Combined Treatment Approach Shows Promise for Acne Scars

15 patients treated with fat tissue, laser, and surgical release

This Italian study tested a three-part treatment approach for stubborn acne scars. Researchers combined micro-fragmented adipose tissue (specially processed fat from your own body) with CO2 laser treatment and a surgical technique to release scar tissue. The goal was to see if using these methods together would work better than any single treatment alone.

The study included 15 patients—12 women and three men—aged 19 to 54 years. All had atrophic acne scars, which are the indented or depressed scars that form when skin loses collagen during the healing process. Patients were followed for 12 months after treatment.

Three techniques work together to rebuild scarred skin

The treatment combined three different approaches, each targeting a specific problem:

• Surgical release: A small cannula or needle breaks up the fibrous bands pulling the skin down, freeing the scar tissue

• Fat tissue injection: Micro-fragmented adipose tissue containing regenerative cells is placed beneath the scars to stimulate new collagen and blood vessel growth

• CO2 laser resurfacing: Deep laser treatment activates skin cells to produce fresh collagen from the surface

The researchers chose this combination because each technique addresses a different layer of the scar problem. The surgical release creates space, the fat tissue provides building blocks for repair, and the laser encourages the skin to renew itself.

Scar scores improved in all patients by final visit

The team measured results using the ECCA score, a clinical scale that rates acne scar severity. Twelve of 15 patients showed significant score reductions at their first follow-up visit. By the final 12-month check-up, all patients demonstrated measurable improvement.

Patients also rated their own satisfaction. At the final visit, 12 patients reported 51% to 75% improvement in their scars. The remaining three patients reported 26% to 50% improvement. Every patient showed reduction in scar depth, pore size, and skin roughness.

Recovery time averaged less than five days

The average downtime—meaning time away from normal work and social activities—was just 4.5 days. Eleven patients experienced temporary side effects including mild pain, redness, swelling, and dry skin. All these effects resolved within four days.

No patient developed new scars or any permanent complications from the treatment. The researchers noted that the fat tissue injection appeared to help reduce inflammation and speed healing compared to laser treatment alone.

Fat tissue may enhance healing and reduce side effects

The micro-fragmented adipose tissue used in this study contains pericytes (helper cells that support blood vessels) and MSCs (mesenchymal stem cells that can become various tissue types). These regenerative cells release growth factors that:

• Stimulate collagen production

• Encourage new blood vessel formation

• Attract fibroblasts (cells that build skin structure)

The researchers suggest that adding fat tissue to traditional scar treatments not only improves results but also makes recovery easier. Patients experienced less swelling and discomfort than typically seen with laser treatment alone.

What this means for your treatment decision

This study supports using multiple treatment approaches together for acne scars. While the results are encouraging, it's important to note this was a small case series without a comparison group. Larger studies would help confirm these findings.

If you're considering treatment for acne scars, this research suggests that combining techniques—including regenerative fat tissue—may offer better outcomes than single treatments. The relatively quick recovery time and absence of serious complications are also reassuring. Talk with your doctor about whether this combined approach might be appropriate for your specific scar type and skin characteristics.

Source: Miegge et al., Modern Research in Plastic and Reconstructive Surgery, 2023.