{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T23:19:29Z","timestamp":1787527169695,"version":"build-2736575974"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"abstract":"Abstract<\/jats:title>\n Autologous plasma-based fillers have gained interest in regenerative aesthetics as biologically active alternatives to conventional dermal fillers. However, conventional PRP-Gel formulations may be limited by rapid degradation, variable bioactivity, and insufficient structural persistence. This study aimed to evaluate ExoFiller, an activated and concentrated platelet-rich plasma (PRP)-based biofiller, in comparison with conventional PRP-Gel.<\/jats:p>\n ExoFiller was prepared through controlled mechanical activation, concentration, filtration, and thermal restructuring of PRP to combine platelet-derived bioactive mediators with structural plasma proteins in a filler matrix.<\/jats:p>\n A pilot clinical application was performed in 20 patients aged 20 to 65 years presenting with facial volume loss, scarring, or aesthetic rejuvenation demands. Patients were evaluated by dermatological examination and medical history screening before treatment.<\/jats:p>\n ExoFiller and PRP-Gel were assessed using swelling behavior analysis, degradation analysis, in vitro cytocompatibility testing with human dermal fibroblasts, cytokine microarray analysis, and preliminary clinical evaluation.<\/jats:p>\n Patients were advised to avoid excessive facial manipulation, heat exposure, strenuous exercise, and additional aesthetic procedures immediately after treatment.<\/jats:p>\n ExoFiller demonstrated improved swelling capacity, slower degradation, favorable fibroblast viability, and increased levels of regenerative mediators compared with PRP-Gel. Preliminary clinical observations suggested improvements in facial volume, contour, and skin quality without adverse effects.<\/jats:p>\n ExoFiller showed improved stability, cytocompatibility, and regenerative potential compared with conventional PRP-Gel. By integrating structural plasma proteins with platelet-derived bioactive components, this approach may provide a biocompatible and durable autologous option for soft tissue augmentation and aesthetic tissue regeneration.<\/jats:p>","DOI":"10.1055\/a-2925-9527","type":"journal-article","created":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T22:30:22Z","timestamp":1787524222000},"source":"Crossref","is-referenced-by-count":0,"title":["Development and Clinical Application of a Thermally Reconstructed Platelet-Rich Plasma Concentrate-Based Biofiller (ExoFiller)"],"prefix":"10.1055","author":[{"given":"Ali Nurhan","family":"\u00d6zbaba","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Beykent University, \u0130stanbul, Turkiye","place":["Istanbul"],"department":["Department of Plastic, Reconstructive and Aesthetic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cansen Yeni","family":"Kut","sequence":"additional","affiliation":[{"name":"Yeditepe University, \u0130stanbul, Turkiye","place":["Istanbul"],"department":["Department of Genetic and Bioengineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7710-2414","authenticated-orcid":false,"given":"Kemal Tun\u00e7","family":"Tiryaki","sequence":"additional","affiliation":[{"name":"Cadogan Clinic, United Kingdom of Great Britain and Northern Ireland","place":["London"],"department":["Department of Plastic, Reconstructive and Aesthetic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Skin and Laser Center, University of California, California, United States","place":["San Diego"],"department":["Department of Plastic, Reconstructive and Aesthetic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naz","family":"Unal","sequence":"additional","affiliation":[{"name":"Yeditepe University, \u0130stanbul, Turkiye","place":["Istanbul"],"department":["Department of Genetic and Bioengineering"]},{"name":"London Regenerative Institute, United Kingdom of Great Britain and Northern Ireland","place":["London"],"department":["Department of Research and Development"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaren","family":"Kul","sequence":"additional","affiliation":[{"name":"London Regenerative Institute, United Kingdom of Great Britain and Northern Ireland","place":["London"],"department":["Department of Research and Development"]},{"name":"Yildiz Technical University, \u0130stanbul, Turkiye","place":["Istanbul"],"department":["Department of Bioengineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceren","family":"Duyan","sequence":"additional","affiliation":[{"name":"Yeditepe University, \u0130stanbul, Turkiye","place":["Istanbul"],"department":["Department of Genetic and Bioengineering"]},{"name":"London Regenerative Institute, United Kingdom of Great Britain and Northern Ireland","place":["London"],"department":["Department of Research and Development"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serli","family":"Canikyan","sequence":"additional","affiliation":[{"name":"London Regenerative Institute, United Kingdom of Great Britain and Northern Ireland","place":["London"],"department":["Department of Research and Development"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3390\/cosmetics11020049","article-title":"Advancements in regenerative medicine for aesthetic dermatology: a comprehensive review and future trends","volume":"11","author":"F Trovato","year":"2024","journal-title":"Cosmetics"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"5851","DOI":"10.4081\/dr.2015.5851","article-title":"Delayed immune mediated adverse effects to hyaluronic Acid fillers: report of five cases and review of the literature","volume":"7","author":"O Bitterman-Deutsch","year":"2015","journal-title":"Dermatol Rep"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jdds.2016.01.001","article-title":"Complications of hyaluronic acid fillers and their 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