Millions of people with scars suffer from pain, discomfort, and the inability to perform regular activities. Some may have to revert to addicting pain medicine to get rid of their ailments.
However, a new technique which injects the patient’s own fat cells is an effective treatment for hard, contracted scars resulting from burns or other causes, according to a study in The Journal of Craniofacial Surgery.
Dr Marco Klinger and co-authors, of Università degli Studi di Milano, report good results with fat grafting in hundreds of patients with difficult-to-treat scars, which cause pain and limited motion: ‘For scar treatment, where medical and surgical therapies seem to be ineffective especially in the long term, autologous fat graft has proven to be a new chance to repair tissue damage.’
Dr Klinger and colleagues used autologous fat grafting to treat persistent scarring problems in almost 700 patients over 6 years. All patients had abnormal, painful scars that caused hardening or tightening of the skin, often with limitation of motion. The scars—resulting from burns, surgery, or other causes—had not improved with other treatments.
The fat grafting procedure began with liposuction to collect a small amount of the patient’s own fat tissue. After processing, surgeons reinjected the fat cells under the skin in the area of scarring. Fat was distributed in different directions, with the goal of creating a ‘web’ of support for scarred, damaged skin.
Fat grafting led to significant improvement ‘both from an aesthetic and functional point of view.’ The skin in the scarred area became ‘softer and more flexible and extensible, and very often color seem[ed] similar to the surrounding unharmed skin.’
After fat grafting, the patients had decreased pain and increased scar elasticity. Improvement began within 2 weeks, continued through 3 months, and persisted through 1 year and beyond. In a sub-group of patients, objective testing of skin hardness and clinical ratings by doctors and patients provided further evidence of treatment benefits.
Treatment was associated with improved motion in areas where movement was limited because of tightness and stiffness of contracted scars. For example, in patients with scarring after burns to the face, fat grafting led to improved facial motion.
In recent years, there has been renewed interest in techniques using the patient’s own fat for reconstructive and cosmetic plastic surgery. The new experience suggests that fat grafting may provide an effective new ‘regenerative medicine’ technique for patients with difficult-to-treat scars.