**4.3 Case 3 – Congenital constriction band syndrome**

Congenital bands are compressive rings with a groove of different depths that can be partially or wholly circular at one end.

Its etiology remains unknown. Its rupture has been described through the use of Z- and W-plasty and excision and primary closure; However, new alternatives to its treatment have recently been described.

A 36-year-old woman with no relevant medical history presents a simple congenital constriction band in the distal part of both legs, without functional impairment (Type 1 Patterson Classification). The right leg had an incomplete circumferential constriction band with minimal depth, and the left leg a circumferential constriction band of moderate depth. The left leg was treated. The procedure was performed under epidural anesthesia with intravenous sedation [32] (**Figure 4**).

Three approaches (2 mm) that were remote to the constriction band were marked. Initially, the fibrous band was released from the deep tissues with a flatgrove blunt-tipped 2-mm Toledo cannula, 10 cm in length. Afterward, with this same cannula, multiple perpendicular cuts were made in the inner surface of the

#### **Figure 2.**

*(A, C, E) preoperative view. (B, D, F) postoperative view 12 months after lipoinjection enriched with stem cells and elements of the stromal vascular fraction.*

*The Versatility of Autologous Fat Transplantation in Abnormalities... DOI: http://dx.doi.org/10.5772/intechopen.97015*

#### **Figure 3.**

*Intraoperative view. (A) Glabellar lipoinjection was performed in a fan shape until adequate symmetry was achieved. (B) the treated left area. (C) both treated areas.*

**Figure 4.** *Preoperative images of the left leg. (A) Lateral view, (B) frontal view, (C) medial view.*

fibrous ring leaving a 1 cm gap between each cut until completing the circumference of the band.

Lipoinjection was performed in the virtual subcutaneous space from a deep to a superficial plane with a 2-mm blunt cannula with 5-ml syringes. We injected the amount of fat needed to reverse the appearance of depression without overcorrecting (**Figure 5**).

#### **4.4 Case 4 – Facial esthetics**

A 27-year-old female with no significant history requested a facial profiling procedure.

The patient presented adequate skin quality; however, she was not satisfied with the definition of her facial frame and neck. Today, patients come to our consultation with a lot of Internet information, and in many cases, they request specific procedures. It is always good to listen to them, and in this way, know how to properly advise our patients. After an adequate clinical evaluation, we suggested carrying out the following procedures: Bichectomy, neck liposculpture, and enhance the definition of the entire lower facial frame by volumetric lipoinjection with adipose stem cells, in addition to a slight increase in projection on the upper lip in the philtrum region.

For seven years, we have developed an innovative alternative for nasal modeling. In this case, we also use fat and stem cells (in our practice, we have named this RINO-CELL®).

To a large extent, we consider that the success of any procedure in facial esthetics lies in obtaining an adequate definition of the full jaw contour. In this way, it is possible to visualize the border between the face and the neck, and it is also our objective to redefine the cervicofacial angle. All these characteristics represent a clear sign of beauty and youth (**Figure 6**).

#### **Figure 5.**

*Change in the concave surface ("hourglass sign") for a homogeneous surface. (A, C, E) preoperative view. (B, D, F) postoperative view 18 months after the procedure (note the three approaches with some degree of hyperpigmentation).*
