摘要

Objectives: Show data on fat grafting process devices Show data on facial fat graft outcomes using different techniques Review concepts of facial fat graft survival Introduction: The Coleman technique was introduced in 1984 as a standardized approach to facial fat grafting. Since then numerous devices for processing and cleaning fat, adjunctive treatments such as the addition of PRP, stromal vascular fraction, nanofat and anatomical replacement of lost deep compartment fat have been introduced in an effort to improve outcomes and fat graft survival. Materials / method: Review of the literature reveals a changing landscape. New processing devices, the discovery of stem and regenerative cells in fat and a better understanding of the theories of fat graft survival have been reviewed. Data has been collected on 187 patients undergoing a new protocol of anatomic and regenerative fat grafting and objective three dimensional imaging with Vectra has demonstrated unique volume curves. Results: Using a new protocol of anatomic and regenerative fat grafting with microfat for structural replacement and a cell optimized nanofat for regeneration has demonstrated objective volumetric improvement of nearly 80 percent at 19 months after treatment. Conclusion: New protocols and new understanding of fat graft survival are presented that have demonstrated remarkable regenerative and volumetric effects. This protocol of anatomic replacement and regenerative fat grafting with microneedling and a nanofat biocream have far exceeded previous reports of fat graft survival.