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A Double Blinded Trial to Evaluate Pure PDGF+ Versus Nanofat in Conjunction with CO2 Laser and Microneedling for the Treatment of Aging Skin
Grace C. Tolan
1, Patricia Fuentes
1,
4, Brannon Claytor
1, Samuel Lynch
2, Kay Durairaj
3
1Claytor Noone Plastic Surgery, Bryn Mawr, PA, United States. 2Lynch Regenerative Medicine, Franklin, TN, United States. 3Beauty By Dr. Kay, Pasadena, CA, United States. 4Florida International University, Herbert Wertheim College of Medicine, Miami, FL
Background: Facial aging treatment with microneedling or CO2 laser resurfacing are often associated with pain, and have been considered too injurious to be combined, prompting exploration into adjunct therapies to reduce pain. Nanofat has been shown to promote tissue regeneration and healing through paracrine signaling to modulate inflammation. While effective, harvesting nanofat can cause discomfort and extend procedure time. Scientists have sought alternative therapies with similar rejuvenating and pain modulating effects. Platelet-Derived Growth Factor (PDGF) has been shown to stimulate proliferation and activation of fibroblasts and stem cells, and angiogenesis. Given the similarities in their effects, it can be inferred that treatment with PDGF will offer the same healing benefits as nanofat, while reducing discomfort and procedure duration.
Methods: Five patients underwent CO
2 lasering and immediate microneedling with application of nanofat to half the face and recombinant pure PDGF to the contralateral half. Biopsies and blind evaluations were taken preoperatively, 4 days, 1 month, and 3 months post treatment.
Results: Blinded evaluations revealed no difference in aesthetic outcomes between the two groups. Clinical and histological analyses demonstrated excellent biocompatibility and tissue healing in both nanofat and pure PDGF treated skin. Given the small sample size this study was not powered to determine statistical differences between groups.
Conclusion: Multimodal facial resurfacing techniques improve skin texture, though associated with significant pain. Physicians have incorporated biologics like nanofat to alleviate pain and expedite recovery. Harvesting nanofat increases procedure time and causes discomfort for the patient. Recombinant pure PDGF and nanofat and have each been shown to improve tissue healing and regeneration. This pilot clinical trial indicates that substituting pure PDGF for nanofat yields comparable patient outcomes. Histologically both treatments showed excellent biocompatibility and tissue healing.
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