Page 9 - Read Online

Page 4 of 10 Braswell et al. Plast Aesthet Res 2024;11:46 https://dx.doi.org/10.20517/2347-9264.2023.136

Table 1. Injection volume (fat and PRP) based on recipient site and/or specific pathology
Recipient site/pathology (n = 50) Amount (mL) of fat and PRP grafted mean (range)
Nose (n = 1) 2.4 (2.4)
Hidradenitis suppurativa (n = 1) 23.0 (23.0)
HIV facial atrophy (n = 2) 32.0 (25.0-39.0)
Keloid (n = 4) 22.5 (7.0-60.0)
Buttocks (n = 4) 266.7 (250.0-300.0)
Breasts (n = 6) 81 (25.0-230.0)
Face cosmetic (n = 13) 20.3 (6.0-33.0)
Burn/hypertrophic scars (n = 19) 28.9 (5.0-60.0)
PRP: Platelet-rich plasma; HIV: human immunodeficiency virus.

Figure 1. Before any intervention (left) and 8 months post-op (right) after fat grafting with PRP, Kenalog, and 5-FU to a hypertrophic
burn scar on the back. PRP: Platelet-rich plasma; 5-FU: 5-fluorouracil.

The fat was processed intraoperatively by normal washing, rolled out on Telfa, emulsified, put into 10 mL
syringes, and mixed with the patient’s PRP. For his first treatment, 80 mL of fat and PRP was injected (9 mL
fat/1 mL of PRP), as well as 1 mL of 5-FU (45 mg/0.9 mL)/triamcinolone (1 mg/0.1 mL) and 2mL of (10 mg/
mL) Kenalog. For his second operation, 50 mL of fat and PRP was injected at the same ratio as the first
treatment and 3 mL of 5-FU (45 mg/0.9 mL)/triamcinolone (1 mg/0.1 mL). For his third treatment, 18 mL
total of fat and PRP was injected (2.5 mL fat/0.5 mL PRP), along with 2 mL 5-FU (45 mg/0.9 mL)/
triamcinolone (1 mg/0.1 mL) and an additional 1 mL (40 mg/mL) of Kenalog. Figure 1 highlights the
impressive results for this patient. On the left, the image shows the scarring on the patient’s first visit. On
the right, the image displays the area following three surgical injection treatments and 4 fractional CO laser
2
treatments. The procedures significantly improved the overall appearance and texture of the scar area. The
area of the lesion has flattened and shows obvious cosmetic improvement. The patient was satisfied with his
results and even reported an increased range of motion of his right shoulder due to decreased skin tightness
and thickness.

Additionally, the benefits of fat grafting with PRP for cosmetic purposes alone can be seen in Figure 2. This
patient had previously undergone a facelift in 2014 and presented to the clinic with complaints of
infraorbital volume loss and the appearance of dark circles. She previously had filler injections elsewhere,
one of which was Aquamid. She then underwent a facelift in September 2021 with fat grafting and PRP
injections (26.3 mL) to the face. The sites grafted included the infraorbital rims and zygomas, temples, lips,
right side of nasal bones, over the left upper lateral cartilage, the marionette lines, and the nasolabial folds.