Joris van Dongen

157 The power of fat and ASCs for scar treatment: a review compared to saline injection: lipofilling significantly increased skin pliability and all but one parameter of the patient and observer scar assessment scale improved. Thus, lipofilling apparently improves appearance of existing scars. Pain reduction Efficacy of lipofilling as a means for pain reduction was investigated in six case reports or studies 7,9,41-45 (Table 1b). No complications were recorded in six of seven studies with a total of 204 patients; one study did not mention any complications. All studies reported a significant reduction of pain after treatment of painful scars: only in two of these studies there was no difference found in one 7 and in two 41 patients out of the entire population. Three studies included control groups, where lipofilling was compared to no treatment 9,42,43 . Two of these studies, performed at the same institute, focused on lipofilling as treatment for neuropathic pain after total mastectomy 9 or breast conserving surgery 42 . In both studies, it was shown that lipofilling can reduce pain as measured on a visual analogue scale by approximately 3 points in the lipofilling group, compared to about 1 point in the control group. The third study compared results with a representative patient cohort: women who have undergone breast reconstruction and irradiation after mastectomy 43 . In the lipofilling group there was a significant improvement of all parameters of the LENT-SOMA classification (pain, telangiectasias, breast edema, atrophy and fibrosis) after treatment. For unknown reasons, the authors did not compare and analyze the treatment group with a control group, still but they concluded that lipofilling leads to pain relief as well as amelioration of scar appearance.