ABSTRACT
In this chapter, we consider the use of fat transfer for the treatment of cancer therapyrelated side effects and for a vulvar skin dystrophy with low neoplastic potentiallichen sclerosus (LS). Significant scarring may result in cases where radiotherapy, with or without concomitant chemotherapy, has been used to treat anogenital neoplasia. This can lead to morbidity from inflexible areas, causing pain when sitting or moving, and can also lead to impaired sexual function. LS, an autoimmune skin dystrophy which more often affects the genital skin than extragenital areas, may also cause significant scarring and poor skin compliance, leading to easy or even spontaneous skin splitting and sexual dysfunction. The true incidence of LS is unknown but is estimated to be at least 1/1000 and like most autoimmune conditions, affects more women than men. LS is estimated to have a 2% to 5% lifetime risk of developing cancer. Fat transfer is a widely accepted technique in plastic surgery since its first description in 1893 by Gustav Neuber, who transferred fat from the orbit to treat depressed scars resulting from osteomyelitis. It has since been shown to act as more than simply a “filler.” Animal and clinical studies have shown that fat transfer improves the quality of the skin, with changes in skin texture and mechanical properties, associated with stimulation of collagen synthesis. It is associated with low complication rates.
