Elliptical Lipoaspirate Activation Versus Coleman Technique: A Randomized Double-Blinded Clinical Trial on Adipose Tissue Grafting for Scar Treatment

Background

Autologous fat grafting is widely used in reconstructive surgery and its use is increasing in different areas of regenerative medicine. This study evaluates the impact of elliptical lipoaspirate activation on adipose tissue grafting outcomes, focusing on scar-related pain reduction, improved scar characteristics, and increased tissue elasticity, comparing these outcomes with the traditional Coleman method.

Methods

This randomized double-blinded clinical trial study was conducted at the Humanitas Research Hospital in Milan from October 2022 to December 2023. Forty-three women aged 18–75 undergoing second-stage breast reconstruction were enrolled. The control group (19 patients) received the Coleman technique, while the study group (24 patients) underwent an additional elliptically oriented centrifugation. Method for evaluations included the Visual Analog Scale (VAS) for pain, Range of Movement (ROM), the Patient and Observer Scar Assessment Scale (POSAS), and shear wave elastography for tissue elasticity.

Results

Both groups showed significant improvements over time. The case group demonstrated a greater decrease in VAS scores at 3 months (p = 0.015). POSAS scores were consistently better in the elliptical lipoaspirate activation group, significantly improving scar pruritus, pain, color, stiffness, thickness, and irregularity. Total POSAS score for both patient and observer scales were statistically higher for the case group at 12 months (p = 0.009 and p = 0.003, respectively). Elastography showed higher tissue softness in the case group at 6 months (p = 0.015) and 12 months (p = 0.0005). Tissue hardness, measured with elastography, was significantly lower for the case group at 12 months (p = 0.003).

Conclusions

The elliptical lipoaspirate activation technique significantly enhances clinical outcomes, reducing pain and improving scar quality and tissue elasticity compared to the standard Coleman method.