Nanofat hair restoration involves the use of tiny injections where the patient’s own processed fat cells will be placed. Fat grafting has been used in the past to restore volume loss and redefine the facial features.

Adipose-derived stem cell-conditioned medium (ADSC-CM) is loaded with growth factors such as vascular endothelial growth factor, platelet-derived growth factor, hepatocyte growth factor, and insulin-like growth factor. Vascular endothelial growth factor manages hair growth and follicle size via angiogenesis. Hepatocyte growth factor impacts the cyclic growth of hair follicles.

Platelet-derived growth factor stimulates and maintains the anagen stage of hair follicles. The insulin-like growth factor manages the hair growth cycle and differentiation of hair shafts. Treatment with adipose-derived stem cell-conditioned medium involves each growth factor activating hair follicles and contributing to increasing the number of hairs in patients with alopecia.

But now, evidence suggests that fat grafts can also effectively stimulate hair growth when placed into the hair follicle, similar to the PRP hair restoration process.

NOTE: The FDA shifted their stance on autologous fat grafts, reclassifying them as products allowed to be used without premarket approval. "The FDA, while formulating these guidelines regarding fat-based therapeutic products, has considered only the adipocyte, not taking into account the potential constituents of the extracellular matrix such as multipotent stromal cells, pericytes, and endothelial precursor cells and restricted their approved usage only to the spectrum of disorders homologous to the utility of only the adipose lineage cellular component of the tissue complex. Appropriate homologous use of these heterogeneous populations with undesignated cellular capabilities needs to be clarified. Since nanofat is processed in a non-enzymatic method, it comes under the minimal manipulation norms of the FDA guidelines". (Jeyaraman M, Muthu S, Sharma S, Ganta C, Ranjan R, Jha SK. Nanofat: A therapeutic paradigm in regenerative medicine. World J Stem Cells. 2021 Nov 26;13(11):1733-1746)

Candidates for nanofat hair restoration are those who experience hair thinning (initial stages of hair loss respond may likely respond more robustly), a receding hairline, or balding due to aging or other factors. Nanofat hair restoration can be an effective alternative for those who are not candidates for other hair restoration techniques like PRP or hair transplant. Nanofat can also be combined with many other hair restoration procedures for added benefit.

To be a successful candidate for nanofat hair restoration, patients must have enough excess fat to be used for placement and be ready to undergo liposuction to obtain the fat cells. Many patients are drawn to the fact that they can receive the slimming benefit of liposuction on one area of the body, and put their own natural fat cells to good use restoring their hair.

Candidates should have reasonable expectations as the outcomes can differ between patients, and the permanence of outcomes may not be assured.

Nanofat hair restoration begins by obtaining the fat cells for placement. This is done using liposuction techniques where adequate fat is present, typically on the thighs, hips, abdomen. Liposuction requires tiny incisions where a cannula device can be inserted and used to break up and gently remove the fat cells. This can be done under local anesthesia. The fat cells are then processed and purified and placed into a syringe. Small injections of the fat cells will then be placed in the scalp where thinning and balding have occurred

After nanofat hair restoration, you can expect some redness and swelling in the injection sites, as well as some general discomfort, swelling, and bruising in the liposuction treatment area. Patients should plan for about a week off work to properly recover.

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The side effects from nanofat injections for hair loss may include pinpoint bleeding, minimal pain, and redness when the injections are being delivered. Certain patients report a “full” or “tight” sensation in the scalp right after the injections that may last up to one day. In exceptional cases, patients will complain of a mild headache the next day.

Early published data have shown encouraging preliminary results for the use of adipocytes and their stem cells as a treatment option for hair growth. Patients can typically expect growth several months after injections.

Nepal S, Venkataram A, Mysore V. The Role of Adipose Tissue in Hair Regeneration: A Potential Tool for Management? J Cutan Aesthet Surg. 2021 Jul-Sep;14(3):295-304