (IFP) vascular pattern from computed tomography scans of barium perfused normal equine specimens (n = 8; age 10 days to 18 years), as well as routine histology to serve as a reference for future investigations into PL pathology and IFP disease.
RESULTS
The PLs received a bipolar blood supply. Vascular architecture consisted of numerous distinct longitudinal vessels with several horizontal connections, which branched into extensive latticeworks of smaller vessels throughout the ligaments. Several vascular connections between the PLs and the IFP were identified. One distinct longitudinal vessel was seen entering each of the IFP lobes at the distocranial aspect, branching extensively into lobar vascular networks which anastomosed by several horizontal branches at the mid portion of the IFP where the two lobes merge. Histologically, there were large variations in PL interfascicular endotenon thickness, vascularity and fatty infiltration; these parameters increased with age for the intermediate and medial PL. Areas of metaplastic tenocytes / chondroid metaplasia were identified in all investigated adult medial PLs; in 2/7 in the intermediate PL and in 4/7 in the lateral PL. The adult IFP consisted of white unilocular adipose tissue, organized in lobules separated by thin connective tissue septa increasing in thickness towards the periphery and the distocentral aspect.
CONCLUSIONS
The equine PLs and IFP are highly vascularized structures with ample vascular connections suggestive of crosstalk. This, together with the large variation in PL endotenon thickness, vascularity and fatty infiltration, should be taken into consideration when assessing potential PL histopathology as these changes increase with age and are found in horses without clinical signs of stifle disease. Metaplastic tenocytes / chondroid metaplasia should be considered a normal finding throughout the medial PL and is not age dependent. The role of the equine IFP in stifle disease has yet to be elucidated.
Topics: Animals; Adipose Tissue; Horses; Knee Joint; Patella; Patellar Ligament; Stifle; Tomography, X-Ray Computed
PubMed: 36691004
DOI: 10.1186/s12917-023-03579-3 -
Journal of Orthopaedic Research :... Jul 2022Knee osteoarthritis, the most prevalent degenerative joint disorder worldwide, is driven by chronic low-grade inflammation and subsequent cartilage degradation. Clinical... (Review)
Review
Knee osteoarthritis, the most prevalent degenerative joint disorder worldwide, is driven by chronic low-grade inflammation and subsequent cartilage degradation. Clinical data on the role of the Hoffa or infrapatellar fat pad in knee osteoarthritis are, however, scarce. The infrapatellar fat pad is a richly innervated intracapsular, extrasynovial adipose tissue, and an abundant source of adipokines and proinflammatory and catabolic cytokines, which may contribute to chronic synovial inflammation, cartilage destruction, and subchondral bone remodeling during knee osteoarthritis. How the infrapatellar fat pad interacts with neighboring tissues is poorly understood. Here, we review available literature with regard to the infrapatellar fat pad's interactions with cartilage, synovium, bone, menisci, ligaments, and nervous tissue during the development and progression of knee osteoarthritis. Signaling cascades are described with a focus on immune cell populations, pro- and anti-inflammatory cytokines, adipokines, mesenchymal stromal cells, and molecules derived from conditioned media from the infrapatellar fat pad. Understanding the complex interplay between the infrapatellar fat pad and its neighboring articular tissues may help to better understand and treat the multifactorial pathogenesis of osteoarthritis.
Topics: Adipokines; Adipose Tissue; Cytokines; Humans; Inflammation; Knee Joint; Osteoarthritis, Knee
PubMed: 35451170
DOI: 10.1002/jor.25347 -
The British Journal of Radiology Feb 2021The heel fat pad (HFP) is a specialized soft tissue structure formed of adipose tissue that overlies the inferior and posterior aspect of the calcaneus and provides the...
OBJECTIVE
The heel fat pad (HFP) is a specialized soft tissue structure formed of adipose tissue that overlies the inferior and posterior aspect of the calcaneus and provides the cushioning effect of the heel. Lesions of the HFP are rare and can be a cause of debilitating heel pain that may often pose a challenge to clinicians. This study provides a series of lesions identified within the HFP.
METHODS AND MATERIALS
A retrospective review of heel pad lesions over a 12 year period was conducted at our tertiary orthopaedic oncology centre. All lesions of the heel fat pad were included in the study. Plantar fasciitis was excluded.
RESULTS
There were 17 heel pad lesions identified, of which the majority (n = 15) were benign.
CONCLUSION
We highlight a wide spectrum of pathologies that can occur in the HFP. Although rare, clinicians should be aware of these lesions, to initiate appropriate management.
Topics: Adipose Tissue; Adolescent; Adult; Aged; Aged, 80 and over; Child; Diagnostic Imaging; Female; Foot Diseases; Heel; Humans; Male; Middle Aged; Retrospective Studies; Soft Tissue Neoplasms; Young Adult
PubMed: 33002374
DOI: 10.1259/bjr.20200648 -
Lipids in Health and Disease Apr 2014The fat body in invertebrates was shown to participate in energy storage and homeostasis, apart from its other roles in immune mediation and protein synthesis to mention... (Review)
Review
The fat body in invertebrates was shown to participate in energy storage and homeostasis, apart from its other roles in immune mediation and protein synthesis to mention a few. Thus, sharing similar characteristics with the liver and adipose tissues in vertebrates. However, vertebrate adipose tissue or fat has been incriminated in the pathophysiology of metabolic disorders due to its role in production of pro-inflammatory cytokines. This has not been reported in the insect fat body. The link between the fat body and adipose tissue was examined in this review with the aim of determining the principal factors responsible for resistance to inflammation in the insect fat body. This could be the missing link in the prevention of metabolic disorders in vertebrates, occasioned by obesity.
Topics: Adipose Tissue; Animals; Fat Body; Invertebrates; Metabolic Syndrome; Vertebrates
PubMed: 24758278
DOI: 10.1186/1476-511X-13-71