Autologous Nanofat for Treatment of Atrophic Scars

This prospective, randomized, split-scar, within-participant controlled clinical study was conducted to evaluate the efficacy and safety of autologous nanofat injection in the treatment of atrophic postburn and posttraumatic scars.

Twenty participants with atrophic scars were included. Each participant had two comparable scar areas suitable for split-scar comparison. The two scar sites were randomly allocated to either the experimental intervention or the control intervention, allowing each participant to serve as his or her own control.

The experimental site received a single session of autologous nanofat injection followed by topical silicone gel application for 3 months. Autologous nanofat was prepared from the participant's own adipose tissue using the standardized study technique and injected into the assigned atrophic scar site. The control site received topical silicone gel alone for the same 3-month period.

Participants were evaluated at baseline, 1 month, and 3 months after treatment. Assessment included clinical history and physical examination, standardized digital photography, and evaluation using the Patient and Observer Scar Assessment Scale (POSAS). Patient satisfaction was assessed using a Likert satisfaction scale at follow-up visits.

Treatment-related adverse events and local reactions were recorded throughout the follow-up period, including pain, erythema, edema, bruising, infection, pigmentation changes, nodules, contour abnormalities, and other unexpected or clinically relevant events.

The primary objective was to determine whether the addition of a single session of autologous nanofat injection to topical silicone gel resulted in greater improvement in atrophic scar characteristics compared with topical silicone gel alone. The primary efficacy assessment was based on the change in POSAS score from baseline to 3 months.

Because of the split-scar design, comparisons between the nanofat-treated and control sites were performed within the same participant, thereby reducing the effect of interindividual variability in scar characteristics and healing response.

Inclusion criteria

• Adults aged 18 years or older.
• Presence of clinically diagnosed atrophic postburn or posttraumatic scars.
• Scars were stable and mature at the time of enrollment.
• Presence of two comparable scar areas suitable for the split-scar study design.
• Scar sites were suitable for standardized clinical and photographic assessment.
• Participants were willing to undergo a single session of autologous nanofat injection.
• Participants were able to comply with the study visits and 3-month follow-up.
• Written informed consent was obtained before participation.

Exclusion criteria

• Hypertrophic scars or keloids.
• Active infection, inflammation, ulceration, or dermatitis at the selected scar sites.
• Previous procedural treatment of the selected scar sites that could affect study assessment.
• Significant uncontrolled systemic disease that could interfere with wound healing or treatment.
• Bleeding disorders or other contraindications to the fat-harvesting or injection procedure.
• Pregnancy or breastfeeding.
• Known allergy or intolerance to the topical silicone gel used in the study.
• Inability to provide informed consent or comply with study follow-up.
• Any medical condition considered by the investigator to pose an unacceptable risk or interfere with study evaluation.

Exclusion criteria

-