Joris van Dongen

257 Facial lipografting on skin quality: a systematic review Intervention and injection methods Seven studies used lipografting 19,21-23,98-100 , while one study used cSVF 97 and one study used Nanofat as a treatment to improve facial skin quality. 96 Botti et al. compared different adipose tissue processing techniques i.e, filtering and washing versus centrifugation. 19 Two studies used cSVF enriched lipografting and compared this with cultured ASCs injection of which Rigotti et al. included a third group using platelet rich plasma (PRP) enriched lipografting. 20,22 Willemsen et al. compared PRP enriched lipografting to saline 0.9% enriched lipografting. 25 Covarrubias et al. compared lipografting with no treatment. 21 Liang et al. compared platelet rich fibrin (PRF) enriched Nanofat with hyaluronic acid injection (Table 5). 96 The injected fat volumes differed highly among all studies, ranging from 0.05 ml – 43 ml per region of the face (Table 4). In five of the nine studies the same subject was used for both the intervention group as well as the control group. 19,21-23,98 Song et al. compared different adipose tissue injection techniques i.e. conventional hand push injection versus an electric injection device (YSZTQ-01, Lanzhou Wenhe Medical Instrument R&D Co., Ltd, Lanzhou). 23 Seven out of the nine studies mentioned the injection plane (Table 5). 21,22,96-100 CLINICAL OUTCOME Skin texture Skin texture improvement after lipograftingwas reported in three studies (n=149). 19,24,96 Trivisonno et al. reported 25% improvement in skin texture measured with a non- validated skin surface profilometryanalyzer (Antera 3Dmultispectral analyzer,Miravex Limited, Dublin, Ireland) ninety days postoperative (p<0.01). 24 A dermatologist also reported improvement of skin texture with the use of a non-validated 3-grade scale. 24 The skin texture homogeneity score decreased from 2.43 ± 0.68 to 1.19 ± 0.4 and the skin roughness score decreased from 2.33 ± 0.73 to 1.19 ± 0.4 (P<0.05). Trivisonno et al. did not use a control group. 24 Liang et al. reported improvement in skin texture after PRF enriched Nanofat measured with a non-validated VISIA skin imaging analyzer (VISIA Canfield Imaging Systems, Fairfield, NJ, USA) one, twelve and twenty-four months postoperative. 96 Botti et al. reported that 68% and 72% of the included subjects scored ‘high’ on improvement in skin texture for filtered and washed adipose tissue and centrifuged adipose tissue, respectively. 19 The level of improvement in skin texture was measured with a non-validated self-evaluated questionnaire. No statistical analysis was mentioned in this study (Table 6).