Comparative study between nanofat injection with and without Platelet-Rich Plasma (PRP) in improvement of mature scar: clinical study

and poor suppleness. Regenerative therapy include nanofat, rich in stromal vascular fraction, and PRP, a concentration of autologous platelets releasing growth factors. The combination has been hypothesized to improve scar remodeling Objectives: To compare nanofat injection with and without Platelet-Rich Plasma(PRP) in improvement of mature scar. Patients and methods: This prospective, split-scar study at Qena University Hospital(August 2024–2025) included 15 adults with facial scars(>6 months old). The study was ethically approved under SVU-MED-SUR011-1-24-9-947. Each patient received nanofat on one half of the scar and nanofat+PRP on the other. Fat was harvested mainly from the abdomen, emulsified and filtered into nanofat; PRP was obtained by double centrifugation. Injections were superficial or subdermal, followed by standard wound care and medications. Scars were evaluated at 1, 3, and 6 months using Patient and Observer Scar Assessment Scale (POSAS), Vancouver Scar Scale (VSS), and pain scores. Results: The nanofat + PRP group showed significantly lower POSAS scores at 1(34.67±4.71 vs. 41.87±6.28; p=0.0019), 3(25.2±3.66 vs. 31.27±6.48; p=0.0049), and 6 months(17.4±2.68 vs. 22.6±4.67; p=0.0012). VAS pain scores were also significantly lower at 3(3.6±0.95 vs. 5±0.89; p=0.0004) and 6 months(1.8±0.75 vs. 2.93±0.85; p=0.0009). VSS scores improved significantly at 3(p < 0.0001) and 6 months(p=0.0438). Patient satisfaction was significantly higher with the combination therapy(p=0.0086). Conclusion: Nanofat with PRP improves mature scar look, discomfort, and patient satisfaction more than nanofat alone without increasing side effects.