Objectives: German surgeon, Neuber described the first human auto-fat grafting in 1893, and fat grafting continues to be applied clinically because of the ease of fat harvesting, the abundance of graft material, and the lack of transplant rejection. However, fat survival and retention rates are unpredictable, and complications such as abscesses, cysts, nodulation, and neurovascular injury may occur.
Introduction: Asians often look to enhance the appearance of the nasal dorsum and chin profile due to certain ethnic deficiencies. Various nasal and chin implants have been adopted for this purpose. In 1963, Dr. Landazuri was the first surgeon to use the term “profiloplasty,” defined as rhinoplasty plus mentoplasty. However, the results seemed unsatisfactory, and potential morbidities were often bothersome. In past decades, fillers have garnered attention, despite complications and other concerns such as allergy, the necessity of repeat injection, and cost-effectiveness.
Materials / method: There were 102 patients (92 female/10 male) with an average age of 43.5 receiving micro-autologous fat transplantation (MAFT) as a strategy for profiloplasty (nasal dorsum and chin augmentation/re-contouring) from Jan. 2010 to Dec. 2020. The autologous fat was mainly harvested from the lower abdomen and then processed and refined by centrifugation at 3 min 3000 rpm (~1200 g) for purification. An average of 2.5 mL (ranging from 3 to 12 ml) and 5.2 mL of the fat grafting was micro-transplanted evenly and precisely in the nasal dorsum and chin, respectively, under intravenous general anesthesia.
Results: The total mean procedural time of applying MAFT for chin augmentation was 45.5 minutes. All patients were uneventfully post-operatively without significant complications reported. The mild swelling and ecchymosis were found but subsided within 7~10 days. During the long-term follow-up (> 6 months) period, 78.0% of patients demonstrated good results (33% were very satisfied, and 45% were satisfied).
Conclusion: The accurate, precise micro-(from 1/60 to 1/240 mL per injection) controlling of fat parcels provides critical facilitation in fat survival with an innovative instrument. Moreover, the patent controlling mechanism facilitates surgeons to perform a superior fat graft as compared with traditional, which was unpredictable, with potential complications with higher survival/retention rate and good long-term follow-up. Micro-autologous fat transplantation appears necessary and determinant in fat grafting and serves as an alternative strategy in Asian profiloplasty.
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