Introduction
Fat grafting, also known as autologous fat transfer, is a relatively safe procedure because it is biocompatible, there is no risk of immunogenicity (an immune response to foreign substances), and it is widely available. In addition, it is an aesthetic and reconstructive process with an array of applications ranging from plastic surgery to wound healing.
The different types of fat grafting are:
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Autogenous (from the same patient) fat grafting.
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Dermal fat grafting.
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Free fat flaps.
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Fat injections.
What Are the Modern Fat Grafting Techniques for the Face and Neck?
With increasing numbers of patients opting for plastic surgery, researchers and surgeons are being pushed to develop new and improved innovative techniques to keep patients satisfied. According to ISAPS statistics, around half a billion facial fat grafting procedures are performed globally, which underscores the fact that more patients opt for facial aesthetic-enhancing procedures compared to the last decade. People will have greater access to these treatments as more doctors and surgeons are trained, which explains the rising numbers.
A few of the modern fat grafting techniques that are discussed here are:
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Second stage fat grafting in facial contour rejuvenation by reduction malarplasty.
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Facial autologous muscular injection (FAMI).
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Fat graft to the face with adjunctive micro-needling.
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Fat grafting to improve the results of a facelift.
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Autologous fat graft for facial deformity.
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Fat graft in periorbital rejuvenation.
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Cell assisted lipotransfer.
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Forehead fat grafting.
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Chin lift with fat graft.
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Neck rejuvenation.
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Autologous fat grafts in lip fillers.
What Is Second Stage Fat Grafting in Facial Contour Rejuvenation By Reduction Malarplasty?
Reduction malarplasty, also called zygomatic reduction surgery, is a plastic surgery procedure to reduce the width of the face. It is most common in the Asian population, where cheekbones are more prominent. The primary goal of malarplasty is to shape the cheek to suit the face’s contour. This procedure involves the following steps:
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Cutting the prominent part of the zygomatic bone that needs trimming.
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Bone fixation.
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Removal of fat from the buccal part of the face.
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Adjusting the position of adjacent muscles, fat and tiny nerves.
Reduction malarplasty, when combined with fat grafting, can yield better and longer-lasting results. However, there are cases where fat grafting or a facelift alone would not deliver satisfactory results. Nevertheless, this modern facial rejuvenation technique is gaining popularity due to its increased patient satisfaction and decreased reports of complications.
What Is the Facial Autologous Muscular Injection (FAMI) Procedure?
This procedure is a minimally invasive fat transfer procedure compared to its counterparts. First, the donor site is cleaned, and fat is harvested and re-injected into the desired area after proper refining. Although a lot of skill and science go into getting it done, patient comfort and convenience are paramount in the procedure.
This technique is far superior to the traditional fat grafting method because it considers the vascular pathways following the facial muscles, which leads to a more pronounced and long-lasting effect on the patient's face.
The FAMI procedure is done without any anesthesia, and the chances of allergic reactions are also absent since the patient's fat is used to fill voids.
Corrections that can be done using FAMI include the following:
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Hollow depressions on the face due to aging.
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Loss of fat in the cheek or chin areas.
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Sagging jaws due to the downward migration of fat.
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Drooping eyelids.
In most cases, patients can resume routine activities within a few days. There might be slight discomfort and swelling, but other complications are rare.
What Is Fat Graft to the Face With Adjunctive Micro-Needling?
Despite the benefits of fat grafting for the face, the major downside of this procedure is its inconsistent viability. However, with more options available to replace or accompany fat grafting, the disadvantages are rarely overlooked.
Microneedling is a newer addition to the cosmetic world. It is rapidly gaining popularity with its visible and long-lasting effects, especially when done alongside a fat grafting procedure. Microneedling is a simple procedure that involves rolling a cylindrical tool over the affected area. This tool contains numerous tiny needles that help create thousands of microchannels over the skin, providing a controlled trauma environment. This results in collagen induction, leading to younger-looking skin and a reduced appearance of scars.
Microneedling tools are available in the market for use at home. But the ideal situation would require a qualified dermatologist or plastic surgeon to perform the procedure.
What Is Fat Grafting to Improve the Results of a Facelift?
A facelift, called a rhytidectomy, is plastic surgery done on the face and neck. As the name suggests, this treatment helps to remove signs of aging like wrinkles and loose skin and tighten facial tissues. Overall, this procedure aims to give the patient a more youthful look.
Even though it is a very successful procedure, the results are less long-lasting than hoped. Therefore, combining it with an autologous fat graft procedure is necessary to boost its effectiveness and increase its longevity.
It is to be noted that facelifts fail to address age-related volume loss. Face-related aging issues are rarely isolated. Volume loss is usually accompanied by loose skin or ptosis (drooping). Hence, a combination of fat grafting and a facelift can be done to successfully and efficiently address these issues.
What Role Does Fat Graft Play in Periorbital Rejuvenation?
The eye area, or periorbital region, is the most prone to aging on the face. Sunken eyes, drooping eyelids, and under-eye wrinkles are some of the most common aging signs related to the eye. In addition, people in the modern world, where technology is abundant, spend hours in front of screens, resulting in premature skin and eye aging.
Treatment options like fillers have always been popular, but with recent studies, fat grafting as a periorbital rejuvenation technique has seen more success. Since the periorbital area is very delicate, it needs extra skill to complete the procedure successfully. Make sure the surgeon is equipped with the required skill set.
The treatment involves various steps:
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Proper evaluation and assessment by the surgeon.
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Collecting fat from dense areas like the thigh, abdomen, etc.
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Subjecting the fat cells to centrifugation to collect pure and healthy fat cells.
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Aestheticization of the face.
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Careful introduction of the healthy fat cells into the localized periorbital area.
The advantages of fat grafting in periorbital rejuvenation are:
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High safety and a lower chance of allergic reactions.
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Low downtime after the procedure.
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Minimally invasive.
What Is Cell-Assisted Lipotransfer(CAL)?
It is a modern method of autologous fat grafting that includes modifying the fat with adipose stem cells. This method has the potential to aid in various conditions where conventional methods fail to show promising results.
Adipose-derived stem cells (ADSC) are becoming increasingly attractive due to their ease of harvest and availability. ADSC (adipose-derived stem cells) are harvested from adipose tissues by liposuction, filtration, and centrifugation. These cells are then used along with lipo injections in cell-assisted lipotransfer (CAL).
There are several applications of CAL (cell-assisted lipotransfer) such as:
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Combined with injectable scaffolds as fillers.
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In post-mastectomy breast augmentation.
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In cosmetic breast augmentation.
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To treat side effects of radiation.
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Helps in increasing angiogenesis (blood vessel formation).
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To improve the efficiency of grafts.
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In conditions like lupus erythematosus profundus and parry-romberg syndrome.
How Are Fat Grafts Used in Neck Rejuvenation?
A younger-looking neck plays a vital role in improving aesthetics, which is possible through the fat grafting technique, becoming the treatment of choice in such cases.
Fat grafts in the neck can not only enhance appearance but also help increase the thickness of the fat layer, which helps increase collagen production.
This treatment aims to increase fat thickness under the skin, creating a fuller look. It also helps to remove lines or wrinkles that might have developed over time.
What Is the Role of Fat Grafts in Lip Fillers?
Lip fillers are a lip augmentation procedure to address the loss of volume or correct the shape of the lips. It is one of the most commonly performed plastic surgeries worldwide due to its ease and convenience for the patient.
Traditionally, hyaluronic acid injections were used as lip fillers. However, the satisfaction rate for this procedure among patients decreased because it needed to give permanent results. Touch-up or refilling sessions are needed to maintain hyaluronic acid lip fillers.
An alternative to hyaluronic acid fillers that has been gaining popularity is fat grafts. The reason for its popularity is its permanent nature, and there is usually no need for a second session.
Unfortunately, there is a downside to this treatment. Since the viability of autologous fat cells transferred cannot be assured, some cells are likely to die after the treatment. To combat this aspect, surgeons usually tend to overfill lips, which can be aesthetically unappealing. In other cases, all the cells might die, and the treatment will have to be repeated, which is an inconvenience.
What Are the Risks and Complications Involved in Fat Grafting?
Fat grafting comes with risks and potential complications like any other cosmetic procedure. Some risks are:
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Anesthesia complications.
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Bleeding during surgery.
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Blood clots.
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Infection.
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Skin scarring.
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Skin discoloration.
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Asymmetry.
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Allergic reaction.
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Sagging of skin.
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Fat necrosis.
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Delayed healing.
Conclusion
The modern techniques coming up in cosmetic surgery are promising, and they allow patients to safely alter or improve faulty features of the face and neck. But people should be informed enough not to overdo any treatment, which can harm the health of the person involved. Always make sure that the benefits outweigh the risks before undergoing any procedure.
