Lipofilling Clinical Trial
Official title:
The Use of Activated Platelet Rich Plasma (PRP) in Human Autologous Fat Transfer
In this prospective, randomized clinical trial, lipofilling of the midface with Platelet Rich Plasma (PRP) is compared with lipofilling of the midface without PRP. The main objective of this study is to investigate the effect of the addition of PRP to the autologous fat transfer on local skin quality improvement, graft survival, and recovery after the procedure.
Soft tissue augmentation by the means of lipofilling is nowadays a frequently used technique
in all forms of plastic surgery. In aesthetic facial surgery it has shown to increase the
rejuvenating effect, in reconstructive surgery it has earned its place in the correction of
soft tissue defects and athropy.
Post-operative loss of volume of the transplanted fat remains an uncertain factor in the
procedure. In current literature, there are three main hypotheses on etiology of
postoperative decrease in the graft volume; 1: the viability of the injected fat cells 2:
impaired graft revascularization at the target site 3: the degree of fibrosis in the target
area. Mentioned factors have limited the application of (large) volume lipotransfer.
Positive effects of lipofilling on skin quality have been reported. Coleman observed
softening of wrinkles, decreasing pore size and pigmentation improvements on graft sites.
Possible mechanisms of the claimed regenerative properties of the lipograft are explained by
the high number of adipose derived stem cells. Although frequently described in literature,
no objective results have been published to this date.
In this prospective study the investigators examine new methods in preventing postoperative
volume loss by the addition of Platelet Rich Plasma (PRP), derived from the patients own
blood, to the injected fat graft. The added PRP contains a wide range of growth factors for
instance: Epidermal growth factor (EGF), Platelet derived growth factor (PDGF-AA),
Transforming growth factor (TGF-B1, TGF-B2), Fibroblast growth factor (FGF) and Vascular
endothelial growth factor (VEGF).
All previously mentioned factors have shown to play a key role in tissue regeneration after
tissue damage. Especially VEGF is of great interest with the ability to promote
neo-angiogenesis in the graft, and thus, in theory, reducing fat necrosis and seroma
formation.
Current, scientifically validated, use of PRP include treatment of chronic and soft tissue
ulcerations, applications in the periodontal and oral surgery, maxillofacial surgery,
orthopaedic and trauma surgery, cosmetic and plastic surgery, spinal surgery, heart bypass
surgery, and burns. In all mentioned applications, PRP showed to have a positive influence on
the tissue recovery and regeneration. Local PRP application in damaged animal and human skin
showed to have regenerative properties. Structural changes to the dermal layer were observed
in biopsies.
In this prospective, randomized clinical trial, lipofilling of the midface with PRP is
compared with lipofilling of the midface without PRP. The main objective of this study is to
investigate the effect of the addition of PRP to the autologous fat transfer on local skin
quality improvement, graft survival, and recovery after the procedure.
The synergy achieved by lipofilling with PRP may hold many future applications in both
reconstructive and aesthetic plastic surgery. Current limitation of lipofilling, especially
large volume lipo transfer (allowing reconstruction in one procedure in stead of multiple
with smaller volumes) and lipofilling in pour vascularised tissue (eg. fibrosis after
radiation therapy) may be countered by the addition of PRP. Furthermore, the suggested local
skin improvements could be used in scar revisions and burn treatment in the future, bypassing
invasive surgery.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT03965936 -
Effect of Adipose Derived Stem Cells on Survival of Fat as Filler
|
N/A |