Evaluating composite PRF–fat–matrix strategies for soft-tissue augmentation: A preliminary screening study in a porcine model

Soft-tissue augmentation using lipografting remains challenging in constrained recipient environments characterized by scarring, limited vascularity, restricted volume, and high demands on shape stability and tissue quality. Secondary correction of the soft palate in velopharyngeal insufficiency (VPI) represents a clinically relevant example of such conditions. A porcine dorsal skin model was designed to simulate a vascularly compromised recipient environment using standardized full-thickness defects covered in selected groups with split-thickness skin grafts (STSG). In this model (3 × 3 cm defects), spontaneous healing, STSG alone, autologous fat grafting, fat combined with platelet-rich fibrin (PRF), and fat + PRF combined with an acellular dermal matrix (ADM; MatriDerm®), a non-dermal acellular matrix (ANDM; DuraGen Plus®), or an absorbable gelatin matrix (AGM; Cutanplast®) were compared. Macroscopic healing was evaluated at 3 and 5 weeks, focusing on exudation, contraction, and geometry preservation. Fat + PRF showed reduced exudation and improved surface quality compared with other composite approaches. Matrix-based combinations were technically feasible but associated with increased exudation, while AGM demonstrated better preservation of defect geometry. These findings indicate that the proposed porcine model is suitable for detecting differences between composite lipografting strategies and support further experimental optimization prior to clinical translation.