The Addition of Tissue Stromal Vascular Fraction to Platelet-Rich Plasma Supplemented Lipofilling Does Not Improve Facial Skin Quality: A Prospective Randomized Clinical Trial

Abstract

Background Lipofilling has become popular as a treatment to improve aging related skin characteristics (eg, wrinkles, pigmentation spots, pores, or rosacea). Different additives such as platelet-rich plasma (PRP) or stromal vascular fraction (SVF) have been added to lipofilling to increase the therapeutic effect of adipose derived stromal cells (ASCs). Objectives In this study, we hypothesized that mechanical isolated SVF augments the therapeutic effect of PRP supplemented lipofilling to improve facial skin quality. Methods This prospective, double-blinded, placebo-controlled, randomized trial was conducted between 2016 and 2019. In total, 28 female subjects were enrolled with 25 completing the follow-up. All patients received PRP supplemented lipofilling with either mechanical isolated SVF or saline. SVF was isolated by means of the fractionation of adipose tissue (FAT) procedure (tissue-SVF). Results were evaluated by changes in skin elasticity and transepidermal water loss, changes in skin aging related features, ie, superficial spots, wrinkles, skin texture, pores, vascularity, and pigmentation as well as patient satisfaction (FACE-Q), recovery, and number of complications up to 1 year postoperative. Results The addition of tSVF to PRP supplemented lipofilling did not improve skin elasticity, transepidermal water loss nor skin aging related features. No improvement in patient satisfaction with overall facial appearance nor facial skin quality was seen when tSVF was added to PRP supplemented lipofilling. Conclusions PRP supplemented lipofilling with tSVF compared to PRP supplemented lipofilling alone does not improve facial skin quality nor patient satisfaction in a healthy population. PRP supplemented lipofilling with tSVF can be considered a safe procedure.

Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical Appraisal

“…Of which, 359 were excluded: 38 papers were not in English, 41 were review articles, 279 articles were not reporting recipient site complications, 1 was not on human subjects. A total of 103 [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ,…”

Platelet-Rich Plasma in Plastic Surgery: A Systematic Review

“…Seventeen studies concerning to combination of PRP application and fat grafts were found, and three of those were RCTs [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]. Eight articles fell under the category "reconstruction," focusing on chronic ulcers and wounds (three), scars (three), or breast reconstruction (two).…”

“…Many factors had to be considered, such as differences in number of PRP applications or the use of activators. In seventeen studies [10, 11, 13-15, 21, 24, 27, 31, 34, 35, 38, 40-42, 50, 53], double spin centrifugation was performed, 21 studies used a single spin protocol [16, 17, 19-23, 29, 30, 32, 33, 36, 37, 43-49, 51, 58], and twelve authors merely disclosed the name of the device used, or no information about this process at all [12, 18, 25, 26, 28, 39, 52, 54-57, 59]. Twenty-two authors reported the use of CaCl and/or Thrb for platelet activation [11, 13-15, 18, 19, 21, 24, 28, 30, 31, 37, 39, 42-47, 50, 51, 58].…”

“…Twenty-two authors reported the use of CaCl and/or Thrb for platelet activation [11, 13-15, 18, 19, 21, 24, 28, 30, 31, 37, 39, 42-47, 50, 51, 58]. Nonactivated PRP (na-PRP) was applied in 6 cases [34, 52-55, 57], and two authors reported the use of both na-PRP and a-PRP [22, 23]. One author applied photo-activated PRP [40].…”

“…A few authors compared the effects of PRP in lipofilling to those of stromal vascular fraction (SVF) as an adjuvant to FG. van Dongen et al [57] and Sasaki [53] provided data suggesting PRP is equally effective in facial lipofilling compared to SVF. The outcome of two studies by Gentile et al [46,47] demonstrates significantly higher graft maintenance in breast reconstruction and scar therapy for both PRP-and SVF-enhanced lipofilling; however, PRP showed slightly better results in both studies.…”