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

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.

Nanofat Cell Aggregates: A Nearly Constitutive Stromal Cell Inoculum for Regenerative Site-Specific Therapies

“…16–18 Most importantly, recent studies have reported a successful outcome of nanofat application in surgical procedures for facial rejuvenation and skin graft reconstruction. 19–21 In addition, a condensed form of nanofat has been shown to promote wound healing and improve flap survival in a mouse model. 22,23 The present study aimed to evaluate the cell content of nanofat preparations and compare the cell yield and performance of lipoaspirate processing between mechanical disaggregation and enzymatic dissociation methods.…”

Systematic review: Advances of fat tissue engineering as bioactive scaffold, bioactive material, and source for adipose-derived mesenchymal stem cells in wound and scar treatment

“…The most commonly used procedures were enzymatic SVF isolation [ 18 – 21 , 25 , 28 , 30 , 31 ] and nano-fat [ 22 – 24 , 26 , 27 , 29 , 32 – 34 ], while Wu et al [ 17 ] used spectroscopy for SVF isolation. The fatty tissue was harvested from the abdomen or multiple sites, including flanks, hips, or thighs.…”

“…Centrifuged, 10 min at 800 g 5. Pellet resuspended in 15 ml Hartmann solution 2.37–9.83 × 10 7 viable cells/g of fat SVF Subcutaneous injection 19G needle 26 ± 6.22 YO 6.7 ± 4.3 YO 6 MO Bhooshan et al [ 26 ] Site : N/A Infiltration : N/A Technique : 3-mm mirrored triport Coleman’s cannula Negative pressure: manual Volume: N/A Lipoaspirate mechanically emulsified by 30–35 passes through triport connector N/A Classic nano-fat Intralesional 27G needle 32.2 ± 12 YO 3 to 204 MO (17 years); 79.4%—scars <5 years, 20.6%—scars > 5 years 3 months Gu et al [ 27 ] Site : peri-umbilically Infiltration : 20 ml of lidocaine, 0.5%, and 1 ml of 1:1000 epinephrine per 1000 ml of saline Technique : 3-mm multi-hole aspiration cannula to a 20-ml syringe Negative pressure : manual by a retracted plunger Volume : N/A 1. Saline rinsing and filtering 2.…”

Evidence-based surgical management of post-acne scarring in skin of color

“…The recent technique to process the fat to finer components (nanofat) gives more predictable results. [ 93 ]…”

“…In this method,[ 93 ] fat is harvested either from the lower abdomen or the thigh after tumescent anesthesia. After the preparation of nanofat, it is then injected just beneath the dermis to replace lost tissue volume to get a smooth surface [ Video 4 ].…”