Objectives: - Evaluate facial contouring results, including lifting and filling effects, with a focus on reduced nasolabial folds, refined jawlines, and filled hollow areas (forehead, temples, malar) that enhance overall facial shape.
- Assess changes in skin quality, such as increased moisturization, thickness, brightness, and reduction of fine lines.
- Evaluate complications
- Measure patient satisfaction with the outcomes of the procedure.
Introduction: Facial rejuvenation is a key concern for aesthetic physicians and clients. Facial aging is a complex, multidimensional process affecting bones, muscles, ligaments, fat pads, and skin, with each layer influencing the others. Aging is driven by genetics, lifestyle, and environmental factors, leading to changes in skin texture, loss of elasticity, and fat redistribution, which alters facial shape and contour. Minimally invasive procedures, using a combination of PDO/PCL threads and fat grafting, target over 70% of these aging issues by rejuvenating multiple facial layers.
Materials / method: Patients undergo liposuction to collect fat, which is filtered to remove impurities. We use 50 mL of refined fat for facial grafting and 50 mL is processed into nanofat.
For deep layer rejuvenation, we fill hollow areas (forehead, temples, malar) with fat grafts and use 19G PDO threads in the SMAS layer and 21G PDO threads in the fat layer for lifting.
For the skin layer, we use mesotherapy technique using nanofat along with 30G PCL Mono threads across the entire face.
Patients are followed at 1, 3, 6, and 12 months
Results: 73 patients underwent with this procedure, averaging 45 years old.
Facial contouring improvements are noticeable after surgery & more pronounced after 2-4 weeks. Skin quality enhancements are seen after 1-3 months.
Common complications include bruising, swelling, discomfort during facial movements, asymmetry, and thread migration. There have been no cases of infection or permanent nerve damage.
After one month, 92% of patients were satisfied. However, at 3 and 6 months, some noticed slight to moderate reductions in contouring effects. 60% of patients willing to undergo the treatment again.
Conclusion: Combining different types of threads with various fat grafting techniques provides a safe and effective method for multi-layered facial rejuvenation. While improvements in contouring and skin quality are clear, it's essential to also prioritize minimizing complications and increasing the longevity of the contouring (lifting and filling) results. In addition to innovations in thread structures, combining pure fat with SVF, stem cells, exosomes, or growth factors represents a promising approach for enhancing treatment outcomes.
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