Numerous techniques have been tried to treat acne scarring. Given its filling properties and the presence of adipose tissue-derived stem cells, autologous fat has been tried for treating acne scars in multiple studies, either alone or combined with other treatment approaches. This review focuses on autologous fat grafting in its different forms, including nanofat and stromal vascular fraction, as an efficient and safe modality for treating acne scars. PubMed, Embase, and Cochrane Library databases were used to search for relevant studies published from January 2017 to December 2022. We used a combination of the following keywords: “acne scar,” “acne scars,” “autologous fat transplantation,” “autologous fat grafting,” “fat grafting for acne scars,” “stromal vascular fraction,” “SVF,” and “nanofat.” Twelve studies were found utilizing autologous fat grafting in different forms, either used alone or combined with other treatment methods such as lasers and platelet-rich plasma for treating atrophic post-acne scars. Most studies showed that autologous fat grafting effectively treated acne scars with satisfying results.
TawfikAARagehMA. Fractional CO2 laser as monotherapy or combined with platelet-rich plasma in the treatment of atrophic post-acne scars: a narrative review. Dermatol Sin. 2024;42(1):3-11. doi:10.4103/ds.DS-D-23-00154
2.
MajidIImranS. Fractional CO2 laser resurfacing as monotherapy in the treatment of atrophic facial acne scars. J Cutan Aesthet Surg. 2014;7(2):87-92. doi:10.4103/0974-2077.138326
3.
GoodmanGJ. Management of post-acne scarring. What are the options for treatment?Am J Clin Dermatol. 2000;1(1):3-17. doi:10.2165/00128071-200001010-00001
4.
AlserOHGoutosL. The evidence behind the use of platelet-rich plasma (PRP) in scar management, a literature review. Scars Burn Heal. 2018;4:2059513118808773. doi:10.1177/2059513118808773
5.
RiveraAE. Acne scarring: a review and current treatment modalities. J Am Acad Dermatol. 2008;59(4):659-676. doi:10.1016/j.jaad.2008.05.029
6.
EllenbogenR. Free autogenous pearl fat grafts in the face—a preliminary report of a rediscovered technique. Ann Plast Surg. 1986;16(3):179-194. doi:10.1097/00000637-198603000-00001
7.
FultonJESuarezMSilvertonKBarnesT. Small volume fat transfer. Dermatol Surg. 1998;24(8):857-865. doi:10.1111/j.1524-4725.1998.tb04263.x
CovarrubiasPCardenas-CamarenaLGuerrerosantosJ, et al. Evaluation of the histologic changes in the fat‑grafted facial skin: clinical trial. Aesthetic Plast Surg. 2013;37(4):778-783. doi:10.1007/s00266-013-0126-0
12.
LiuWShiKZhuX, et al. Adipose tissue-derived stem cells in plastic and reconstructive surgery: a bibliometric study. Aesthet Plast Surg. 2021;45(2):679-689. doi:10.1007/s00266-020-01615-3
13.
HanXJiDLiuYHuS. Efficacy and safety of transplantation of autologous fat, platelet-rich plasma (PRP) and stromal vascular fraction (SVF) in the treatment of acne scar: systematic review and meta-analysis. Aesthetic Plast Surg. 2023;47(4):1623-1632. doi:10.1007/s00266-023-03295-1
GentileP. New strategies in plastic surgery: autologous adipose-derived mesenchymal stem cells contained in fat grafting improves symptomatic scars. Front Biosci (Landmark Ed). 2021;26(8):255-257. doi:10.52586/4940
16.
GentilePSterodimasACalabreseCGarcovichS. Systematic review: advances of fat tissue engineering as bioactive scaffold, bioactive material, and source for adipose-derived mesenchymal stem cells in wound and scar treatment. Stem Cell Res Ther. 2021;12(1):318. doi:10.1186/s13287-021-02397-4
17.
RagehMAEl-KhalawanyMIbrahimSMA. Autologous nanofat injection in treatment of scars: a clinico-histopathological study. J Cosmet Dermatol. 2021;20(10):3198-3204. doi:10.1111/jocd.14363
18.
GuZLiYLiH. Use of Condensed nanofat combined with fat grafts to treat atrophic scars. JAMA Facial Plast Surg. 2018;20(2):128-135. doi:10.1001/jamafacial.2017.1329
19.
PalluaNKimBS. Microfat and lipoconcentrate for the treatment of facial scars. Clin Plast Surg. 2020;47(1):139-145. doi:10.1016/j.cps.2019.08.010
20.
BehrangiEMoradiSGhassemiM, et al. The investigation of the efficacy and safety of stromal vascular fraction in the treatment of nanofat-treated acne scar: a randomized blinded controlled clinical trial. Stem Cell Res Ther. 2022;13(1):298. doi:10.1186/s13287-022-02957-2
21.
Abou EittaRSIsmailAAAbdelmaksoudRAGhezlanNAMehannaRA. Evaluation of autologous adipose-derived stem cells vs. Fractional carbon dioxide laser in the treatment of post acne scars: a split-face study. Int J Dermatol. 2019;58(10):1212-1222. doi:10.1111/ijd.14567
22.
KwonHHYangSHLeeJ, et al. Combination treatment with human adipose tissue stem cell-derived exosomes and fractional CO2 laser for acne scars: a 12-week prospective, double-blind, randomized, split-face study. Acta Derm Venereol. 2020;100(18):adv00310. doi:10.2340/00015555-3666
23.
GronovichYMaisel LotanA. Treatment of scars with autologous fat grafting and 1540 nm non-ablative erbium laser. J Cosmet Laser Ther. 2022;24(6-8):80-83. doi:10.1080/14764172.2022.2055078
24.
NilforoushzadehMAHeidari-KharajiMAlaviS, et al. Transplantation of autologous fat, stromal vascular fraction (SVF) cell, and platelet-rich plasma (PRP) for cell therapy of atrophic acne scars: clinical evaluation and biometric assessment. J Cosmet Dermatol. 2022;21(5):2089-2098. doi:10.1111/jocd.14333
25.
ShettyVHBhandarySNBhandaryRSuvarnaC. A comparative study of efficacy and safety of autologous fat grafting versus platelet-rich plasma in the treatment of post-acne scars. J Cosmet Dermatol. 2021;20(11):3454-3461. doi:10.1111/jocd.14503
26.
TennaSCogliandroABaroneM, et al. Comparative study using autologous fat grafts plus platelet-rich plasma with or without fractional CO2 laser resurfacing in treatment of acne scars: analysis of outcomes and satisfaction with FACE-Q. Aesthetic Plast Surg. 2017;41(3):661-666. doi:10.1007/s00266-017-0777-3
27.
PonsSJammetPGalmicheS, et al. Nanofat and platelet-rich plasma injections used in a case of severe acne scars. J Stomatol Oral Maxillofac Surg. 2022;123(5):572-575. doi:10.1016/j.jormas.2022.04.018
28.
RoohaninasabMSeifadiniAAtefiN, et al. Evaluating the effectiveness of stromal-vascular fraction (SVF) cells along with subcision method in the treatment of acne scars: a double-blind randomized controlled clinical trial study. J Cosmet Dermatol. 2022;21(12):6928-6938. doi:10.1111/jocd.15375
29.
TabitCJSlackGCFanKWanDCBradleyJP. Fat grafting versus adipose-derived stem cell therapy: distinguishing indications, techniques, and outcomes. Aesthetic Plast Surg. 2012;36(3):704-713. doi:10.1007/s00266-011-9835-4
30.
RigottiGMarchiAGalièM, et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg. 2007;119(5):1409-1422. doi:10.1097/01.prs.0000256047.47909.71
31.
KlingerMMarazziMVigoDTorreM. Fat injection for cases of severe burn outcomes: a new perspective of scar remodeling and reduction. Aesthetic Plast Surg. 2008;32(3):465-469. doi:10.1007/s00266-008-9122-1
32.
TonnardPVerpaeleAPeetersGHamdiMCornelissenMDeclercqH. Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013;132(4):1017-1026. doi:10.1097/PRS.0b013e31829fe1b0
33.
BiHLiHZhangC, et al. Stromal vascular fraction promotes migration of fibroblasts and angiogenesis through regulation of extracellular matrix in the skin wound healing process. Stem Cell Res Ther. 2019;10(1):302. doi:10.1186/s13287-019-1415-6
34.
FredmanRKatzAJHultmanCS. Fat grafting for burn, traumatic, and surgical scars. Clin Plast Surg. 2017(4);44:781-791. doi:10.1016/j.cps.2017.05.009
35.
XuXLaiLZhangX, et al. Autologous chyle fat grafting for the treatment of hypertrophic scars and scar-related conditions. Stem Cell Res Ther. 2018;9(1):64. doi:10.1186/s13287-018-0782-8
36.
La PadulaSPonzoMLombardiM, et al. Nanofat in plastic reconstructive, regenerative, and aesthetic surgery: a review of advancements in face-focused applications. J Clin Med. 2023;12(13):4351. doi:10.3390/jcm12134351
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
