Joris van Dongen

224 Chapter 10 ABSTRACT Background Lipofilling has become popular as a treatment to improve aging related skin characteristics e.g. 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 receivedPRPsupplemented lipofillingwith eithermechanical isolated SVF or saline. SVFwas 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 i.e. superficial spots, wrinkles, skin texture, pores, vascularity and pigmentation aswell 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 lipofillingwith tSVF can be considered a safe procedure.