Pilot Study Investigating the Efficacy of Autologous Fat Grafting As a Treatment for Male and Female Facial Acne Scarring

Goals/Purpose: A variety of methods have been developed to reduce the appearance of acne scars including, but not limited to, dermabrasion, chemical peels, ablative laser technologies, punch techniques and various soft-tissue fillers. Autologous fat transfer is a minimally invasive technique in which an individual’s own fat is harvested and injected into soft tissues to correct contour. This process serves to stimulate the mechanisms of wound healing, promoting fibroblast activation and new collagen production. While there have been studies that have investigated the use of autologous fat grafting for improving scar appearance, the vast majority focus on traumatic, surgical, and burn scars. The literature is lacking objective evaluations of autologous fat grafting and its effects within the face for treatment of acne scars. Thus, the purpose of this study was to assess the efficacy and tolerability of autologous fat grafting when used by men and women with facial acne scars.

Methods/Technique: Nine subjects between 18 and 60 years old underwent a single autologous fat grafting procedure to correct acne scars on the face. Fat harvest sites included the abdomen, flanks and inner thighs. Once removed, fat was centrifuged for 2 minutes and then injected in 1 cc aliquots into designated areas to fill soft tissue deficits present on the face. Following the procedure, subjects returned for follow-up visits at 3-months and 6-months post-treatment. At every visit, standard photography as well as 3D, cross-polarized, and UV photography for evaluation of improvement in skin tone, texture, pore size, actinic sun damage, porphyrins, and/or skin age, were performed. In conjunction with photography, non-invasive skin measurements were obtained using high-resolution ultrasonography, optical coherence tomography (OCT), transepidermal water loss (TEWL) and BTC 2000. Additionally, 0.33 mm skin biopsies were obtained pre- and post-treatment to assess for histological and genetic changes that occur below the skin surface as a result of treatment. Overall assessment of clinical outcome was obtained via subjective and objective analysis at 3-months and 6-months post-treatment. Subject’s assessment of satisfaction was characterized using the Subject Global Aesthetic Improvement Scale (SGAIS) based on a live assessment of his or her face compared to pre-treatment photographs. Data obtained from non-invasive measurements were aggregated and analyzed as an average change compared to baseline. Biopsy results were evaluated using one-sample-t-tests.

Results/Complications: Nine subjects (66.7% female, 33.3% male) have completed the fat grafting procedure up to this point, seven of whom have completed follow-up visits at three- and six-months post-treatment. Clinical evaluation has demonstrated that autologous fat grafting improved the severity of facial acne scars. All subjects experienced anticipated risks such as erythema and edema following the procedure which was transient and resolved within days. Subjects developed no complications after the procedure.

Conclusion: The results from this study illustrate the safety, efficacy, and tolerability of a single autologous fat grafting procedure for aesthetic correction of facial acne scarring. Both non-invasive skin measurements and microbiopsy data demonstrated changes in skin architecture and collagen/elastin gene expression. The treatment was well-tolerated by all subjects, with discomfort managed appropriately with anesthetic injections. There have been no adverse events related to the treatment. Autologous fat grating provides a viable and effective treatment for facial acne scars. It is readily accessible to many patients, inexpensive, biocompatible and inherently nonallergenic.