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Background: Adipose tissue is an abundant source ofmesenchymal stem cells. The use of transplantation of preadipocytesand adipocytes to restore the volume of tissueshas added a lot to the value of fat transplantation strategies.These cells are more advantageous as a cell source than matureadipocytes. They are capable of both proliferating to obtainlarger cell numbers and of differentiating to obtain the tissueof interest. This study aims to compare the results of traditionalfat injection and activated adipose derived mesenchymal stemcells injection enriched with platelet rich fibrin matrix inaugmentation and rejuvenation of the distal leg.Patients and Methods: The study was conducted on 14patients who had fat injection of the leg. They were dividedinto 2 groups: 7 cases by traditional fat injection and 7 casesby injection of (PRFM) with the adipose derived mesenchymalstem cells. Post-operative assessment at 3, 6, 18 months weredone subjectively. Patients in group 11 were subjected tomonthly injection of platelet rich plasma. The final results ineach patient were evaluated according to the comparison ofpre-and post-operative photos and measurements of circumferencefor the degree of improvement by the patients. Threepopulations including the patient herself, a surgeon not involvedin the procedure and nurse were subjected to standardizedquestionnaire.Results: All patients were treated bilaterally, they knoticedthat the use of fat grafting not only provided a volumetriceffect but also improved the quality of skin. They felt theirskin is thicker, firmer with less wrinkles and pigmentationand less need for moisturizers.Conclusion: Mixing fat containing activated mesenchymalstem cells with platelet rich fibrin matrix gave better longlasting results than traditional fat injection as regarding bothvolume and skin quality.

egyptian journal of plastic and reconstructive surgery

The Study of Adipose Derived Mesenchymal Stem Cells Mixed with Platelet Rich Fibrin Matrix in Augmentation and Rejuvenation of The Lower Leg: A Comparative Study