Objectives: To demonstrate and convince the audience why fat grafting should be performed in most patients who present with facial volume loss at the time of their facial rejuvenation procedure.
To discuss the major features of facial aging and why they should be addressed anatomically with multiple modalities, including biologic restoration of tissue losses
Introduction: Facial aging is associated changes in the skin surface, the deeper tissue layers and the bone. When a patient presents for facial rejuvenation, our preference is to evaluate the degree of photo-damage, the degree of volume loss and the degree of laxity and to make recommendations based on a continuum of care, ranging from prevention to non-surgical and minimally invasive approaches to a full range of surgical treatments.
Materials / method: Patients are evaluated for degree of photo-damage, volume loss and laxity. Volume loss is not a generalize finding, but is composed of losses in specific tissues including thinning of the epithelium and dermis, loss of superficial and deep compartment fat and losses of bone. From facial topography, these specific losses in each of the tissues comprising the face are evaluated and a treatment plan is composed.
Results: Patients undergoing facial rejuvenation almost always presented with volume loss. In the majority of patients, volume loss was treated with 3 types of fat grafts, a more structural graft called millifat (2mm parcel size), a microfat graft (1mm parcel size) and nanofat (500 micron parcel size). Fat was injected prior to the facelift and following grafting, the facelift was performed, generally using a high SMAS approach.
Conclusion: Each of the major features of facial aging should be simultaneously addressed and following treatment should be maintained in a serial fashion. Facial volume losses are not corrected by skin and SMAS operations alone and the vast majority of surgical candidates benefit from fat grafting that is performed as a procedure that anatomically replaces decayed tissues.
Disclosures
Did you receive any funding to support your research for this TOPIC?
No
Were you provided with any honoraria, payment or other compensation for your work on this study?
No
Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): Tulip, Millenium Medical, Lipocube
Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
Yes
Please specify date...: Patent pending
and status : ITR2, Lipocube
This work was not supported by any direct or non direct funding. It is under the author's own responsability