Randomized controlled study using autologous fat grafts, hybrid filler, and fractional CO 2 laser resurfacing in the treatment of elastosis: analysis of outcomes and satisfaction

Background Actinic elastosis is a non-curable skin condition manifesting with wrinkling, reduction of elasticity, pigmentation, and roughness of the skin. Many aesthetic treatments aimed at reducing its aesthetic impact have been suggested. The aim of this study is to compare fat grafting, fractioned CO 2 laser resurfacing, and hybrid filler in order to detect which one is more effective in improving actinic elastosis. Methods Patients meeting the following criteria were included in the study: dermatological diagnosis of elastosis, primary surgical or non-surgical treatment for elastosis, at least 1 year follow-up, pre- and post-operative photo-documentation, proficiency in Italian language, and signed consent for study participation. The study was performed with a randomized design; patients were randomly divided in three groups: group 1, fat grafting; group 2, hybrid filler; and group 3, CO 2 laser resurfacing. All patients were asked to answer the FACE-Q satisfaction with the face post-operative module. Two plastic surgeons, blinded to the treatment method used, were selected to examine pre- and post-operative photographs, rating the outcomes on a 1–5 VAS scale. Results Seventy-five patients were enrolled, 4 males and 71 females, aged between 50 and 80 years. Both the FACE-Q and VAS scores were higher in groups 1 and 2. No major complications were reported in any of the groups. Conclusions Elastosis remains a genetically based skin condition, which cannot be considered curable. Hybrid filler and adipose tissue transfer can be both considered valid options to improve skin elastosis both in terms of patient satisfaction and enhancement of skin quality. Level of evidence:Level II, Therapeutic study2229