الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Facial scars are devastating and can result in disfigurement that affects quality of life which, in turn, can lead to lowered self esteem, social isolation and job discrimination .It can develop mainly as a result of trauma, burns or acne. Standard treatments for facial scars include the use of surgery, pressure therapy, silicone devices, intra-lesional steroid injections, radiotherapy, pulsed-dye laser treatments and dermal fillers. The fat grafting procedure is considered a minimally invasive procedure .it began with liposuction to collect a small amount of the patient’s own fat tissue. After processing, the fat cells are reinjected in the area of scaring. Fat was distributed in different directions to create a ’’web ’’of support for scarred, damaged skin. Adipose tissue is a connective tissue which contains a reserve of mesenchymal stem cells (MSCs). These present an innovative therapeutic opportunity in many clinical fields including plastic and reconstructive surgery, especially for their ability to enhance mechanisms of repair in many tissues. Injection of processed autologous fat seems to be a promising and effective therapeutic approach to scars of different origin. The treated areas regain characteristics similar to normal skin and clinically assessable, with not only aesthetic but also functional results. The treated skin becomes more elastic and softer, allowing even in the case of facial scars a gradual recovery of mime. The precise mechanism by fat graft that leads to tissue improvement is still unclear. These results may be achieved through mesenchymal stem cells rather than adipocyte-derived products, stromal growth factors, hormones, tissue macrophages components, or all these. This clinical study included thirty patients presented with obvious facial scars admitted to Menoufia University Hospital and Benha Teaching Hospital in the period from July 2015 to November 2016. The age of the patients at the time of operation ranged from 8 to 48 years (mean was 25. 3 years).There were 16 males and 14 females. The volume of the injected fat ranged between 2- 50cc depending on the length and surface area of the scar with a mean of 25.75 cc. Post traumatic scars represented the majority of cases (22 cases) followed by post burn and post inflammatory scars (4 cases for each type).post traumatic scars were higher in males rather than females owing to higher activity and being more physically aggressive . Lower abdomen was the donor site in most cases (21cases) due to easy accessibility and abundant fat. Thigh was selected in (5 cases) and buttocks in (4 cases) in thin muscular patients and children. There was significant reduction in the degree of pain and pruritus with increased scar elasticity and decreased degree of hyperpigmentation. Accordingly treatment was associated with improved motion in areas where movement was limited because of tightness and stiffness of contracted scars and its adherence to the underlying tissue. Post operative complications are noted in the form of fat resorption in 6 cases. Neither donor site complication nor morbidity was observed. Patient satisfaction was achieved in 76% of cases as regarding overall improvement of scars.