The usual lipofilling and lipostructure techniques used to scar reduction and remodeling, are burdened with some complications that occur, depending on the series, with different frequency: – Fat indurations – Contour irregularities – Umpredictable reabsorption of the transplanted fat – Important postoperative swelling . These complications do not affect favorable the particular structure of hypertrophic or keloid scarring and thus the cosmetic and functional results are often not so significant. When planning a lipofilling, not targeted for purely cosmetic, it should be considered the full patient’s compliance who offers the availability to harvest the fat from body areas (healthy and intact) recommended by the surgeon, based on anatomical operational, logistic, etc assessments to obtain the best therapeutic outcome; the synchronicity of the two interventions (harvesting and grafting) is still a psychological factor to consider in the patient’s aesthetic expectations. In selected cases with localized retracting scars in noble areas (neck, face, hands, feet, etc) and close to the main joints we use, a microfragmented and purified adipose tissue graft; the fat is treated with a specific device (Lipogems®) able to perform, through a shaker movement, 2 volumetric reductions of adipose clusters and the elimination of blood and oil residues; This combined action is essential to mitigate the inflammatory response post-grafting and to obtain a fluid fat, free of fibrotic tissue frustules, easily injectable and rich in mesenchymal multipotent cells. The use of Lipogems® technology thus allows us to realize a real dynamic structural fat transplantation, injectable with 25 and 27G needles, able to achieve the following outcomes:
- > graft survival rate
- less traumatic technique
- better scar penetration of the micronized fat graft
- easier introduction through scar bridles.
Usually surgery is performed under general anesthesia but we made small functional and aesthetic corrections under local anesthesia. The evaluation of the result was carried out by applying methods both objective and subjective: – Vancouver Scar Scale (pigmentation, vascularization, pliability, thickness) – Patient Self-evaluation Scale (itching, pain, elasticity, softness). The analysis of the operated cases showed that the Lipogems® technique in particular presents: – Convincing results on the pliability and thickness factors – Significant improvements of pain and itching. In summary this technology, offers us the opportunity, without using enzymes, additives or centrifugation to separate the fat, to transfer a regenerative micro-environment within a tissue (scar and scarring) in which the reparative process have been frozen in an abnormal direction.