الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 118 |  |  |
| | | from | 118 | | |
Abstract
Autologous fat graft is ideal soft tissue fillers as it is durable and safe. The principal challenge is the high variation in resorption rate. Undesirable outcomes are avoided by using different PRPs generations with growth factors to enhance fat survival rate and increase satisfaction level. Patients and methods: Sixty patients of different age and sex complaining from volume loss of the face whatever the cause were randomly allocated in two equal groups. Patients were scheduled for fat graft which mixed either with platelet rich plasma and platelet rich fibrin. All patients undergo routine investigations, photography and ultrasonography to determine the thickness of the skin preoperatively. Surgery was done under general anesthesia and tumescent infiltration performed. Lipoaspiration was done under low negative pressure then fat was prepared with washing and centrifugation then mixed with prepared either PRP or PRF. Assessment was done after 1 month and after 6 month post operative through photography, ultrasonography, and patient satisfaction and surgeons satisfaction. Results: The results of both groups evaluated by the patients and the surgeons revealed that no statistical difference in satisfaction at 1 month, but at 6 month postoperative, satisfaction was higher in group A. Also, the augmented thickness of fatty layer was significantly higher in group A more than group B at 6 months (P value <0.007*) confirmed by high resolution ultrasonography. Conclusion: The use of growth factors during fat graft seems to give the best results as it improves the long term fat graft survival. PRF would be more effective than PRP because the PRF clot forms a strong fibrin matrix with a complex 3-dimensional structural design and does not dissolve quickly after application with controllable long term release of growth factors.