The authors of this study show the results of two different protocols of fat grafting using adipose-derived stem cells. This is a prospective study with six consecutive patients in whom bilateral fat grafting was performed using centrifuged stromal cells on one side and expanded adipose-derived mesenchymal stem cells on the other. Histologic changes three months after graft injection were evaluated under light and electron microscopy. Results showed a decrease in elastosis and an increase of the oxytalan elastic network in the papillary dermis, a richer microvascular bed and a larger amount of adipose tissue at the junction of the reticular dermis and the subcutaneous tissue and an improvement in skin hydration. No significant differences were found between the two different protocols. Regarding this equal outcome, the authors recommend the first one (centrifuged stromal cells) due to its lower costs and simplicity. This is a very interesting study on the use of adipose-derived stem cells; its design is impeccable, with pre and postoperative biopsies of the grafted tissue and optical and electron microscopy studies performed in every case. However, some important weaknesses may reduce its relevance. The number of patients is too limited to draw any conclusions; the length of time from grafting procedure to postoperative biopsy (three months) is inadequate to evaluate the behaviour of the fat graft and the changes in the recipient tissue. There are no objective parameters and no aesthetic analysis. Anyway, it is worth reading and may be a good model for future research on fat grafting.

Antiaging treatment of the facial skin by fat graft and adipose-derived stem cells.
Charles-de-Sá L, Gontijo-de-Amorim NF, Maeda Takiya C, et al.
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Eduardo Morera Serna

Hospital Universitario Son Espases, Palma de Mallorca, Spain.

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