American Association of Plastic Surgeons

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Randomized Controlled Study Using Autologous Fat Grafts, Hybrid Filler And Fractional Co2Laser Resurfacing In Treatment Of Elastosis: Analysis Of Outcomes And Patient Satisfaction
Rosa Salzillo, MD, Mauro Barone, MD PhD, Riccardo De Bernardis, MD, Paolo Persichetti, MD PhD;
Campus Bio-Medico University of Rome, Rome, Italy

PURPOSE: Actinic elastosis is a non-curable skin condition manifesting with wrinkling, reduction of elasticity, pigmentation, and roughness of the skin. The aim of this study is to compare fat grafting, fractioned CO2 laser resurfacing and hybrid fillers in order to detect which one is more effective in improving actinic elastosis.METHODS: Patients meeting the following criteria were included in the study: dermatological diagnosis of elastosis, primary surgical or non-surgical treatment for elastosis, < 2 years follow-up, pre and postoperative photo-documentation, proficiency in Italian language, signed consent for study participation. The study was performed with a double-blinded randomized design: both the patients and two of the authors measuring outcomes were blinded to the treatment methods. Patients were randomly divided in three groups: group 1, fat grafting; group 2, hybrid filler; and group 3, CO2 laser resurfacing. All patients were asked to answer the FACE-Q satisfaction with the face post-operative module. Two plastic surgeons reviewed pre- and postoperative photographs, rating the outcome on a 1-5 VAS scale.
RESULTS: Seventy-five patients were enrolled, 4 males and 71 females, aged between 50 and 80 years. Both the FACE-Q and VAS scores were higher in groups 1 and 2. No relevant complications were reported in any of the groups.
CONCLUSION: Elastosis remains a genetically based skin condition, which cannot be considered curable. Hybrid fillers and adipose tissue transfer can be both considered valid options to improve skin elastosis both in terms of patient satisfaction and enhancement of skin quality.
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