Fat transfer has become an increasingly important method of facial rejuvenation both as a standalone procedure and in combination with traditional rejuvenation methods, like face-lifting, brow lifting, and Blepharoplasty. A variety of fat transfer names commonly used are fat transfer, fat injection, and autologous fat grafts. The word autologous means material (fat) is harvested from one area and donated to another in the same individual.
Fat transfer is particularly suited for restructuring the proportion of the face. Typical facial structures can also be aided by adding constructive elements to correct a broad range of perceived facial deficiencies. For example, a stronger jawline creates a youthful, more powerful-looking face; eliminating the hollowness of lower lids helps reduce that tired, sad appearance; and fuller lips create a more youthful, attractive appearance.
Other indications include congenital, traumatic defects, or surgical defects and scars. Nanofat is applicable in a wide range of indications to improve the skin quality; trophic skin changes caused by age and sun damage, pigmentary skin conditions, and scarring non-facial areas such as the neck, the décolleté area, and the hands can also greatly benefit from the use of nanofat grafting, sometimes in combination with microfat.
What is Fat Injection?
Fat transfer is known by various names: fat transfer, fat injection, and fat injection. The word autologous means material (fat) is harvested from one area and donated to another in the same individual. Although Fat transfer has been used in medicine for more than 100 years, the concept of injecting human fat back into the patient as an effective means to fill in wrinkles and loss of tissue throughout the body and face has been available only since the mid-1980s.
Fat transfer has become an increasingly important method of facial rejuvenation both as a standalone procedure and in combination with traditional rejuvenation methods, like face-lifting, brow lifting, and Blepharoplasty.
Is Fat Injection Skin Rejuvenation Superior to Filler? What is the Difference?
Why are we reluctant to enforce the same grounds and common-sense treatment of the aging face? The old face results from several concurrent factors: skin laxity, soft tissue ptosis, and volume loss. We assume that with age, fat redistributes on the torso. Slim hips become rounded, breasts droop, knees deposit fat medially, and the lower abdomen protrudes. The young face is complete, with an even, ample distribution of superficial and deep fat. It appears homogenized and balanced without distinction of the cosmetic units.
In contrast, the old face shows compartmentalization, with a “hill and valley” topography. There is a vivid demarcation of the aesthetic units, which leaves the face unbalanced. As viewed on a cellular level, aging occurs because of decreased adipocyte cell size, function, and differentiation. Besides, redistribution of facial fat and atrophy of muscles and bone leads to structural changes in the face as one ages.
It is likewise accompanied by loss of underlying connective tissue and reduced collagen, causing skin sagging. Improving the skin’s condition is done with resurfacing procedures, laser and light therapy, daily skincare, and ultraviolet (UV) protection.
Correction of soft tissue ptosis is usually surgically treated with a forehead lift, mid-face lift, and a lower face Rhytidectomy or non-surgically by energy-based technologies such as radiofrequency or ultrasound. To re-capture a youthful face, I must repair volume loss at our disposal —prostheses made of silicone, bone, cartilage, or recently fillers or fat shots.
We cannot deny that Sub-dermal fat gives our ugly underlying muscle-skeletal structures soft contours. That imparts an aesthetically pleasing aspect to our eyes, interpreted as health and animation by our mines. Getting rid of your fat and then injecting it into your wrinkles sounds like the best creations!!! Fat transfer is particularly suited for restructuring the proportion of the face.
Typical facial structures can also be helped by adding constructive elements to correct a full scope of perceived facial deficiencies. For example, a sharper jawline creates a youthful, more powerful-looking face; eliminating the hollowness of lower lids helps reduce that tired, sad appearance; and fuller lips create a more youthful, attractive appearance. Besides, fat transfer is used for augmenting body contours, such as the breasts or buttocks.
Other areas where fat injection techniques are considered superior to synthetic fillers in terms of the total volume required to perform more significant aesthetic corrections include the buttocks and breasts. Prof. Moawad and many others insist on the unique dynamic quality of fat as it will age as we age. This exceptional fat quality is perfect for soft tissue augmentation since facial structure changes as we age, and a permanent filler will be out of proportion if used.
Furthermore, fashion and trends change, and what is accepted now as beautiful may not be accepted later. Best of all, fat injection is forgivable, while the mistake of permanent filler is permanent! Prof Moawad says. The only relative drawback of fat injection has been the resorption of some of the fat transfer. However, with proper technique, 30–70% of the fat is kept, Prof Moawad says. The Disputes about longevity and the technique variation have postponed the announcement of fat as the perfect filler, added Prof. Moawad.
Nevertheless, its use stays limited compared to commercial fillers. Surgically trained and oriented cosmetic practitioners are far more likely to use fat and complement other surgical procedures such as face–neck lifts and Blepharoplasty. In sheer numbers, less surgically aggressive dermatologists and now a wide array of non-surgically trained “cosmetic practitioners” – not to mention non-physician “extenders” such as physician assistants and nurse practitioners, and even simple registered nurses – inject the bulk of commercial filler.
While synthetic fillers can smooth out wrinkles and folds, they cannot restore fullness that is naturally lost as fat and bone diminish, and it is not for everyone. Some individuals are allergic to synthetic materials and may develop an allergic reaction. Furthermore, it cannot use synthetic materials in copious quantities to restore body deformities, augment breasts or buttocks, or even hands due to high cost, making fat injection a much more desirable and economical treatment choice.
Are Results of Fat Injection Skin Rejuvenation Permanent?
There are many factors recognized to exert substantial influence on the success of Fat transfer. Some of these include the patient’s systemic health, a genetic predisposition for cellular fat storage from the preferred donor sites (so-called “primary” fat deposit locations), pre-and post-grafting patient nutrition, basal metabolic rate, use of minimally traumatic harvest and handling techniques, proper preparation of the recipient bed, and relative early graft immobilization in the recipient sites.
A widespread practice is that the amount of fat extracted is enough for at least three injections, three months apart. Based on the experience of treating thousands of patients, Prof Moawad believes that fat injections should be repeated at least three times, three months apart. Survival of the fat is around three to five years in most patients, often longer (up to 20 years) due to incorporating fat transfer into surrounding tissue and establishing its blood supply.
Different areas of the body differ concerning fat transfer survival, e.g., areas injected with bones, such as the back of hands, last longer and needless repetition. The face and lips need more repetition for a longer-lasting effect with solid facial movement. According to scientific literature and the experience of
Prof. Moawad in treating thousands of patients at MSI, the highest chance of fat cell survival is achieved utilizing a-traumatic harvesting, low injection pressures, and multi-layer thin infiltration. Recent improvements in fat injection include plasma-rich platelets (PRP), adipose tissue-derived stem cells (ADCs), or digest fat, showing excellent promise in prolonging fat transport.
Fat can be stored in disposable syringes for up to one year or more without contamination or deterioration in its ability to survive. Frozen fat is a way to gradually improve the patient and avoid extended first downtime. It also allows us to “touch up” areas where the fat may have dissipated or been under-corrected.
What are the Risks of Fat Injection Skin Rejuvenation?
Proper adherence to the described technique minimizes complications because the facial fat injection is well tolerated. The most common category of complications is minor, aesthetic irregularities. Such difficulties can take the form of palpable lumps because of too superficial placement or placement of aliquots that are too large, resulting in fat necrosis. Fat injection in thin-skinned areas should be performed cautiously to avoid such complications.
These irregularities can be managed by suction lipectomies using the same cannulas for infusion, direct open excision, or Lipo-dissolve. All patients are undergoing fat injection experience bruising and swelling postoperatively. Pigmentation of the lower eyelids after fat injection gives the appearance of dark tea shining through the tear trough and can be referred to as tea staining.
This problem resolves quickly but may persist for up to several months, or even a year, in some patients as the skin thickens. Although this should be considered an expected outcome rather than a complication, patients should be prepared for bruising that can last up to 3 weeks after fat placement. Infection after fat injection is exceedingly rare. Despite the rarity of infections, strict adherence to sterile techniques should be practiced while harvesting, processing, and placing grafts to avoid contamination and later fat resorption.
Oral site infusion and lip augmentation should last because these sites are contaminated with oral flora despite Betadine preparation. Patients with a history of cold sores should be receiving prophylaxis with acyclovir. The most feared complication of fat injection is fat embolism from the intravascular infusion. This complication is infrequent and has never been reported using blunt-tip Coleman cannulas for placement. Using an epinephrine-containing solution at the graft site also reduces the possibility of fat.
Who is the Best Candidate for Fat Injection Skin Rejuvenation?
Patient selection plays a vital role in the success or failure of any procedure. It never pays to operate on patients with unrealistic expectations, as they are never satisfied with the outcome. It is vital to have a detailed history, including their past, personal, and psychiatric history. In people with severe depression, facial outlook acts only as a part of the problem and will only help but not treat the cause of depression. It is noticed during the consultation that some patients are not sure what the most proper procedure is for them.
In nonmedical terms, I should explain the process and its potential complications and alternatives to those and others. An ideal candidate will be an individual in good health, with no current or preexisting medical condition, who is not on any immunosuppressive or anticoagulation therapy and has realistic expectations. The fat injection could be considered ideal for those areas where you need a lot of filler, such as in those patients who have full-face lipoatrophy.
Individuals who are allergic to bovine collagen (animal origin) or other synthetic materials, but want youth-enhancing results, are good candidates for Fat transfer. People with “contour deformities” may receive help from Fat transfer. By contour deformity, we mean a large surface area of skin sunken or otherwise uneven due to a traumatic injury or surgery, for example, after liposuction. Another indication could be the atrophy typically seen in the aging dorsum of the hands, Prof Moawad says, offering a more lasting treatment solution for this cosmetic thorn.
Most often, Fat transfer has been used for aesthetic purposes. However, it has also been used for non-aesthetic purposes such as migraine headaches, chordoma surgery, congenital short palate, vocal cord paralysis, lumbar laminectomy, sulcus vocalis, vocal cord scar, hemifacial atrophy, myringoplasty, eye socket reconstruction, frontal sinus fracture, temporomandibular joint reconstruction, and other disorders. Patients with a history of underlying current infection, smoking, anticoagulants, coagulation disorders, herpes simplex, and significant acne scarring are not ideal candidates for fat transfer.
Patients with gross rhytids and poor skin tone will need added procedures for optimum results. One must be careful in dealing with patients with poor or delayed wounds. People with bleeding disorders, or those who have diabetes, are not suitable candidates for the procedure. Additionally, skinny people with inadequate donor fat sites should not undergo this procedure.
Fat Injection Skin Rejuvenation Consultation with Prof Moawad
During your consultation with Prof. Moawad, a complete medical history is taken to evaluate the patient’s general health. A careful examination is conducted; examine those areas to be worked on. You are supplied with full details of the procedure, including the type of anesthesia (local anesthesia for donor/recipient sites usually is enough).
Additionally, Prof. Moawad will cover any risks and complications associated with the procedure and discuss the results you can expect. Depending on each case, Prof Moawad may recommend having Botulinum toxin injections to enhance results: when combined, both procedures give impressive results.
Botulinum toxin is valid for the upper part of the face (dynamic wrinkles). At the same time, the fat transfer is suitable for augmenting the nasolabial, lips, chin, cheeks, and areas around the eyes. Another advantage of botulinum toxin is that muscles are relaxed with less movement. Thus, fat injection is maintained in areas longer.
How do I Prepare before Fat Injection for Skin Rejuvenation?
- A careful examination is conducted, and areas to be worked on are meticulously marked.
- I may take preoperative and postoperative photographs to serve as a guide and determine the amount of improvement.
- Preoperative instructions may include eliminating certain drugs such as aspirin, non-steroidal anti-inflammatory, and Vitamin E supplements to minimize the possibility of bleeding. Antibiotics are prescribed one day before the procedure to prevent infection.
- Topical (Red Out cream) and oral Vitamin K is prescribed before the procedure to lower the likelihood of bruising.
HOW DO WE DO FAT GRAFTING OR FAT TRANSFER, OR FAT INJECTION?
Fat transfer is performed at MSI on an outpatient basis and usually under local anesthesia. Medication to alleviate any pain will be given one hour before the procedure if needed. The entire procedure takes one hour. Fat transfer is a two-step process involving extracting fat cells from a body site having enough subcutaneous adipose tissue, serving as an appropriate source for the donor site (the area where fat is removed).
Fat is extracted from the abdomen, buttocks, thighs, or knees and re-injected beneath the skin in areas where cosmetic correction is needed. First, the donor site is injected with tumescent anesthesia, making the fat extraction process painless. Then a tiny incision is made, and fat is withdrawn using a micro-cannula (an instrument used in liposuction procedure).
Unlike liposuction, fat is not withdrawn with an aspirator machine but with a syringe under significantly lower pressure. The syringe method of harvesting fat is the gentlest method for removing suitable fat for reinjection.
After adequate anesthesia of the donor site, the cannula (attached to the syringe) is inserted into the fat. The syringe’s plunger is pulled to create a negative pressure within the fat. The cannula is moved in a back and forth motion several times in the same area.
This maneuver is repeated radially until the entire donor site is lipo-sculptured or enough fat is obtained. Before fat can be re-injected, it must be processed to get viable fat cells. Fat is centrifuged (rapidly spins liquid down), separating pure fat tissue. Blood, lidocaine, or other material is completely removed; avoiding exposure of delicate fatty tissue to chemicals or mechanical damage is essential.
Fat injection. My Way
Fat is then injected with a small syringe after the area is anesthetized or numbed with Emla cream, with or without local infiltration of lidocaine. It is inserted in a manner described as “weaving” or “layering” in lesser amounts to achieve the desired cosmetic effect, especially when treating large areas. Prof Moawad believes fat should be injected into tiny pearls or strands of fat in targeted depths of the skin or muscle. These tiny pearls have enough blood supply, allowing the transferred fat cells to survive in their new recipient site.
What Can I Expect After Fat Injection Skin Rejuvenation?
Ice packs are immediately postoperative and applied to the recipient site to decrease swelling or ecchymoses. Bandages or a garment are needed for a few days for both donor and recipient sites to prevent swelling. When correcting the hands, patients are recommended to keep their hands elevated and avoid sleeping or pressing on the back of the hands.
There is minimal pain with the procedure. Any discomfort is controlled with Tylenol or other pain relief medication. Patients are instructed to continue taking antibiotics for three to five days to prevent infection and apply topical Vitamin K (Red Our Cream) to lessen bruising. Patients are up and about the same day and can resume regular activity after one day.
New Trends in Fat Transfer (Fat Injections)
The future of Fat autologous transfer may lie in stem-cell research, specifically adipose stromal cells. Stem Cells are capable of differentiation to mature fat cells. Mature tissues, such as adipose, hold some stromal cells. Stem cells are smaller, more resilient cells that may be more viable than mature fat cells.
Developing technology to expand clones of adipose stromal cells would supply a filler material for patients who do not have adequate fat for transfer. Other future research endeavors include the development of pre-adipocyte transplants, hormonal manipulation of Fat transfers, and the use of growth factors added to harvested tissue to increase the survival of transplanted adipocytes.
Fat transfer and Platelet Rich Plasma (PRP) or Stem Cell Fat Transfer
In our experience, one of the most important influences of grafting adult lipocytes plus the stimulation of the vibrant mesenchymal stem cells found within adipose tissues is the addition of platelet-derived factors added to the harvested graft materials before graft placement. The PRP is added to the autologous graft materials in an approximate ratio of 10% in small volume cases and 0.5–1% of the total graft prepared for large volume transplantation. PRP treatment increases graft weight and volume and improves graft quality in small and large volume applications.
PRP enhances the survival and quality of Fat transfers. Although several mechanisms may be responsible for this result, the most important mediator of the survival of Fat transfers is the induction of angiogenesis. PRP has mitogenic and chemotactic growth factors important in angiogenesis, including VEGF and EGF. These factors promoted angiogenesis during the growth of fat. A second potential mechanism by which PRP enhances Fat transfer survival is a more significant proliferation of adipose stromal cells (ASCs) or stimulation of ASCs to differentiate into adipocytes.
Stem cell-enriched fat injection or Cell Assisted Lipo-transfer (CAL)
The concept of regenerative medicine, using the body’s stem cells and growth factors to repair tissue, is an alternative therapeutic strategy for damaged tissue repair. Adipose adult stem cells (ASCs) have been used as a cell source for adipose tissue engineering because I could readily differentiate them into adipocytes with specific induction factors. It has been suggested that the pre-adipocytes and adipose stromal cells are the cells that are the components of surviving grafts.
These cells are more resistant to trauma and have lower metabolic requirements than mature adipocytes. Adipose tissue-derived stem cells (ADSCs) can be obtained from adipose aspirates after conventional liposuction. Cell aided fat transfer ASC-poor fat is converted to ASC-rich fat by supplementing with cells freshly isolated from the adipose tissue during the preparation of the injectable material.
The procedure of ASC-enriched fat injection had excellent feasibility and safety. Results show that ASC graft enrichment could render lipofilling a reliable alternative to primary tissue augmentation, such as breast surgery, with allogeneic material or significant flap surgery. Furthermore, ADSCs and their secretory factors promise application in cosmetic dermatology, especially in skin aging.
Collagen Dissociate Digested Fat Transfer
The fat is transformed into a cell suspension that can be injected using small gauge syringes. The harvested fat was centrifuged at 1,500 9 g for 3 minutes. I drained cellular debris at the bottom, and the oil layer was removed using a sterile pad. I mixed the remaining fat layer with collagenase type II. Collagenase dissociates the connecting fibrils between the fat cells in fat lobules to create a fluid suspension with smaller clusters of digested fat cells.
These techniques improve the transplanted fat’s longevity due to increased surface area contact with the nutrient bed. The digested fat can pass through small-bore (25- to 27-gauge) needles, which are less traumatic and allow for a more precise delivery into the superficial layer of the skin, such as the dermis, which has become the preferred location for several nonfat filler substances to treat superficial wrinkles and scars.
Autologous Collagen Micro-injections
Autologous collagen is a safe, natural, and non-allergenic material. Several techniques are applied to extract autologous collagen from fat; adding sterile, distilled water to extracted fat, breaking it down by mechanical manipulation to render it in a non-viscous form and centrifuging (spin) it at one thousand revolutions per minute to separate the oily infra-nate composed of triglycerides that allows fat extracted to be injected through a small gauge needle intradermally.
The collected material is injected through a 25-gauge needle into the papillary dermis to correct fine lines, wrinkles, and superficial scars.
Non-Aesthetic Application of Fat Injection
A contour concavity is not only a tissue deficiency; there is a fibrous network tethering down its uneven surface. Directly pumping fat will not correct the defect. The tethering fibers need to be released by jackhammer grafting and needle meshing for the procedure to succeed. Overzealous release destroys the fibro-vascular recipient framework and creates cavities where the graft will die.
To better release tethering scars, we often place these fibers under tension by injecting tumescent fluid. I must then follow the previously discussed principles and techniques of fat injection. Estimate the recipient capacity and realize that some defects may require more than one grafting session. Fat is not an expander. Even with meshing, tissues can hardly accommodate a greater than 50 percent volume increase. Repeated sessions result in exponential gains.
Breast reconstruction is more challenging than primary augmentation because its smaller recipient site has less compliance and vascularity. Furthermore, radiation therapy and scars create a hostile environment for graft survival. Still, the same principles and techniques apply Autologous Fat transfer is widely used in reconstructive breast surgery.
Plastic surgeons and patients seeking breast reconstruction may have drastically different images in their minds of what constitutes an attractive, natural, and ideal breast shape. Lipofilling (fat injections) is a simple solution to restore the correct profile of the breast after reconstruction.
In fact, in the immediate or late postoperative period, secondary contour defects of the reconstructed breast can develop. Indeed, there are essential landmarks in the female breast; for example, creating a well-defined inframammary fold is fundamental in obtaining an excellent aesthetic result after breast reconstruction.
Lipofilling can be used after reconstruction with implants or muscle flaps with or without tissue expansion. Proper tissue expansion allows autologous flaps or the insertion of traditional prosthetic implants for breast reconstruction. This could be carried out with a computer program to help the surgeon select the proper tissue expander while planning breast reconstruction.
Breast reconstruction with external vacuum expansion plus autologous fat transfer is in vivo tissue engineering. The expansion generates a vascularized recipient scaffold that we seed with fat. To reconstruct a mastectomy that is non-irradiated and un-scarred from earlier reconstruction failures usually requires three consecutive outpatient grafting sessions three months apart.
Fibrosis and Scar Treatment
Fat is the soft-tissue alternative to fibrous scar. What was once a dense fibrous scar becoming the loose supporting fibrous scaffold for Fat transfers? Judicious lipofilling turns the fibrous scar into a recipient matrix. The cicatrix-to-matrix concept explains how autologous fat transfer can turn tight and stiff into free and soft. Scars Patients with retractile and painful injuries compromising the joint’s average daily activity/mobility can use lipofilling treatment.
I can use fat transfer to fill atrophic scars and reduce scar contracture as a regenerative alternative to other surgical techniques. This is made possible by the presence of ASCs in the fat tissue. From a histological point of view, Fat autologous transfers show the ability to regenerate the dermis and subcutaneous tissue and improve the dermal and dermo-hypodermic quality in scar areas, with an increasing amount of fat layer – destroyed in cases of thermal insults and poorly regenerated during tissue repair after any trauma – new collagen deposition, and local neo-angiogenesis.
The regenerative role of fat in scarred areas is attributable to the release of multiple nerve entrapments to improve neuropathic pain. In addition, the improvement in neurogenic pain may be kept by placing Fat transfers around the nerve to avoid the recurrence of scar contracture. Autologous Fat transfers allow the skin to become softer, more flexible, and extensible, and very often, the color seems like that of the surrounding unaffected skin.
Another essential quality of scars release, both superficial and deep, is the improvement in the mobility of the body part involving the affected joints, eyelids, nasal valve, and mouth, as well as the possibility for the patient to have a partial restoration of facial expression. In patients with marked skin depression, scar release by autologous fat injection often fills these volume deficits, leading to excellent cosmetic results and positively affecting the patient’s body image.
Scar Contractures and lipo-filling (PALF)
Percutaneous aponeurotomy and lipofilling (PALF) have appeared as a regenerative alternative to flap surgery to treat scar contractures. Percutaneously meshing the restrictive scar and expanding the resultant microcavities with fat injection expands the cicatrix into a fat-filled matrix. Nicks must be staggered in multiple planes in multiple directions wherever restrictive fibers prevent expansion for proper three-dimensional release.
This percutaneous meshing expands the restrictive block of scar tissue to create a more massive three-dimensional recipient scaffold for autologous fat transfer. The loosened grafted scar becomes softer and closer to the healthy surrounding fat tissue. Repeating the process a few months later leads to substantial tissue volume gain and can cut the injury to replace it with a healthy fat. The Rigottomy is useful when grafting fat into scarred tissue to correct a volume deficiency. It transforms a restrictive cicatrix into a regenerative matrix.
Dupuytren and Other Hand Contractures
Needles preferentially cut tensed fibers while leaving intact the looser structures. Forceful digital extension tenses the Dupuytren cords before healthy neuro-vascular structures become tight. The key to the procedure is a robust digital extension retractor that places the restrictive fibers under tension. The selective cutting of a needle for structures under stress divides the Dupuytren fibers that prevent extension while preserving the neurovascular bundles.
The procedure is safe and particularly suited for multidigit contractures. Lipofilling the meshed cord treats the subcutaneous atrophy and helps prevent the recurrence of fibrosis. Multiple percutaneous aponeurotomies mesh-expand the fibrous cord and turn it into a recipient for fat. Furthermore, abdominal fat is inhibitory to Dupuytren fibroblasts.
Subcutaneous perioral micro fat injection in patients with systemic sclerosis is beneficial in treating facial handicap, skin sclerosis, mouth opening limitation, sicca syndrome, and facial pain. Effects on the scleroderma of the hand are also impressive.
Regenerative medicine using stem cells is an efficient, low-morbidity, and high-quality therapy for skin coverage in burns due to the regeneration of skin appendages and the minimal risk of hypertrophic scarring. Sub-scar and intra-scar fat injections are modern techniques that improve scar quality. Lipofilling allows a dramatic change in this status, making the tissue much more like healthy tissues from a histological point of view.
It may need serial fat transplant sessions to improve scarred recipient sites. To enhance the therapeutic response after stem cell treatment in burns patients, intense tissue engineering with the development of 3D scaffolds or matrices is of vital importance and improved preconditioning cell treatments and optimized culture conditions.
Radiation kills cancer cells and the adipose-derived stem cells responsible for tissue upkeep and engraftment ability. Fat is rich in adipose-derived stem cells. Although initially poor to engraft because of the hostile environment, the little graft in the first round makes it easier for more to engraft in the second round. The advantage is exponential, with more grafting, making the tissue more abundant in healthy cells and more like non-irradiated tissue.
Autologous fat transfer is best after radiation treatment, while the tissues are still inflamed, and before fibrosis sets in, it tends to soothe the inflammation and reduce fibrosis. Radiation dermatitis is produced by prolonged exposure of the skin to ionizing radiation. It can be seen in patients receiving radiation therapy, with or without adjuvant chemotherapy. Inflammation of the skin after radiotherapy (radiodermatitis) can be classified into three specific types.