Objectives: Large-volume facial fat transfer offers effective rejuvenation but faces challenges with graft retention. This case series reviews outcomes in two patients receiving over 240 ml of fat. One-year follow-up showed sustained volume and no complications. Findings emphasise the role of fat compartmentalisation, technique refinement, and post-op care in optimising results.
Introduction: Autologous fat transfer is key in facial rejuvenation, restoring volume lost with age. ISAPS 2023 reports facial fat grafting makes up 4.7% of global plastic surgeries. Grafting is volume-based: small (<100 ml), large (100–300 ml), and mega (>300 ml). Ageing affects fat compartments unevenly, causing volume loss and imbalance. Large-volume grafting targets atrophic areas for natural correction. This study explores outcomes, fat survival, and technique refinement for lasting results.
Materials / method: Patients with facial volume loss underwent large-volume fat grafting. Pre-op prep included photos, labs, and cessation of smoking/alcohol. Fat was harvested under GA with a 10-ml syringe after tumescent infiltration, decanted, and injected across different planes ,via 1-ml syringes using 18G blunt cannulas in a radial, multi-plane pattern. Post-op care included antibiotics, facial massage, no compression, supine sleep for a week, and continued smoking/alcohol avoidance for four weeks.
Results: Two patients received large-volume facial fat grafting (257 ml and 247 ml), targeting multiple facial areas. One-year follow-up showed sustained volume, natural rejuvenation, and no complications. Radial, multi-layered injection ensured even distribution and minimised risk. Post-op photos confirmed improved contour, and both patients reported high satisfaction with long-term results
Conclusion: Large-volume facial fat transfer is effective for natural rejuvenation. Success relies on precise anatomy, careful fat handling, and multi-plane, radial injection to boost graft survival and prevent ischemia. Post-op care, including avoiding compression and lifestyle changes, supports retention. This case series shows safety, efficacy, and sustained results at one year.
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