Panfacial volume restoration with fat.
BACKGROUND
A careful look at the aging face shows it to consist of more than loose skin and rhytids. With aging, the face loses its anterior projection, with a resultant displacement of skin inferiorly. There is mimetic muscular accentuation and an abundance of deep grooves and shadows. In addition, fat redistributes in specific patterns in overweight versus lean individuals.


OBJECTIVE
To restore the three-dimensional projection and overall shape of the face to more youthful contours and to eliminate shadowing and muscle to skin interactions.


METHODS
Autologous fat is harvested with an open-tipped, blunt cannula under tumescent anesthesia. It is then transferred to 1 mL syringes for injection into the face under local anesthesia. Fat is woven into the deep tissues of the face using a small-bore blunt cannula. The entire face is addressed by filling one cosmetic unit at a time. Fat is anchored deep to the muscles, in the muscles, and subcutaneously depending on the anatomic site and desired result.


RESULTS
Dramatic changes in contour are achieved with judicious placement of fat. Skin redraping and the interruption of muscle to skin interactions occur when autologous fat is infiltrated in small aliquots, with specific direction at appropriate tissue levels. Complications are rare and minor with this technique.


CONCLUSIONS
Autologous fat is an excellent tool for replacing volume and restoring contour to the aging face.
Donofrio
Lisa M
LM
Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA. donofrio@pobox.com
D000273:Adipose Tissue / Q000637:transplantation*; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging; D013525:Surgical Instruments; D014182:Transplantation, Autologous; D016896:Treatment Outcome