PURPOSE: The promising applications of nanofat in regenerative and aesthetic surgery have recently become “hot topics” in the international literature1-3. The purpose of this study was to investigate in a randomized case-control fashion the efficacy and safety of nanofat in facial rejuvenation.
METHODS: We enrolled 12 consecutive female patients, between 40 and 50 years of age, affected by moderate to severe facial rhytides at our private practice. Each patient face was vertically and symmetrically divided in case and control areas following randomization. Each patient was treated with nanofat on case area and saline on control area. Nanofat was obtained from the liposuction aspirate using the Tulip NanoTM kit device.
Each patient underwent blind assessment of the case and control areas and at baseline, and then 1, 3, and 6 months post treatment through the Wrinkle Severity Rating Scale (WSRS) and the Global Aesthetic Improvement Scale (GAIS). At the same time points patients underwent instrumental assessment by spectrophotometric examination (Antera 3DTM) of a series of cutaneous parameters (vascularization, pigmentation, texture, etc). A patient satisfaction multi-item FACE-Q score was also recorded at the post-treatment visits. Adverse events were recorded at each follow up by physicians and by patient through the FACE-Q.
RESULTS: Each treated area in every patient showed an improvement in blinded WSRS and GAIS, as well as in spectrophotometric parameters, superior to the control area, starting at the 1 month follow up, peaking at 3 months, and persisting at 6 months. The patient case area FACE-Q score increased similarly, with max mean values at 6 months, significantly higher than control areas. Besides transient edema and erythema, no adverse events were reported.
DISCUSSION: The literature, just like the cosmetic market, is full of countless therapeutic options targeting facial rejuvenation and revitalization4,5. Most commercially available solutions lack the potential to provide tissue regeneration and thus true rejuvenation. Our experience indicates a significant and enduring response to treatment with a single session of nanofat in facial rejuvenating in females between 40 and 50 years of age with moderate to severe rhytides. At 6 months the results persisted in all cases, although to varying degrees. Considering that these patients were treated with a single session of nanofat and did not undergo any other rejuvenating treatment these results are significant. Only minor adverse effects were recorded during our observation. This is a pilot study; further controlled experiences will be needed in order to validate our preliminary results.
1. Tonnard P, Verpaele A, Peeters G, et al. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013;132(4):1017–26.
2. Banyard DA, Sarantopoulos CN, Borovikova AA, et al. Phenotypic Analysis of Stromal Vascular Fraction after Mechanical Shear Reveals Stress-Induced Progenitor Populations. Plast Reconstr Surg. 2016;138(2):237e-47e
3. Alexander RW. Biocellular Regenerative Medicine: Use of Adipose-Derived Stem/Stromal Cells and It’s Native Bioactive Matrix. Phys Med Rehabil Clin N Am. 2016;27(4):871–891.
4. Zachary CB. Facial Rejuvenation: 40th Anniversary Review. Semin Cutan Med Surg. 2016;35(6 Suppl):S122-4.
5. Dickey RM, Louis MR, Cox JA, et al. Noninvasive Facial Rejuvenation. Part 2: Physician-Directed-Neuromodulators and Fillers. Semin Plast Surg. 2016;30(3):134–42.