title: Expanded Stem Cells, Stromal-Vascular Fraction, and Platelet-Rich Plasma Enriched Fat: Comparing Results of Different Facial Rejuvenation Approaches in a Clinical Trial.
abstract: BACKGROUND
  In a previous study, the authors demonstrated that treatment with expanded adipose-derived stem cells or stromal vascular fraction (SVF)-enriched fat modify the pattern of the dermis in human beings, representing a skin rejuvenation effect. Considering that expanded stem cells require a cell factor, the authors wanted to assess similar results by replacing them with platelet-rich plasma (PRP), which is easier to obtain and for which an empirical regenerative effect has been already described.
  
  
  OBJECTIVE
  To determine if PRP injection could replace the cutaneous regenerative effect of adipose-derived stem cells.
  
  
  METHODS
  This study was performed in 13 patients who were candidates for facelift. The patients underwent sampling of fat by liposuction from the abdomen and submitted to one of three protocols: injection of SVF-enriched fat or expanded adipose-derived stem cells or fat plus PRP in the preauricular areas. Fragments of skin were removed before and 3 months after treatment and analyzed by optical and electron microscopy.
  
  
  RESULTS
  The use of fat plus PRP led to the presence of more pronounced inflammatory infiltrates and a greater vascular reactivity, increasing in vascular permeability and a certain reactivity of the nervous component. The addition of PRP did not improve the regenerative effect.
  
  
  CONCLUSIONS
  The use of PRP did not have significant advantages in skin rejuvenation over the use of expanded adipose-derived stem cells or SVF-enriched fat. The effect of increased vascular reactivity may be useful in pathological situations in which an intense angiogenesis is desirable, such as tissular ischemia.
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Gino
authors.initials: G
authors.lastname: Rigotti
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Luiz
authors.initials: L
authors.lastname: Charles-de-Sá
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Natale Ferreira
authors.initials: NF
authors.lastname: Gontijo-de-Amorim
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Christina Maeda
authors.initials: CM
authors.lastname: Takiya
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Paola Romina
authors.initials: PR
authors.lastname: Amable
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Radovan
authors.initials: R
authors.lastname: Borojevic
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Donatella
authors.initials: D
authors.lastname: Benati
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bernardi
authors.affiliation: Dr Rigotti is Chief of Plastic and Regenerative Surgery, Regenerative Surgery Unit, San Francesco Clinic, Verona, Italy. Dr Charles-de-Sá is PhD student and Dr Takiya is a Professor, Postgraduate Program in Surgical Science, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Ferreira Gontijo-de-Amorim is a PhD course student at Verona University, Drs Benati and Berdardi are Researchers, and Dr Sbarbati is a Professor and Chief, Department of Neurological and Motor Science, Section of Anatomy and Histology, University of Verona, Italy. Dr Amable is a Researcher and Dr Borojevic is Chief, Excellion Biomedical Services, Petrópolis, Rio de Janeiro, Brazil.
authors.forename: Andrea
authors.initials: A
authors.lastname: Sbarbati
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000368:Aged; D001938:Brazil; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D015187:Lipectomy; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D053657:Platelet-Rich Plasma / Q000166:cytology*; D012060:Rejuvenation; D012867:Skin / Q000648:ultrastructure*; D015595:Skin Aging; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome