Abstract

Objectives: This study assesses the synergistic effects of a combined protocol using SVF-enriched nanofat, PRP, and ultrafine mono collagen-stimulating threads for facial rejuvenation. It aims to restore dermal volume, elasticity, and skin quality by addressing aging changes like fat loss, dermal thinning, and matrix degradation. The combination promotes stem cell replenishment, angiogenesis, and collagen production, improving facial contour and reducing fine wrinkles. Introduction: Facial aging involves loss of skin, fat, and connective tissue integrity, causing fat pad depletion, dermal thinning, collagen degradation, and vascular insufficiency that form wrinkles like barcode lines and crow’s feet. Reduced fibroblast activity and ECM production worsen this. A combined protocol using SVF-enriched nanofat, PRP, and ultrafine PDO threads targets all layers, promoting stem cells, angiogenesis, collagen synthesis, and neocollagenesis to restore volume, elasticity, and smooth wrinkles safely and minimally invasively. Materials / method: This 18–24 month study included 120 patients aged 40–65. Around 20 cc of adipose tissue was harvested under tumescent anesthesia. Nanofat was processed via multi-stage filtration; SVF was isolated by mechanical emulsification to preserve cell viability. The SVF-enriched nanofat was injected into facial compartments with 25G–27G needles. PRP, prepared via centrifugation, was injected in mid/lower face. PDO mono threads (29G–31G) were placed in mesh patterns at barcode lines/crow’s feet to induce neocollagenesis. All under aseptic technique. Results: Patients demonstrated marked improvement in facial firmness, skin texture, and reduction of static wrinkles, especially perioral barcode lines and crow’s feet. The synergistic effect of combining SVF-enriched nanofat, PRP, and fine mono threads led to significant improvements in: • Collagen density and dermal thickness (clinically and ultrasonographically observed), • Sustained wrinkle reduction up to 24 months, • Reduced need for repeat procedures, often limited to once every 2 years. No major complications were reported. Mild bruising and swelling resolved within 5–7 days. Conclusion: This multimodal protocol combining biocellular fat grafting (nanofat + SVF), autologous PRP, and ultrafine mono threads addresses the multilayer nature of facial aging. The regenerative synergy results in durable skin rejuvenation, reduced wrinkle depth, and increased dermal quality in the aging face. This approach offers a minimally invasive yet comprehensive solution for mid-aged individuals seeking natural, long-lasting facial restoration.