Clinical, ultrasonic, and histopathologic evaluation of autologous fat transplantation plus platelet-rich plasma with versus without fractional carbon dioxide laser in the treatment of aging hands

Background Aging hands show soft tissue atrophy with prominent bones, tendons, and visible veins as well as pigmented changes and skin rhytids. Autologous fat grafting (AFG) combined with platelet-rich plasma (PRP) sessions can be used in hand rejuvenation for improvement of cutaneous and subcutaneous defects with long lasting results. Objective To evaluate the efficacy, tolerability, and possible side effects of AFG plus PRP with versus without fractional carbon dioxide (CO2) laser in hand rejuvenation. Patients and methods This comparative randomized study included 60 apparently healthy participants in need for hand rejuvenation who were divided into two groups: group I, two hands of 30 participants were treated by AFG with PRP and fractional CO2 laser. Group II, two hands of 30 participants were treated by AFG with PRP. The evaluation was done by clinical evaluation, ultrasound scanning, histopathology, and patient satisfaction. Participants were followed up for 6 months. Results Significant improvement was detected on both groups after treatment with no significant difference between both sides by clinical evaluation, ultrasound scanning, histopathologic evaluation, and patient satisfaction that persisted for 6 months. However, addition of fractional CO2 laser produced significant improvement in skin pigmentation and improvement with nonsignificant difference in wrinkling. Conclusion The enriched AFG with PRP was very effective and safe in the treatment of hand aging especially in volume restoration and disappearance of visible underlying structures. Moreover, fractional CO2 laser produced more improvement in skin pigmentation.