Nanofat in Plastic Reconstructive, Regenerative, and Aesthetic Surgery: A Review of Advancements in Face-Focused Applications

Abstract

Nanofat is a relatively novel technique in fat grafting that has gained significant interest in the fields of regenerative medicine, aesthetic and translational research. It involves the extraction of autologous fat from a patient, which is then transformed into “nanofat”, consisting of small fat particles with a diameter of less than 0.1 mm and containing high concentrations of stem cells and growth factors. This article focuses on the use of nanofat in facial rejuvenation and its potential for lipomodelling. Fat tissue is a “stem cell depot” and nanofat contains many stem cells that can differentiate into various cell types. The Lipogem technology, developed in 2013, enables the isolation of nanofat with an intact perivascular structure, utilizing the high concentration of mesenchymal stromal cells near the pericytes of the adipose vascular system. Nowadays nanofat is used primarily for cosmetic purposes particularly in rejuvenating and improving the appearance of the skin, especially the face. Indeed, it has wide applicability; it can be used to treat fine lines, wrinkles, acne scars, sun-damaged skin, scar repair, and as an alopecia treatment. However, further studies are needed to assess the long-term efficacy and safety of this technique. In conclusion, nanofat is a safe and minimally invasive option for tissue regeneration with considerable therapeutic potential. This study reviews the application and effects of nanofat in regenerative medicine and facial cosmetic surgery.

PHAT Lips and PHAT Face: Platelet Hybridized Adipose Therapy for Superficial Musculoaponeurotic System and Dermal Rejuvenation

“…Recent research has demonstrated that the mechanical shear stress imposed on the fat during the preparation of nanofat generates an upregulation of signaling pathways to enhance stem cells' regenerative capacity. 18,32 These complex pathways result in enhanced tissue remodeling with collagen deposition and skin elasticity, dermal thickening, angiogenesis, and a decrease in melanin synthesis. 18 Studies suggest that the multiple cell types in the stromal vascular fraction may work in combination synergistically as the culprit to trigger the rejuvenative capacity of the stem cell and the tissue itself.…”

“…18,32 These complex pathways result in enhanced tissue remodeling with collagen deposition and skin elasticity, dermal thickening, angiogenesis, and a decrease in melanin synthesis. 18 Studies suggest that the multiple cell types in the stromal vascular fraction may work in combination synergistically as the culprit to trigger the rejuvenative capacity of the stem cell and the tissue itself. 18,32 Many tissue engineering strategies seek to combine burst kinetics with prolonged release for pharmacologically consistent delivery of drugs and growth factors including VEGF, PDGF, and FGF for engineering-inducible scaffolds for cell transfer and neovascularization.…”

“…18 Studies suggest that the multiple cell types in the stromal vascular fraction may work in combination synergistically as the culprit to trigger the rejuvenative capacity of the stem cell and the tissue itself. 18,32 Many tissue engineering strategies seek to combine burst kinetics with prolonged release for pharmacologically consistent delivery of drugs and growth factors including VEGF, PDGF, and FGF for engineering-inducible scaffolds for cell transfer and neovascularization. [33][34][35][36] Not surprisingly, the regenerative properties of nanofat grafting sparks its interest in both cosmetic and reconstructive surgery.…”

“…Autologous platelet and fat concentrates are promising therapeutic agents in regenerative medicine since they are a great source of cytokines, growth factors, and other biologically active substances. [9][10][11][12][13][14][15][16][17][18] Novel approaches toward facial rejuvenation include platelet-rich plasma (PRP) 9,10 and Platelet Hybridized Adipose Transplant (PHAT) 11 which we describe here. Fat grafting has been extensively applied as natural filler and has been very promising in restoring volume loss.…”

“…It has previously shown efficacy for burn scars, fibrosis, pain, and radiation damage. [15][16][17][18] PRP and its effects on facial rejuvenation have been described. PRP is a product made by concentrating human blood, to separate the plasma and platelet-rich portions of the blood.…”