Autologous emulsified fat injection for rejuvenation of scars: A prospective observational study

Lekshmi S Bhooshan, M Geetha Devi, R Aniraj, P Binod, M Lekshmi, Lekshmi S Bhooshan, M Geetha Devi, R Aniraj, P Binod, M Lekshmi

Abstract

Background: The skin rejuvenation potential of the autologous emulsified nanofat was studied by Tonnard et al. in 2013. This property is due to the viable adipose-derived stem cells present in the nanofat; although, there are no viable adipocytes. The aim of this study was to determine the aesthetic outcome of autologous emulsified nanofat injection in scars using a standardised and validated Patient Observer Scar Assessment Scale (POSAS) and photographs.

Materials and methods: A total of 34 patients with scars of varied aetiologies were included in the study as per inclusion criteria. Pre-operative scoring of the scars with the POSAS scale was done, and photographs were taken. Fat aspiration was done from the lower abdominal wall using syringe liposuction under tumescent anaesthesia. The lipoaspirate was mechanically emulsified, filtered and injected intralesionally into the scar using 26G needle and insulin syringe. Post-operative scar reassessment was done at 3 months with the POSAS scale score and photographs. The improvement in scar characteristics and symptoms were tested statistically using a paired t-test. Pre-operative and post-operative photographic comparison was also done.

Results: Out of the 34 patients included in the study, male:female ratio was 22:12. Majority (79.4%) had post-traumatic facial scars. On statistical analysis, there was statistically significant improvement in symptoms such as pain (P = 0.001), itching (P = 0.001), stiffness (P = 0.001), thickness (P = 0.001), colour (P = 0.001), irregularity (P = 0.001) and scar characteristics such as vascularity (P = 0.005), relief (P = 0.001), pliability (P = 0.001), thickness (P = 0.001) and pigmentation (P = 0.001) 3 months after injection. The photographic comparison also showed good aesthetic outcome.

Conclusion: Autologous emulsified nanofat injection is effective in improving the scar characteristics as well as symptoms and helps in scar rejuvenation.

Keywords: Adipose-derived stem cells; autologous emulsified fat; nanofat; rejuvenation; scars.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Technique of nanofat injection (a) syringe liposuction (b) separation of fat (c) emulsification (d) filtration with a moist saline gauze (e) emulsified fat (f) yellowish blanching marks the end point of intralesional injection
Figure 2
Figure 2
Bar chart showing the aetiology of scar
Figure 3
Figure 3
Bar chart showing the type of scar
Figure 4
Figure 4
Pre-operative (a) and post-operative (b) photographs after injection of autologous emulsified fat in post-burns facial scar
Figure 5
Figure 5
Pre-operative (a) and post-operative (b) photographs after injection of autologous emulsified fat in post-traumatic scar
Figure 6
Figure 6
Pre-operative (a) and post-operative (b) photographs after injection of autologous emulsified fat in post-traumatic scar
Figure 7
Figure 7
Pre-operative (a) and post-operative (b) photographs after injection of autologous emulsified fat in post-traumatic scar dorsum of nose

References

    1. Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H, et al. Nanofat grafting: Basic research and clinical applications. Plast Reconstr Surg. 2013;132:1017–26.
    1. Draaijers LJ, Tempelman FR, Botman YA, Tuinebreijer WE, Middelkoop E, Kreis RW, et al. The patient and observer scar assessment scale: A reliable and feasible tool for scar evaluation. Plast Reconstr Surg. 2004;113:1960–5.
    1. van de Kar AL, Corion LU, Smeulders MJ, Draaijers LJ, van der Horst CM, van Zuijlen PP, et al. Reliable and feasible evaluation of linear scars by the patient and observer scar assessment scale. Plast Reconstr Surg. 2005;116:514–22.
    1. Coleman SR. Structural fat grafts: The ideal filler? Clin Plast Surg. 2001;28:111–9.
    1. Marwah M, Kulkarni A, Godse K, Abhyankar S, Patil S, Nadkarni N, et al. Fat ful'fill'ment: A review of autologous fat grafting. J Cutan Aesthet Surg. 2013;6:132–8.
    1. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, et al. Multilineage cells from human adipose tissue: Implications for cell-based therapies. Tissue Eng. 2001;7:211–28.
    1. Deans RJ, Moseley AB. Mesenchymal stem cells: Biology and potential clinical uses. Exp Hematol. 2000;28:875–84.
    1. Frese L, Dijkman PE, Hoerstrup SP. Adipose tissue-derived stem cells in regenerative medicine. Transfus Med Hemother. 2016;43:268–74.
    1. Stavrou D, Weissman O, Winkler E, Yankelson L, Millet E, Mushin OP, et al. Silicone-based scar therapy: A review of the literature. Aesthetic Plast Surg. 2010;34:646–51.
    1. Roques C, Téot L. The use of corticosteroids to treat keloids: A review. Int J Low Extrem Wounds. 2008;7:137–45.
    1. Ogawa R. The most current algorithms for the treatment and prevention of hypertrophic scars and keloids. Plast Reconstr Surg. 2010;125:557–68.
    1. Gozali MV, Zhou B. Effective treatments of atrophic acne scars. J Clin Aesthet Dermatol. 2015;8:33–40.
    1. Cooper JS, Lee BT. Treatment of facial scarring: Lasers, filler, and nonoperative techniques. Facial Plast Surg. 2009;25:311–5.
    1. Garg S, Dahiya N, Gupta S. Surgical scar revision: An overview. J Cutan Aesthet Surg. 2014;7:3–13.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться