Background: Burn scars often result in significant cosmetic and functional impairment, with current therapies offering limited efficacy and frequent complications. Nanofat grafting, enriched with adipose-derived stem cells, has emerged as a promising regenerative treatment to improve scar quality. Objective: To evaluate the clinical efficacy of autologous nanofat grafting in the rejuvenation of post-burn scars. Patients and Methods: This prospective case series included 20 patients with disfiguring burn scars treated at Mansoura University Hospital between April 2024 and April 2025. Patients underwent intradermal and subdermal nanofat injections, followed by clinical evaluation at baseline and three months post-treatment using the Vancouver Scar Scale (VSS). Statistical analysis was performed using SPSS version 22. Results: The mean VSS total score significantly improved from 8.90 ± 1.83 preoperatively to 6.60 ± 1.69 postoperatively (mean difference: 2.30 ± 1.26; p=0.001), representing a 25.8% reduction. Vascularity shifted favorably, with red scars decreasing from 50% to 35% and pink scars increasing from 15% to 55% (p=0.013). Pliability improved markedly, with yielding scars rising from 5% to 40% and firm scars declining from 70% to 30% (p=0.001). No significant correlations were found between scar improvement and patient age, sex, or scar surface area. Conclusion: Autologous nanofat grafting is a safe and effective modality for burn scar rejuvenation, leading to significant improvements in scar vascularity, pliability, and overall appearance. Long-term studies are warranted to confirm the durability of these outcomes.
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