Purpose : Fat grafts have always represented a challenge in terms of inducing the necessary neoangiogenesis, which results in significant resorption. This study was designed to compare the efficiency of the first and second generations of platelet-rich plasma in combination with the use of a fat graft during facial lipostructure surgery.

Methods and materials : To address the research purpose, the investigators designed and implemented a double-blinded prospective clinical trial. Patients underwent bilateral facial lipostructure, a natural long-lasting method of filling and supporting the face using intricate layers of infiltrated autologous fat. The method involves the use of platelet-rich plasma (PRP) on one side and platelet-rich fibrin (PRF) on the other side. The study population was composed of all patients presenting to our department for the evaluation and management of facial contouring in cheek and cheekbone areas between June 2008 and December 2010. The primary predictor variable was the type of combination (PRP/fat or PRF/fat). The outcome variables were the amount of resorption, which was estimated by comparing pre- and post-surgical photographic views, pain, edema and bruising. The statistical evaluation of the findings was performed with the help of SPSS (Statistical Package for Social Science) software. Parametric tests (T-test and Levene’s test) were used to compare treatment efficacy and complications between the groups.

Results : Twenty-five patients (8 men and 17 women) underwent bilateral facial lipostructure surgery in cheek and cheekbone areas using PRP and PRF. One year after the operation, a light aesthetic asymmetry was noticeable, with higher average resorption on the PRP-fat side.

Conclusion : This first comparative clinical study suggest that the combination of fat with PRF is more effective than the combination of fat and PRP in the context of facial lipostructure surgery. Key words : platelet-rich plasma; platelet-rich fibrin; fat; lipostructure