Evaluation of Aesthetic Outcome of Combined Micro-needling And External Nano Fat Application in Treatment of Old Scars | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 20 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.416185.4125 | ||
| Authors | ||
| Raafat Abd-ellatif Anany1; Mohamed Abdelhamid Mohamed Hasab-elnaby* 2; Ahmed Abo Hashem Azab1 | ||
| 1Professor of plastic and reconstructive surgery, Faculty of Medicine, Zagazig University, Egypt | ||
| 2Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Zagazig University, Egypt | ||
| Abstract | ||
| Background: Microneedling and nanofat application have each demonstrated efficacy in scar remodeling through complementary mechanisms microneedling induces controlled dermal injury to stimulate neocollagenesis, while nanofat delivers adipose-derived stem cells and growth factors to enhance tissue regeneration. This study aimed to evaluate the aesthetic outcome of combining microneedling with external application of nanofat in the management of old scars. Methods: This prospective case series included 24 patients (79.2% males, mean age 24.8 ± 5.44 years) with scars older than six months of various etiologies. All underwent external nanofat application combined with microneedling. Donor fat was harvested (most commonly from the abdomen) and processed into nanofat for topical application during microneedling. Outcomes were assessed preoperatively and at 3–6 months postoperatively using POSAS (observer and patient components). Results: The overall mean POSAS score improved significantly from 57.3±2.79 pre-treatment to 40.9±2.79 post-treatment (P < 0.01), reflecting a 28.6% improvement. Observer scores showed marked reductions in vascularity (−21.08%), pigmentation (−27.42%), thickness (−24.27%), pliability (−25.21%), and total score (−24.09%). Patient-reported scores improved in pain (−34.25%), itching (−26.87%), stiffness (−44.98%), and total score (−31.80%). Minor complications included transient ecchymosis/bruising (54.2%), hypopigmentation (20.8%), hyperpigmentation (16.7%), and superficial wound infection (8.3%), all managed conservatively. No severe adverse events occurred. Conclusion: The combination of external nanofat application with microneedling is a safe, well-tolerated, and effective minimally invasive approach for improving the aesthetic quality of old scars. The significant improvements across both observer and patient POSAS scores support its inclusion as a valuable modality in modern scar management protocols. | ||
| Keywords | ||
| Nanofat; microneedling; POSAS; regenerative medicine | ||
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