The Effect of Autologous Fat Grafting on Scar Quality and Appearance
DOI:
https://doi.org/10.56056/amj.2025.361Keywords:
Adipose-derived Stem Cells, Hypertrophic Scar, Scar Fibrosis, Scar ManagementAbstract
Background and objective: Scars not only impact individuals' well-being but also strain public healthcare systems, Therefore, there is a necessity for simpler and more effective scar treatment methods. Thus, we evaluated the efficacy of autologous fat grafting on scar quality and appearance.
Methods: This prospective study at the Burn and Plastic Surgery Hospital in Sulaymaniyah, Iraq, from July 2021 to November 2023, included 20 patients aged 8-48 years with prominent scars. Fat was harvested from the abdomen primarily, processed by decantation or centrifugation, and injected into scars using a 2 mm cannula. Outcomes were assessed using the Vancouver Scar Scale at multiple postoperative intervals. Data analysis was performed using SPSS software, with P < 0.05 considered statistically significant.
Results: This study evaluates the impact of fat grafting on scar quality using the Vancouver Scar Scale. Significant improvements were observed in pigmentation (P = 0.012) and pliability (P = 0.002), though vascularity (P = 0.17) and height (P = 0.15) did not show significant changes. Additionally, fat grafting markedly reduced pruritus (P = 0.019) but did not significantly impact pain levels (P = 0.18). The study shows an 80% increase in patient satisfaction after fat injection.
Conclusion: The study found that autologous fat grafting is important for scar remodeling. It improves scar appearance, skin characteristics, volume, and contour. It also helps with symptoms like itching and pain. Autologous fat grafting has comprehensive benefits and can be an effective treatment for scars.
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Deflorin C, Hohenauer E, Stoop R, van Daele U, Clijsen R, Taeymans J. Physical Management of Scar Tissue: A Systematic Review and Meta-Analysis. J Altern Complement Med. 2020 Oct;26(10):854-865. doi: 10.1089/acm.2020.0109. Epub 2020 Jun 24.
Waibel JS, Waibel H, Sedaghat E. Scar Therapy of Skin. Facial Plast Surg Clin North Am. 2023 Nov;31(4):453-462. doi: 10.1016/j.fsc.2023.06.005/
Young VL, Hutchison J. Insights into patient and clinician concerns about scar appearance: semiquantitative structured surveys. Plast Reconstr Surg. 2009 Jul;124(1):256-265. doi: 10.1097/PRS.0b013e3181a80747
Ogawa R. The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids: A 2020 Update of the Algorithms Published 10 Years Ago. Plast Reconstr Surg. 2022 Jan 1;149(1):79e-94e. doi: 10.1097/PRS.0000000000008667/
Chowdhury B, Kassir M, Salas-Alanis J, Nistico S, Galadari H, Fritz K, et al. Laser in surgical scar clearance: An update review. J Cosmet Dermatol. 2021 Dec;20(12):3808-3811. doi: 10.1111/jocd.14325. Epub 2021 Jul 14.
Gold MH, Berman B, Clementoni MT, Gauglitz GG, Nahai F, Murcia C. Updated international clinical recommendations on scar management: part 1--evaluating the evidence. Dermatol Surg. 2014 Aug;40(8):817-24. doi: 10.1111/dsu.0000000000000049/
Cooper DR, Wang C, Patel R, Trujillo A, Patel NA, Prather J, et al. Human Adipose-Derived Stem Cell Conditioned Media and Exosomes Containing MALAT1 Promote Human Dermal Fibroblast Migration and Ischemic Wound Healing. Adv Wound Care (New Rochelle). 2018 Sep 1;7(9):299-308. doi: 10.1089/wound.2017.0775. Epub 2018 Sep 4.
Zomer HD, Jeremias TDS, Ratner B, Trentin AG. Mesenchymal stromal cells from dermal and adipose tissues induce macrophage polarization to a pro-repair phenotype and improve skin wound healing. Cytotherapy. 2020 May;22(5):247-260. doi: 10.1016/j.jcyt.2020.02.003. Epub 2020 Mar 29.
Domergue S, Bony C, Maumus M, Toupet K, Frouin E, Rigau V, et al. Comparison between Stromal Vascular Fraction and Adipose Mesenchymal Stem Cells in Remodeling Hypertrophic Scars. PLoS One. 2016 May 26;11(5): e0156161. doi: 10.1371/journal.pone.015616/
Coleman SR, Katzel EB. Fat Grafting for Facial Filling and Regeneration. Clin Plast Surg. 2015 Jul;42(3):289-300, vii. doi: 10.1016/j.cps.2015.04.001.
Liu YL, Liu WH, Sun J, Hou TJ, Liu YM, Liu HR, et al. Mesenchymal stem cell-mediated suppression of hypertrophic scarring is p53 dependent in a rabbit ear model. Stem Cell Res Ther. 2014 Dec 15;5(6):136. doi: 10.1186/scrt526/
Nemir S, Hanson SE, Chu CK. Surgical Decision Making in Autologous Fat Grafting: An Evidence-Based Review of Techniques to Maximize Fat Survival. Aesthet Surg J. 2021 May 18;41(Suppl 1):S3-S15. doi: 10.1093/asj/sjab080/
Bae SH, Bae YC. Analysis of frequency of use of different scar assessment scales based on the scar condition and treatment method. Arch Plast Surg. 2014 Mar;41(2):111-5. doi: 10.5999/aps.2014.41.2.111. Epub 2014 Mar 12.
Stanescu AM, Totan A, Mircescu D, Diaconescu S, Gabriel Bratu O, Fekete L, et al. Assessment of suicidal behavior in dermatology (Review). Exp Ther Med. 2020 Jul;20(1):73-77. doi: 10.3892/etm.2019.8145. Epub 2019 Oct 30.
Mazini L, Rochette L, Admou B, Amal S, Malka G. Hopes and Limits of Adipose-Derived Stem Cells (ADSCs) and Mesenchymal Stem Cells (MSCs) in Wound Healing. Int J Mol Sci. 2020 Feb 14;21(4):1306. doi: 10.3390/ijms21041306/
Gal S, Xue Y, Pu LL. What Do We Know Now About Autologous Fat Grafting? Ann Plast Surg. 2019 Oct;83(4S Suppl 1):S17-S20. doi: 10.1097/SAP.0000000000002097/
Cervelli V, Gentile P, Grimaldi M. Regenerative surgery: use of fat grafting combined with platelet-rich plasma for chronic lower-extremity ulcers. Aesthetic Plast Surg. 2009 May;33(3):340-5. doi: 10.1007/s00266-008-9302-z. Epub 2009 Jan 21.
Fontdevila J, Serra-Renom JM, Raigosa M, Berenguer J, Guisantes E, Prades E, et al. Assessing the long-term viability of facial fat grafts: an objective measure using computed tomography. Aesthet Surg J. 2008 Jul-Aug;28(4):380-6. doi: 10.1016/j.asj.2008.05.002.
Guyuron B, Majzoub RK. Facial augmentation with core fat graft: a preliminary report. Plast Reconstr Surg. 2007 Jul;120(1):295-302. doi: 10.1097/01.prs.0000264399.40701.71/
Cervelli V, Gentile P. Use of cell fat mixed with platelet gel in progressive hemifacial atrophy. Aesthetic Plast Surg. 2009 Jan;33(1):22-7. doi: 10.1007/s00266-008-9223-x. Epub 2008 Aug 14.
Rohrich RJ, Sorokin ES, Brown SA. In search of improved fat transfer viability: a quantitative analysis of the role of centrifugation and harvest site. Plast Reconstr Surg. 2004 Jan;113(1):391-5; discussion 396-7. doi: 10.1097/01.PRS.0000097293.56504.00/
Padoin AV, Braga-Silva J, Martins P, Rezende K, Rezende ARDR, Grechi B, et al. Sources of processed lipoaspirate cells: influence of donor site on cell concentration. Plast Reconstr Surg. 2008 Aug;122(2):614-618. doi: 10.1097/PRS.0b013e31817d5476/
Trepsat F. Lipostructure du tiers moyen du visage [Midface reshaping with micro-fat grafting]. Ann Chir Plast Esthet. 2009 Oct;54(5):435-43. French. doi: 10.1016/j.anplas.2009.03.008. Epub 2009 May 15.
Klinger M, Caviggioli F, Klinger FM, Giannasi S, Bandi V, Banzatti B, et al. Autologous fat graft in scar treatment. J Craniofac Surg. 2013 Sep;24(5):1610-5. doi: 10.1097/SCS.0b013e3182a24548/
Jackson IT, Simman R, Tholen R, DiNick VD. A successful long-term method of fat grafting: recontouring of a large subcutaneous postradiation thigh defect with autologous fat transplantation. Aesthetic Plast Surg. 2001 May-Jun;25(3):165-9. doi: 10.1007/s002660010115/
Spiekman M, van Dongen JA, Willemsen JC, Hoppe DL, van der Lei B, Harmsen MC. The power of fat and its adipose-derived stromal cells: emerging concepts for fibrotic scar treatment. J Tissue Eng Regen Med. 2017 Nov;11(11):3220-3235. doi: 10.1002/term.2213. Epub 2017 Feb 3.
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Copyright (c) 2025 Omer Walid Majeed, Jalal Ali Hasan, Diyar Abdulwahid Salih
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