Fat Grafting Shows Promise for Cancer Patients with Radiation-Induced Skin Injury

Radiation Therapy (RT) is an effective treatment for a range of malignant conditions. It involves projecting high-energy photons towards a tumor, destroying the DNA of the tumor cells. With their DNA destroyed, the cancer cells lose their ability to divide and grow, and they eventually die.

Radiotherapy goals

When applied in the early stages, or when cancer has just begun to spread, radiotherapy can shrink or completely cure it. But radiation may also be used before surgery to shrink the tumor (neoadjuvant or pre-operative therapy) or after surgery to keep it from recurring (adjuvant therapy).

For cancer that has spread too much to be cured, radiation may be applied to keep the tumor smaller and help relieve problems such as pain, trouble swallowing, breathing difficulty or bowel blockages caused by advanced cancer.

Collateral damage

As radiation is projected to destroy cancer cells, the nearby normal cells may also be exposed to high-energy particles. Though most of the exposed normal cells tend to recover and go back to working the way they should, some cells, like skin cells, are extremely sensitive to the damaging effects of radiation and do not recover.

Because skin-sparing radiotherapy techniques are not yet possible, the skin is particularly vulnerable during radiation therapy for breast cancer, anal cancer, and head and neck cancer. A few months after radiotherapy, patients may develop acute radiation injury characterized by skin inflammation, peeling, pain, swelling and itching.

The symptoms may resolve with time, but in some cases the inflammation continues, resulting in tight, stiff skin (fibrosis) which leads to poor wound healing, skin ulcer and tissue loss. In addition, soft-tissue fibrosis may cause potentially severe functional and cosmetic problems which can adversely impact the quality of life.

Fat grafting after radiotherapy

Fat grafting is the process of removing fat from one area of the body and transplanting it into another area. It can be done in different body areas, including the breasts, buttocks and face.

During fat grafting, the surgeon removes fat from the donor area—usually the belly or thighs—using a liposuction machine. After the fat is harvested, it is prepared and then injected into the desired area. About 50-60 percent of the fat transferred survives; thus, more fat is usually injected than may be needed.

What happens after fat grafting?

Following the injection, the quantity and quality of fat tissue improve around the injection site. The surviving fat cells re-establish their blood supply at the new site and begin to divide, grow and differentiate.

Grafted fat contains adipose stem cells (ASCs) that have healing and regenerative effects on surrounding tissues.

After grafting, some stem cells in the grafted adipose tissue transform into different types of cells around the treated site, helping in wound healing, epithelization, and growth hormone secretion, all of which repair the damaged areas.

Adipose stem cells stimulate the secretion of factors needed for the regeneration of damaged areas. For example, they induce dermal fibroblasts and keratinocytes to release anti-oxidant enzymes such as superoxide-dismutase, helping to protect cells against oxidants. This process reverses radiation-induced soft tissue fibrosis and promotes healing.

Adipose stem cells also promote cytokine production, increase collagen production, and reduce collagen disorganization, resulting in improved skin quality.

The grafted fat inhibits apoptosis—a process that brings about death and removal of cells—helping to relieve fibrosis, minimize skin stiffness, relieve pain, and restore lost cell volume caused by radiation-induced skin injury. That is why, soon after fat grafting, the skin feels and looks healthier.

Benefits of fat grafting after radiotherapy

1. Minimizes pain and itchiness of the skin
2. Reduces tightness and stiffness of the skin
3. Heals radiation damage
4. Treats chronic skin ulcers
5. Prevents disability
6. Improves overall skin appearance, removing scars and depressions
7. Make the skin thicker, softer, and healthier
8. Gives improvements that continue over time
9. Improves the treated area permanently
10. Has no risk of rejection or allergic reaction

Exploiting the power of fat grafting

Do you have a scheduled radiotherapy session? Have you undergone radiation therapy and are struggling with radiation-induced skin injury?

At Politis Plastic Surgery, we provide fat grafting services for patients undergoing radiotherapy as a way of preventing or reducing post-radiation effects on the skin and subcutaneous tissue.

Dr. Effie Politis is a skilled and experienced plastic surgeon who uses fat grafting in cosmetic and reconstructive procedures. She understands that the stem cells in adipose tissues and organs can play a critical role in repairing post-radiation skin injuries. She makes sure to share the benefits of fat grafts with her patients.

If you have undergone radiotherapy, Dr. Politis can help you avoid or reduce pain and other symptoms of radiation-induced skin injury through fat grafting. After the grafting procedure, you will enjoy a more normal skin appearance, have seamless recovery following radiotherapy, and improve your quality of life.

For more information on fat grafting after radiotherapy, visit the Politis Plastic Surgery website.