Initial Experience of Face Augmentation Using Fat Graft-Platlet Rich Plasma Mix

Abstract

Plastic surgeons accustomed to use autologous fat grafs for augmentation of soft tissues in the last two decades. The main drawback of fat grafting is unpredictable graft resorption. Several studies have searched for new ways of increasing the viability of the transplanted tissue to overcome this disadvantage. The most recent and promising approach is to mix the fat graft with Platelet-Rich Plasma (PRP) before transplantation. The purpose of this article is to present the initial experience using the autologous fat injection with platlet rich plasma as a method for fascial augmentation.

A Systematic Review of Autologous Platelet-Rich Plasma and Fat Graft Preparation Methods

“…Interestingly, this was not necessarily a consequence of using different commercial PRP extraction systems—for example, 4 studies using a commercial RegenKit device employed different centrifugation parameters. 31 , 54 , 56 , 69 Only 2 studies quantified mean PRP platelet concentrations 32 , 69 before fat grafting; none of the other studies provided either absolute PRP concentrations or change from baseline data.…”

“…Most studies included a PRP activation step (Table 3 )—2 human studies did not use activated PRP 52 , 70 and 2 studies did not report on whether or not activated PRP was used. 57 , 69 …”

“… 32 , 52 , 64 , 68 Centrifugation was typically performed for 3 minutes at 3000 rpm. Only 2 studies did not include a fat centrifugation step—in both cases, the authors used either saline 69 or Ringer’s lactate 70 to clean the tissue before transplantation. Only one study 52 described routine fat storage—in this case using an ice bath for between 2 and 4 hours to cool fat before implantation, although no rationale was provided for this decision.…”

A novel cannula for uniform mixing of liquid substances

“…These factors bind to the surfaces of cell membranes to stimulate hemostasis and normal healing by promoting processes that include the activation of angiogenesis, cell proliferation, cell differentiation, and new matrix formation for tissue repair. PRP stimulates angiogenic processes and the proliferation of adipose-derived stem cells [3].…”

“…Ever since the Coleman technique [2] was introduced in 1997, consistent operative results have been obtained using that method, and autologous fat has been settled upon as a reliable natural filler. Autologous fat tissue has become a clinical reality for facial augmentation, as it is biocompatible, versatile, natural in appearance, non-immunogenic, inexpensive, and readily obtainable with low donor site morbidity [3]. However, the viability of grafted fat has been reported to be highly variable, in the range of 30% to 80% depending on the study, and is the subject of ongoing debate [4,5].…”