Autologous Fat Grafting Viability: Lower Third of the Face

ABSTRACT

The process of aging is the result of subcutaneous loss of volume, in addition to vertical tissue descent. Surgeons are therefore emphasizing soft tissue augmentation to achieve a natural, rejuvenated appearance in patients. Autologous fat grafting is now a commonly performed aesthetic procedure. Autologous fat grafting is a challenging procedure, due to the fragile characteristic of adipose tissue. Viability of transplanted fat is a main consideration when fat grafting is performed. Poor fat viability produces an inadequate result and thus can be considered as a complication of this procedure. Many studies have demonstrated that fat longevity is dependent upon handling and preparation of fat. This article outlines the history of autologous fat grafting. The technique of fat grafting is described, along with review of the evidence of fat viability according to the technique used. The specific technique for autologous fat grafting in the lower third of the face is described including augmentation of the labiomandibular fold, lips, chin, and the jaw.

KEYWORDS

Autologous - fat - grafting - lower - face

REFERENCES

• 1 Lam S M, Glasgold M J, Glasgold R A. Complementary Fat Grafting. Baltimore, MD; Lippincott Williams & Wilkins 2007
• 2 Toledo L S, Mauad R. Fat injection: a 20-year revision.  Clin Plast Surg. 2006;  33 47-53, vi
• 3 Mojallal A, Foyatier J L. [Historical review of the use of adipose tissue transfer in plastic and reconstructive surgery].  Ann Chir Plast Esthet. 2004;  49 419-425
• 4 Illouz Y G. Body contouring by lipolysis: a 5-year experience with over 3000 cases.  Plast Reconstr Surg. 1983;  72 591-597
• 5 Coleman S R. Stuctional Fat Grafting. St. Louis, MO; Quality Medical Publishing 2004
• 6 Zuk P A, Zhu M, Mizuno H et al.. Multilineage cells from human adipose tissue: implications for cell-based therapies.  Tissue Eng. 2001;  7 211-228
• 7 Sajjadian A, Tandav Magge K. Treating facial soft tissue deficiency: fat grafting and adipose-derived stem cell tissue engineering.  Aesthetic Surg J. 2007;  27 100-104
• 8 Asken S. Autologous fat transplantation: micro and macro techniques.  Am J Cosmet Surg. 1987;  4 111-121
• 9 Moore Jr J H, Kolaczynski J W, Morales L M et al.. Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine.  Aesthetic Plast Surg. 1995;  19 335-339
• 10 Alexander R N. Guidelines for autologous fat transfer. In: Shiffman M Autologous Fat Transfer. New York, NY; Marcel Dekker 2001: 23-30
• 11 Erdim M, Tezel E, Numanoglu A, Sav A. The effects of the size of liposuction cannula on adipocyte survival and the optimum temperature for fat graft storage: an experimental study.  J Plast Reconstr Aesthet Surg. 2009;  62 1210-1214
• 12 Shiffman M A, Mirrafati S. Fat transfer techniques: the effect of harvest and transfer methods on adipocyte viability and review of the literature.  Dermatol Surg. 2001;  27 819-826
• 13 Findik H, Aydain A, Beyhan G, Uzunismail A. The effects of different harvesting techniques, adrenaline, and centrifuge on the survival of fat grafts.  Eur J Plast Surg. 2007;  30 75-79
• 14 Ferguson R E, Cui X, Fink B F, Vasconez H C, Pu L L. The viability of autologous fat grafts harvested with the LipiVage system: a comparative study.  Ann Plast Surg. 2008;  60 594-597
• 15 Piasecki J H, Gutowski K A, Moreno K M, Lahvis G L. Purified viable fat suspended in Matrigel improves volume longevity.  Aesthetic Surg J. 2008;  28 24-32
• 16 Iblher N, Kloepper J, Penna V, Bartholomae J P, Stark G B. Changes in the aging upper lip—a photomorphometric and MRI-based study (on a quest to find the right rejuvenation approach).  J Plast Reconstr Aesthet Surg. 2008;  61 1170-1176
• 17 Eremia S, Newman N. Long-term follow-up after autologous fat grafting: analysis of results from 116 patients followed at least 12 months after receiving the last of a minimum of two treatments.  Dermatol Surg. 2000;  26 1150-1158