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The Use Of Adipose Tissue Based Therapies On Facial Atrophic Post-Acne Vulgaris Scars: A Systematic Review
Jose Antonio Arellano, MD; Mario Alessandri-Bonetti, MD; Giulia Coscarella, MD; Francesco Amendola, MD; Luca Vaienti, MD; Paolo Persichetti, MD, PhD, FEBOPRAS; Peter J Rubin, MD, MBA, FACS; Francesco Egro, MD, MSc, MRCS.
University of Pittsburgh
2024-01-15
Presenter: Jose Antonio Arellano
Affidavit:
Dr. Peter Rubin
Director Name: Dr. Peter Rubin
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background:
Acne vulgaris, a prevalent inflammatory skin condition, often leads to facial scarring, causing significant psychological distress, especially among the youth. Despite numerous scar treatments, no established gold standard exists, prompting investigation into new interventions. Autologous fat grafting and other adipose tissue-based therapies (ATBTs) are emerging as promising interventions due to their scar modulation and tissue regeneration properties. Adipose tissue, comprising mature adipocytes and the stromal vascular fraction (SVF), notably adipose-derived stem cells (ADSCs), holds potential for promoting neovascularization, immunomodulation, and scar remodeling.
Methods:
A systematic review consolidated evidence on ATBTs for treating facial atrophic acne scars using the Prospera database (CRD42022384919). Ten studies, involving 168 patients, were included after querying PubMed, Scopus, and Embase databases. Various ATBTs were employed, including standard fat grafting, nanofat, ADSC-conditioned medium (ADSC-CM), and ADSC exosomes (ADSC-Exo). SVF, administered subdermally under the scar area, was the most commonly utilized ATBT.
Results:
Evaluation of patient and physician satisfaction using subjective outcome measures revealed overall improvement in scar appearance and moderate-to-high satisfaction among patients undergoing ATBT treatment. Biometric assessments, including skin ultrasonography and digital imaging analysis, demonstrated that ATBT effectively reduced scar area, depth, and increased skin thickness. Histological analysis confirmed the regenerative properties of ATBTs, with increased dermal collagen and elastin density observed.
Conclusions:
Results from diverse ATBTs show promising outcomes, including increased elastin and collagen production, enhanced dermal thickness, and improved skin hydration. Larger clinical trials with longer follow-up periods are essential before ATBTs can be considered effective and standard treatment for facial atrophic post-acne scars.
