All the patients gave an informed consent, their full medical history and were photographed before and after the treatment. autologous fat graft seems to be a promising and effective therapeutic approach for atrophic and contractile scars. Abbreviations: PRP platelet-rich plasma, OTI orotracheal intubation, HLLT high level laser therapy, LLLT CYP17-IN-1 low level laser therapy Keywords:scar, fat graft, platelet-rich plasma, preadipocyte == Introduction == All wounds leave scars, unless they CYP17-IN-1 are very small or superficial; over 100 million people acquire postsurgical scars each year in the developed world alone [1]. Skin scars have a unique impact on patients lives; so many treatments have been proposed for CYP17-IN-1 cosmetic and functional improvement of scars. Regenerative medicine is an emerging and rapidly evolving field of research and therapies, thanks to the new discovery on stem cells. The discovery of preadipocytes, their mesenchymal origin, and their role as pluripotent stem cells have been used to maintain graft tissue [2,3]. So, fat grafting, a well-established technique in surgery, became an important tool in regenerative medicine due to the preadipocytes capability to differentiate and its role in collagen synthesis and angiogenesis [4]. Nevertheless, the major problem remains the ability to maintain fat graft survival and to produce more preadipocytes. PRP is plasma with a higher concentration of platelets, >300 350 x 10 platelets/L, Rabbit Polyclonal to RNF149 an increase of up to CYP17-IN-1 3-5 times than normally found [5]. The -granules of the platelets release growth factors in response to platelet activation, and stimulate cell proliferation and cell differentiation for tissue regeneration. These growth factors have an important role in the regulation and proliferation of mesenchymal cells, including fibroblasts and have been shown to reduce healing time and improve the likelihood of complete wound healing so PRP can promote the proliferation of human adipose-derived stem cells [6]. Fractional resurfacing is a new concept in the laser field, which causes minimal disruption of the epidermis and generates macrocolumns of coagulated tissue that extend deep into the dermis. The fractional laser CO treatment causes tissue tightening and collagen remodeling both initially and for a 3 to 6 months period after treatment [7]. Based on the results we obtained by combining fat graft with lasers and PRP in cervico-facial rejuvenation [8], it came up with the idea to use this association in scar treatment. == Methods and Results == Between 2008 and 2013, 64 patients were enrolled in the study, 21 CYP17-IN-1 with contractile scars and 43 with atrophic scars. There were 57 females and 7 males, age range from 18 to 46 years old. All the patients gave an informed consent, their full medical history and were photographed before and after the treatment. Their skin type ranged between III and IV on Fitzpatrick scale. The procedure for the fat harvesting and lipofilling was as it follows: marking the donor and treatment sites harvesting fat from the flanks or the abdomen with a 10, 20 or 60 cc syringe attached to a 14 or 16 G needle or 12-hole Khouri 12 G cannula allow the fat to stand for a moment, discard the lower fraction (water and blood) followed by gentle centrifugation (200 rpm, 5 minutes) perform fat transplantation to the marked areas with a 1 cc syringe and a Fischer cannula 1.21.4, placing small droplets of fat in the cells following Colemans Lipostructure technique [9]. For resurfacing, we used a fractional carbon dioxide (CO) (=10,600) (MedArt 610 FRx, ASAH MEDICIO A/S, Valseholmen 11-13, Denmark) at the following guidelines: power 9-12 W, time 4 ms, medium density. The laser parameters were matched with individual Fitzpatrick type. For an triggered platelet rich plasma we used a standard PRP kit GLOFIN (Salo, Finnland) from 8.5cc individual blood up to 2cc PRP it was obtained after 2 centrifugations, and activated with calcium chloride. They were injected in.