scholarly journals Facial Rejuvenation With Fat Grafting and Fillers

2021 ◽  
Vol 41 (Supplement_1) ◽  
pp. S31-S38
Author(s):  
J Sarah Crowley ◽  
Elizabeth Kream ◽  
Sabrina Fabi ◽  
Steven R Cohen
Keyword(s):  
Calcium Hydroxyapatite ◽  
Fat Grafting ◽  
Facial Rejuvenation ◽  
Volume Loss ◽  
Level Of Evidence ◽  
Tissue Replacement ◽  
Dermal Thickness ◽  
The Face ◽  
Modality Approach ◽  
A New Technique

Abstract Facial rejuvenation requires a multi-modality approach to address the sun damage, volume loss, and thinning of skin that occurs with aging. With age, the collagen fibrils that provide strength become fragmented and fibroblasts connections become weak, leading to skin laxity and loss of youthful skin. Fillers can lead to a more youthful appearance by providing volumetric support. Synthetic fillers such as hyaluronic acid products, calcium hydroxyapatite, polylactic acid, and polymethylmethacralate have bio-stimulatory affects, ranging from small effects on fibroblast production to prolonged stimulatory effects on dermal thickness and blood supply. Fat grafting is also an ideal technique for facial rejuvenation because it is readily available, natural, and has regenerative effects. This review describes a new technique of fat grafting for the face called Injectable Tissue Replacement and Regeneration that specifically addresses the different anatomic compartments of the face with volume loss. With this brief review, we aim to evaluate the currents trends of fat grafting and fillers in the management of facial rejuvenation, including the cellular changes that occur with facial aging, the bio-stimulatory effects of fillers, and the anatomic replacement of tissue with fat grafting. >Level of Evidence: 4

scholarly journals Fat Augmentation as Adjunct to CORE Facelift Surgery

2021 ◽  
Author(s):  
Capi C. Wever
Keyword(s):  
Fat Grafting ◽  
Facial Rejuvenation ◽  
Golden Standard ◽  
The Face

AbstractRuling out cases with strong jawlines, well-developed mid-cheek regions, and good fat presence, if done artistically, fat augmentation strongly assists midface definition and can replenish hollowed regions of the face. This is particularly true for candidates with low bodyfat or smaller skull structures. Hence, fat grafting is a strong adjunct to conventional excisional techniques in facial rejuvenation surgery, regardless of experience, technique, or geographical embedding. While CORE facelift techniques remain the golden standard that define the top level of facelift surgery, fat augmentation has its unique place along the full stretch of an individual surgeon's learning scope, as it will potentially improve results regardless of where one stands.

Halos and Asymmetric Triangles: Designing the Eyelids with Volume Using Fillers and/or Fat

2018 ◽  
Vol 34 (02) ◽  
pp. 173-177
Author(s):  
Samuel Lam
Keyword(s):  
Fat Grafting ◽  
Volume Loss ◽  
Lower Face ◽  
New Models ◽  
The Face ◽  
Principal Method

AbstractPeriorbital aging is mainly a product of volume loss, which can be addressed with fillers and/or fat grafting. This stands in contrast to the lower face where a lifting procedure can be the principal method to improve moderate-to-significant aging. New models to explain these concepts of periorbital rejuvenation to both the surgeon and the prospective patient are outlined herein, namely, three facial halos (around the eyes, around the perimeter of the face, and around the mouth) and asymmetric triangles around the eyes. Specific techniques for fillers and fat grafting are also covered separately in detail in this article.

scholarly journals Fat Grafting for Facial Rejuvenation

2020 ◽  
Vol 34 (01) ◽  
pp. 030-037 ◽  
Author(s):  
Kelly P. Schultz ◽  
Anjali Raghuram ◽  
Matthew J. Davis ◽  
Amjed Abu-Ghname ◽  
Edward Chamata ◽  
...  
Keyword(s):  
Fat Grafting ◽  
Facial Rejuvenation ◽  
Nasolabial Fold ◽  
Volume Depletion ◽  
Systematic Method ◽  
Face Lift ◽  
Facial Aging ◽  
Native Tissue ◽  
The Face ◽  
Injectable Fillers

AbstractFor optimal results, facial rejuvenation procedures should address both the tissue laxity and volume deflation associated with facial aging. The lift-and-fill face lift, in which fat grafting provides volumetric rejuvenation to the face while surgical lift effectively repositions and removes ptotic and redundant tissue, has revolutionized the plastic surgeon's approach to the aged face. An understanding of the intricate anatomy of distinct facial fat compartments and a systematic method to assess areas of fat atrophy and volume depletion are keys to provide patients with a natural and youthful result. Fat grafting may be used to improve contour in any area treatable by nonautologous injectable fillers, including the temples, forehead, upper and lower orbit, cheeks, perioral region, nasolabial fold, jawline, and chin—with the benefit of a more natural contour and integration with native tissue.

Fat Grafting to Improve Results of Facelift: Systematic Review of Safety and Effectiveness of Current Treatment Paradigms

2020 ◽  
Vol 41 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Felipe Molina-Burbano ◽  
J Michael Smith ◽  
Michael J Ingargiola ◽  
Saba Motakef ◽  
Paymon Sanati ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fat Grafting ◽  
Treatment Modalities ◽  
Fat Graft ◽  
Cochrane Library ◽  
Complication Rates ◽  
Volume Loss ◽  
Level Of Evidence ◽  
Superficial Musculoaponeurotic System ◽  
Age Related

Abstract Background Autologous fat grafting is a helpful supplement to facelift surgery that helps to combat age-related volume loss of facial structures. Despite the widespread prevalence of combined facelift and fat-grafting, significant procedural variation exists between providers. Objectives The primary purpose of this systematic review was to study the efficacy and complication rates of facelift with lipofilling compared with facelift alone. Methods A systematic review of the Cochrane Library and MEDLINE databases as completed was undertaken to identify all clinical reports of fat grafting combined with facelift surgery based on the following key terms: (“fat grafting” OR “lipotransfer” OR “lipofilling” OR “fat transfer”) AND (“facelift” OR “rhytidectomy” OR “SMASectomy” OR “facial rejuvenation”). Data on techniques, outcomes, complications, and patient satisfaction were collected. Results The systematic review was performed in April 2017. In total, 248 articles were identified for review. After application of exclusion criteria, 15 primary studies were included in this review. Various facelift techniques were reported, including deep-plane or sub–superficial musculoaponeurotic system (SMAS) facelift, SMAS facelift, modified minimal access cranial suspension lift, component facelift, midface lift, SMAS plication, SMAS-stacking/SMASectomy, and SMASectomy. The most common locations of fat graft injection included the nasolabial folds, tear troughs, temporal regions, midface/cheek/malar eminence, marionette groove, lips, and ear lobes. The addition of fat grafting to facelift surgery resulted in significant improvements in facial volume and aesthetic assessments. Conclusions Combined facelift and fat grafting is a safe and efficacious means to simultaneously address age-related ptosis and volume loss. Further research is required to validate and improve existing treatment modalities. Level of Evidence: 3

scholarly journals A Study Comparing the Efficacy of Monopolar Radiofrequency and Glycolic Acid Peels in Facial Rejuvenation of Aging Skin Using Histopathology and Ultrabiomicroscopic Sonography (UBM) – An Evidence Based Study

2016 ◽  
Vol 59 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Deepal V. Wakade ◽  
Chitra S. Nayak ◽  
Kalpana D. Bhatt
Keyword(s):  
Glycolic Acid ◽  
Facial Rejuvenation ◽  
Collagen Remodeling ◽  
Collagen Formation ◽  
Dermal Thickness ◽  
Chemical Peels ◽  
The Face ◽  
Outer Canthus ◽  
Nasolabial Folds ◽  
Equal Efficacy

Background: Radio frequency (RF) and chemical peels have been used for nonablative skin rejuvenation. Both of these cause collagen remodeling in the dermis and neo-collagen formation resulting in facial rejuvenation. There is limited literature on the evaluation of collagen remodeling by objective methods. Objective: To compare the benefits of monopolar radiofrequency and glycolic acid peels in facial rejuvenation with regards to histopathology and Ultrabiomicroscopic sonography (UBM). Methodology: In this study, forty patients with mild to moderate photoaging received four treatments with 3 weeks interval of monopolar radiofrequency on one side of face and glycolic acid peels in increasing concentrations (NeostrataR) on the other side. Pre and post treatment, 2 mm biopsies were taken from both preauricular areas and Ultrasonography using a 35 MHz probe was done from outer canthus of eye and nasolabial folds from both sides of face. A blinded assessment was done to measure the increase in the grenz zone and dermal thickness. Results: In 35/40 patients there was a significant increase in the grenz zone on histopathology and decrease in subepidermal low-echogenic band (SLEB) on UBM of the nasolabial folds on both sides of the face (p < 0.05). Conclusion: Radiofrequency and chemical peels showed equal efficacy in the treatment of facial rejuvenation.

scholarly journals Intramuscular Insertion of a Radiofrequency Microneedling Device for Facial Rejuvenation: A New Technique and Case Reports

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Andrew N Kornstein
Keyword(s):  
Case Reports ◽  
Modified Technique ◽  
Level Of Evidence ◽  
Reticular Dermis ◽  
Facial Aging ◽  
Bipolar Radiofrequency ◽  
The Face ◽  
Mimetic Muscles ◽  
Rf Energy ◽  
A New Technique

Abstract Skin laxity and dynamic rhytids that signify facial aging are due, in part, to atrophic changes and volume redistribution in the underlying layers of the face: the bone and soft tissue. A microneedling device that delivers bipolar radiofrequency (RF) energy directly to the reticular dermis has been shown to yield rejuvenated, tighter skin in 100% of patients. Herein, the author describes a modification to the standard dermal technique in which the skin is gently gathered with the nondominant hand, and the microneedling device is tilted to deliver RF energy to the mimetic muscles—including the frontalis, orbicularis oculi, and orbicularis oris—as well as the dermis. Muscle penetration was inferred by intraoperative bleeding and postoperative bruising, neither of which is typical of standard RF microneedling. Preliminary findings suggest that the modified procedure may yield greater aesthetic benefits than achieved with dermal application alone, including subtle lifting of the brow and oral commissure, upper-lip shortening with vermilion eversion, tightening of the lower-lid fat pads, and reduction in lateral-canthal rhytids. Although this modified technique will need to be optimized and evaluated in large, controlled studies, the initial results presented herein are encouraging. Level of Evidence: 5

scholarly journals Assessing Clinical Outcomes in Autologous Fat Grafting: A Current Literature Review

2021 ◽  
Vol 41 (Supplement_1) ◽  
pp. S50-S60
Author(s):  
Teri N Moak ◽  
Trina G Ebersole ◽  
Damini Tandon ◽  
Marissa Tenenbaum
Keyword(s):  
Standard Of Care ◽  
Fat Grafting ◽  
The Body ◽  
Autologous Fat Grafting ◽  
Level Of Evidence ◽  
Autologous Fat ◽  
Aesthetic Appearance ◽  
Radiologic Imaging ◽  
The Face ◽  
Surgeon Satisfaction

Abstract Autologous fat grafting, first described in the 1890s, has since undergone many modifications to optimize safety and efficacy. These changes have resulted in the technique that we now consider standard of care, one that is applied to reconstruction and cosmetic enhancement of the breast and the face both independently and in conjunction with surgical treatment. There is a growing body of evidence that this application has positive outcomes for patient satisfaction, surgeon satisfaction, and overall aesthetic appearance. This article summarizes the body of literature regarding these outcomes, reviews complications of fat grafting in the face and breast, and discusses controversies including radiologic imaging changes and longevity of grafting. Level of Evidence: 4

scholarly journals Proposed Treatment Protocols for Facial Rejuvenation using a Novel Absorbable Polydioxanone Monofilament Threadlift in Koreans: Empirical Perspectives of Aesthetic Physicians and Surgeons

2020 ◽  
Author(s):  
Doo-Yeoul Chang ◽  
Hyoung-Moon Kim ◽  
Tae Hwan Ahn ◽  
Sang Bong Lee ◽  
Hyoung-Jin Moon
Keyword(s):  
Current Treatment ◽  
Facial Rejuvenation ◽  
Empirical Treatment ◽  
Level Of Evidence ◽  
Treatment Protocols ◽  
Anatomical Characteristics ◽  
The Face ◽  
Practical Guidelines ◽  
The Aesthetic ◽  
Treatment Procedures

Abstract Background Aesthetic physicians and surgeons should consider differences in anthropometric and anatomical characteristics between Asians and Caucasians in performing facial rejuvenation procedures using absorbable threadlifts in Koreans. Objectives This paper was prepared to propose empirical treatment protocols for Korean aesthetic physicians and surgeons. Methods A panel of five Korean experts on the aesthetic uses of an absorbable polydioxanone (PDO) monofilament threadlift (Mint Lift®; HansBiomed Co Ltd., Seoul, Korea), thus termed as “the Mint Consensus Group,” was convened to recommend practical guidelines for empirical treatment with the Mint Lift®. Results To summarize, our recommendations are as follows: First, the entry and exit points should be determined considering anatomical characteristics of the face (Level of evidence III). Second, treatment procedures may vary depending on indications (Level of evidence III). Conclusions Here, we propose empirical treatment protocols for facial rejuvenation using a novel absorbable PDO monofilament threadlift in Koreans. But more evidence-based efforts should be made to update the current treatment protocols.

Facelift With Power-Assisted Dissection: A Preliminary Report

2020 ◽  
Author(s):  
Steven R Cohen ◽  
Sierra Hewett ◽  
Patrick Baraf ◽  
Sarah Jiwon Crowley ◽  
Michael Atlan
Keyword(s):  
Preliminary Report ◽  
Skin Aging ◽  
Postoperative Recovery ◽  
Fat Grafting ◽  
Volume Loss ◽  
Skin Flaps ◽  
Step Method ◽  
Level Of Evidence ◽  
Estimated Blood Loss ◽  
Soft Tissue Laxity

Abstract Background Subcutaneous elevation of the skin has remained a key component in all facelift techniques. Objectives The aim of this preliminary report was to introduce the ABC facelift as a 3-step method addressing photodamage, soft tissue laxity, and areas of bone and volume loss. Methods The procedure consists of: (A) anatomic and regenerative adipose grafting prior to skin elevation; (B) the use of a Baraf elevator for takedown of perpendicular subcutaneous fibers following hydrodissection of the skin flaps with tumescent solution; and (C) cautery dissection of the superficial muscular aponeurotic system (SMAS) and platysma in the neck. Results Thirty-four patients (31 females; 3 male), aged 50 to 77 years at the date of procedure, underwent an ABC facelift. Dissection of the skin flaps and SMAS elevation were faster than with traditional methods, averaging 10 to 15 minutes per hemiface. Bleeding was reduced (average estimated blood loss, 12 mL) and the skin flaps appeared better perfused with less venous engorgement and ecchymosis than achieved with sharp scissor dissection. In general, patients appeared to have shorter postoperative recovery courses and less social downtime secondary to bruising and edema. Conclusions The ABC facelift addresses facial laxity, volume loss, and skin aging with 3 simple steps: anatomic and regenerative fat grafting, combined with power-assisted dissection of the skin and cautery elevation of the SMAS. The use of more advanced hydrodissection tools to achieve further improvements in layer separation is currently being investigated. Level of Evidence: 4

Techniques for hand rejuvenation with fillers in aesthetic practice

2020 ◽  
Vol 9 (3) ◽  
pp. 108-113
Author(s):  
Kylie Melton
Keyword(s):  
Hyaluronic Acid ◽  
Calcium Hydroxyapatite ◽  
Volume Loss ◽  
Aesthetic Medicine ◽  
Aesthetic Practice ◽  
The Face ◽  
Hand Rejuvenation

The hands are an often-overlooked area of aesthetic medicine that can be improved upon to give a more complete anti-ageing improvement. The hand ages similarly to the face, with volume loss, wrinkling and pigmentation changes. The hands also have more tendons and veins, which become exposed with age. Fillers, such as hyaluronic acid and calcium hydroxyapatite, can be used to improve volume loss and camouflage the tendons and veins. To complete the rejuvenation, lasers/IPLs and peels can be used to improve the age spots to the back of the hands.

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