Objectives: To show the audience how facial topography can be used to diagnose and establish a treatment plan for facial volume loss
To discuss anatomic replacement of losses in volume with like tissues
To explain the rationale for Injectable Tissue Replacement and Regeneration
To show how ITR can be combined with facelift surgery to optimize outcomes
Introduction: As we learn more about the anatomic changes that occur with facial aging, we are able to develop new strategies to replace and regenerate the exact tissues that are aging. Our approach which we call Injectable Tissue Replacement and Regeneration (ITR2) has been developed as a new standardized approach which is anatomically based and dynamically applied during the aging process to reduce the rate of tissue decay and restore decayed tissue.
Materials / method: The procedure begins with proper diagnosis of deep and superficial fat compartment losses, bone losses and degrees of sun damage and skin thinning and texture change. Next, millifat is harvested and converted into microfat and nanofat. In most cases PRP is utilized (20:80) with the fat or as a separate injection at the end of the fat grafting procedure and facelift. Following full facial, neck and chest ITR, the appropriate facelift is chosen.
Results: ITR2 can be performed alone or in combination with facelift surgery. In a small group of patients who had ITR2 and facelifts and were prospectively followed, we saw a gain of 50% facial volume at a month, followed by a decline to 25-30% at 7-12 months followed by an increase to 74% at the end of 2 years. None of these patients had any weight gain. Additional findings from Rigotti and other researchers support the findings of improvement in skin thickness and texture. Complications have been rare with 3 patients requiring removal of small amounts of fat from their lower eyelid.
Conclusion: ITR2 is an anatomic approach to fat grafting that is associated with limited, but noticeable regenerative changes. We speculate that in patients requiring more than one filler, if all areas of anatomic losses are simultaneously replaced using ITR2, the rate of tissue decay will be slowed, if not reversed temporarily. Newer approaches that address the actual changes occurring to facial tissues with aging as they occur will likely become the next standard of care in facial rejuvenation.
利益冲突声明
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请注明名称（个人，公司，学会等等）: Lipocube, Mage Group, Tulip, Millenium Medical
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请注明日期: Patent pending; TM awarded
和审阅情况: Lipocube, ITR2
这项工作没有任何直接或间接的资金支持。由作者自己承担责任。
