Platelet-Rich Plasma and Platelet-Rich Fibrin Enhance the Outcomes of Fat Grafting: A Comparative Study

Autologous fat grafting is an efficient procedure in plastic surgery. However, its long-term tissue absorption is variable and technique-dependent. Platelet-rich plasma positively affects fat-grafting outcomes but still has shortcomings, and platelet-rich fibrin has been reported to have efficacy in fat transplantation. Here, we compared the effects of platelet-rich fibrin and platelet-rich plasma in fat grafting using histologic analysis. Twenty rabbits were divided randomly into two groups. In each group, the groin region fat pads were cut into 1-mm granules. Platelet-rich fibrin-treated or platelet-rich plasma-treated fat granules were transplanted into one ear, whereas the contralateral ear was transplanted with normal saline-treated fat granules. Histologic characteristics and capillary density of grafted tissue were analyzed 12 weeks after fat grafting. The grafted fat in the platelet-rich fibrin-treated group showed higher tissue retention than that in the control group [weight retention, 19.57 percent (interquartile range, 13.87 to 29.93 percent) versus 9.04 percent (interquartile range, 6.16 to 16.80 percent), p < 0.05; and volume retention, 18.00 percent (interquartile range, 10.50 to 26.50 percent) versus 8.00 percent (interquartile range, 5.75 to 13.25 percent), p < 0.05] and higher neovascularized capillary density than that in the platelet-rich plasma-treated and control groups. The platelet-rich plasma-treated group showed higher vessel density without superior tissue retention compared with the control group. Platelet-rich fibrin increased tissue retention, quality, and vascularization of grafted fat compared with the control group and showed effects similar to those of platelet-rich plasma on tissue retention and histologic graft improvement.