A Combined Approach for Fast Nanofat Microneedling.

Background: Lipofilling is currently a fundamental component of rhytidoplasty and fat harvesting has become a common procedure. Tonnard introduced the concept of nanofat grafting, a revolutionary milestone, in which adipocytes are mechanically separated from the stromal vascular fraction and the latter is injected, adding the possibility of cellular therapies to the surgical field. Later, Verpaele et al. published a report using a new device to apply this nanofat in a uniform manner, which they termed nanofat needling. The device has 24 microneedles of 1.5 mm length and is applied as a stamp, in a tapping motion. The same manufacturer offers a similar model with 64 microneedles, 1.0 mm length, and available as a roller. Objectives: We sought to evaluate the combination of the above-mentioned microneedling devices to achieve faster nanofat delivery. Materials and Methods: A prospective evaluation of patients undergoing a combined nanofat microneedling approach for skin rejuvenation and scar revision, using both a stamp device as well as a roller, was performed in a private practice setting, from January 2019 to January 2020. Patient satisfaction, complications, and surgical time were evaluated. Results: We applied this combination treatment to over 100 treatment areas in 86 patients over a 12-month period, with a short operative time, no increase in complications, consistent results, and good patient satisfaction. Conclusions: We recommend the use of this new device in association with the original one, in order to decrease the procedure time. We designate this strategy “fast nanofat microneedling.”