Lipofilling and PRP for aesthetic facial rejuvenation: Understanding and augmenting the lipograft

New insights in facial aging made it apparent that not only sagging/ptosis but also facial volume loss is a major factor of this process. Classic facial rejuvenating procedures that only lift or reposition tissue in a vertical vector did not correct for facial volume loss. Since the (re-)introduction of lipofilling it appeared that this procedure is a well-tolerated natural alternative to correct for volume loss due to facial aging. The success and extent of the effect of lipofilling, however, is plagued by a vast number of variables, like the technique of harvesting, the fat processing and injection of the lipograft; factors that all influence the lipograft viability and the ASC. Platelet Rich Plasma (PRP) has been suggested to increase the lipograft viability and retention Moreover, PRP could also increase wound healing resulting in a faster recovery.
With our studies we have attempted to investigate and clarify the role of lipofilling and lipofilling with the additional use of PRP in facial rejuvenation with regard to the aesthetic outcome, possible regenerative skin effects and recovery time. Also, we have tried to unravel the effects of PRP on the ASC itself.
This thesis concludes that lipofilling is a valuable additive to lifting procedures in order to maximize rejuvenating effect. PRP proves a powerful additive when looking at patient recovery, but its effect on rejuvenation remains uncertain. Mixed clinical results of PRP addition to lipofilling could be explained by its concentration depended effect on ASC fenotype, proliferation and secrotome as demonstrated in vitro. Future lipofilling/ASC/SVF based therapies have the potential of regenerating damaged tissue.