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have been utilized effectively to treat various wrinkles, injection, doctors should pay attention to the following
[15]
[14]
depressed scars, acne irregularities, wounds and points:
atrophy. [16,17] • No lidocaine or epinephrine is mixed to the cell
suspension before injection to avoid the negative impact
In 2007, Weiss et al. in America reported a double- on the viability of the cells.
[18]
blind, randomized comparison on autologous fibroblast • No massage or other manipulation of the areas
injection and placebo for facial contour defects is performed to avoid damaging or altering the cells.
treatment. Results showed that autologous fibroblasts • No soaps, cosmetics, or any other products
generated statistically significantly greater improvements are used to the injection sites for 72 h after operation.
in dermal deformities and acne scars than did placebo. Limited short-term indirect application of ice to the
The difference between fibroblast injections and placebo treatment area was allowed but not recommended. [19]
obtained statistical significance at 6 months (P < 0.0001).
Patients treated with autologous fibroblasts continuously Injections can be given in the forehead wrinkles, perioral
show benifit at 9-month and 12-month follow-up. There wrinkles, nasolabial fold, chin, and periorbital wrinkles
were no serious treatment-related adverse events in this with a minimal interval of 15 days between each session.
study. The injection technique has no obvious difference among
these different injected sites.
In 2012, Smith et al. reported a multicenter, double-
[19]
blind, placebo-controlled trial of autologous fibroblast COMPLICATIONS AND SAFETY
therapy to treat nasolabial fold wrinkles. A large sample
including 372 subjects was enrolled in this trial. There There is no record in the scientific literature of any case
were comparisons between subjects treated with cultured of tumor formation resulting from the stem cell injection
autologous fibroblast and placebo. The results showed at since the first transplants of adult stem cells from bone
least 1-point improvement on both subject and evaluator marrow in the 1960s and the transplant of adult stem
[21]
assessment after 6 months (P < 0.001). cells from umbilical cord blood in 1988. [22]

In 2012, in a South American study, Eça et al. Autologous fibroblast therapy has been considered to
[20]
published the results of their search about the safety be safe and well tolerated in amounts of researches. The
and efficacy of dermal regeneration with the injection wrinkle improvement during this treatment is different
of young autologous fibroblasts obtained from patients from most dermal fillers. The product results in the
themselves. With 4 injections given at 15-day intervals accumulation of new collagen but not direct volume
after 60 days, periorbital tonicity had improved obviously. replacement. Consequently, it has a more gradual onset
Nevertheless, there was little improvement in surface of effect than which has been seen immediate correction
lines and no improvement at all in deeper wrinkles. from other dermal fillers. [19]

In 2013, Munavalli et al. in America reported a Autologous fibroblast therapy has adverse events
[12]
randomized multicenter, prospective, double-blind, including: local redness, bruising, swelling, bleeding,
placebo-controlled clinical trial about the treatment of pain or irritation, erythema, developing nodules, nausea,
bilateral moderate to severe acne scars using autologous headache and so on. The most common adverse events
fibroblasts. Ninety-nine subjects underwent three reported were redness, swelling, and bruising in and
intradermal injection sessions at 14-day intervals. They around the treatment areas. The severity of majority of
were injected autologous fibroblast suspension on one adverse events is mild to moderate and probably related
cheek and cell culture medium on the other cheek. to the process of injection.
The outcome showed that autologous fibroblast had
significantly greater efficacy than vehicle control (cell CONCLUSION
culture medium).
Autologous fibroblast treatment is a novel therapeutic
INJECTION TECHNIQUE method for treating dermal defects. The material has
the ability to produce human collagen in vivo. In sum,
Different anesthesia forms are provided at the discretion autologous fibroblasts injection has the following
of the investigator. A topical anesthetic cream containing characteristics: (1) it’s not a volume filler; (2) injection
4% lidocaine may be applied. The areas of treatment are level is more superficial; (3) need a period of time (about
swabbed with an antiseptic before injections. 6 months) to take effect; (4) treatment effect on fine lines
like nasolabial wrinkles is better; (5) need additional costs
Autologous fibroblast suspension or placebo is injected and processes for harvesting and culturing fibroblasts
using a 1-mL syringe and a 29- or 30-G needle. A retrograde before injection; and (6) adverse reactions are minimal
linear threading technique is utilized. The suspension and comparable with other common injection. Although
is placed into the superficial papillary dermis. Create a the favorable outcomes have been obtained from various
wheal and transient blanching of the skin surface with each studies, the specific cellular and molecular biologic
injection. The current injection dose is 0.1 mL of suspension mechanism remains unknown. They may take effect
with a concentration of (1.0-2.0) × 10 cells/mL. During the through single or several signal pathways that could
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84 Plast Aesthet Res || Vol 3 || Mar 23, 2016