Fat graft, laser CO2 and platelet-rich-plasma synergy in scars treatment.

RATIONALE: Many treatments have been proposed for cosmetic or functional improvement of scars. It is known that fat grafts and laser treatment can have beneficial effects on the remodeling of scar tissue, and platelet-rich plasma (PRP) can be effective during the wound-healing process. We hypothesized that laser and PRP can enhance fat graft survival and the combination would be effective in improving scars appearance. OBJECTIVE: The purpose of this study was to evaluate the efficacy of these combinations in the treatment of atrophic and contractile scars. METHODS AND RESULTS: From 2008-2013, we treated with this combination 64 patients affected by atrophic and contractile scars involving different body parts. At 6 months the patients' overall satisfaction rate was excellent for over 50% of the patients. DISCUSSION: The association of an ablative laser CO2 with PRP and autologous fat graft seems to be a promising and effective therapeutic approach for atrophic and contractile scars. ABBREVIATIONS: PRP platelet-rich plasma, OTI orotracheal intubation, HLLT high level laser therapy, LLLT low level laser therapy.

The sinergy between lasers and adipose surgery in face and neck rejuvenation: a new approach from personal experience.

BACKGROUND AND AIMS: Patients now want a long-lasting youthful appearance but with a minimally-invasive approach. Our unique approach, "AdipoLASER reJuvenation (ALJ)", involves a variety of minimally-invasive laser- and lipolysis-based techniques, and the present study assessed the impact of this ALJ approach. SUBJECTS AND METHODS: From 2008 - 2011, we prospectively enrolled 221 patients into the study. 71 of them, underwent the ALJ approach: 2 reductive techniques via microliposuction and laser-assisted lipolysis (LAL); and 2 regenerative techniques via autologous fat graft and fractional CO2 laser resurfacing. The remaining 150 patients underwent only 1 or 2 of these techniques. Patients were monitored through 1 to 18 months, clinical photography was taken and histological assessments were performed. RESULTS: ignificantly better and long-lasting results were obtained for the complete ALJ approach regarding all aspects of the face, mandible and neck compared with controls. The combination of the regenerative and the reductive approaches delivered on excellent balance, restoring a youthful, natural appearance to the face. CONCLUSIONS: The fractional CO2 laser has both a photodestructive, or HLLT, effect and an LLLT component in the beam periphery. This LLLT effect possibly prolonged the life and improved the take of the fat grafts, with the well-documented HLLT effect inducing swift collagenesis and better remodeling of the dermal matrix. A natural look in depressed areas was thus restored with the combination of fat redistribution and the HLLT/LLLT effect. Microlipolysis and laser-assisted lipolysis (LAL) could at the same time remove those areas of redundant and prolapsed fat while countering skin laxity, and address both jowl formation and submental flaccidity. The unique combination of all four approaches in our "AdipoLASER reJuvenation" proved to be superior to any other lesser approach in both the long- and short term with very little patient downtime, but did not present much more in terms of treatment time and cost to the patient. We believe that the ALJ approach offers a real minimally-invasive alternative to the classic surgical facelift.