Joris van Dongen

266 Chapter 11 oncological breast augmentation as well as anti-scarring treatment for (posttraumatic) scars and burn wounds. 114-117 In a systematic review on lipografting in cosmetic breast augmentation, Groen et al. showed high retention volumes after lipografting after long term follow up (average volume retention 62.4% [range 44.7%-82.6%], mean time follow-up 16.6 months) with high satisfaction rates among patients (92%) and surgeons (89%). 115 Two systematic reviews on lipografting and ASCs in burn wounds showed that autologous lipografting significantly restores volume, improves scar appearance and scar related pain and itchiness. 116,117 Apparently It seems to be that the severity of the skin trauma/damage plays a key role whether lipografting or ASCs could be effective in skin reparative/wound reparative effects. In case of low amounts of damage e.g. aging of the extracellular matrix in physiological processes such as ageing of the skin, lipografting or ASCs are not or hardly able to remodel the extracellular matrix. However, in case of severe skin damage, as in pathological processes i.e. burn wounds or scarring, lipografting or ASCs seem to be highly effective in remodelling the damaged skin. 116,117 CONCLUSION This systematic review demonstrates a lack of scientific evidence that autologous facial lipografting or any other substance of adipose tissue i.e. cSVF and ASCs improves normal aged facial skin quality but also demonstrates that the procedure can be considered to be safe. ACKNOWLEDGEMENT We thank W. Bramer, biomedical information specialist of Erasmus MC, for his assistance with the literature search.