Autologous fat transfer for facial recontouring: is there science behind the art?
BACKGROUND
Clinical use of autologous fat grafts for facial soft-tissue augmentation has grown in popularity in the plastic surgery community, despite a perceived drawback of unpredictable results.


METHODS
The authors' review of the literature and their current techniques of autologous fat transfer focused on (1) the donor site, (2) aspiration methods, (3) local anesthesia, (4) centrifugation and washing, (5) exposure to cold and air, (6) addition of growth factors, (7) reinjection methods, and (8) longevity of fat grafts.


RESULTS
Clinical experience and basic science data showed a slight preference for the following: harvesting abdominal fat with "nontraumatic," blunt cannula technique, preparation by means of centrifugation without washing or addition of growth factors, and immediate injection of small amounts of fat by means of multiple passes. Quantitative evidence of clinical fat survivability and predictability of volume restoration does not exist, yet reports of patient satisfaction with this procedure do. Clinicians report the need for revisionary procedures to optimize results.


CONCLUSIONS
Although there is an increased trend in replacement of soft-tissue volume with autologous fat transfer, the literature fails to provide definitive evidence of fat survival. A large-scale clinical assessment using three-dimensional volumetric imaging would provide useful outcome data.
Kaufman
Matthew R
MR
Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles.
Miller
Timothy A
TA
Huang
Catherine
C
Roostaien
Jason
J
Wasson
Kristy L
KL
Ashley
Rebekah K
RK
Bradley
James P
JP
D000273:Adipose Tissue / Q000637:transplantation*; D003357:Cosmetic Techniques; D005145:Face / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage; D015187:Lipectomy; D013048:Specimen Handling; D023822:Tissue Engineering; D020858:Tissue and Organ Harvesting; D014182:Transplantation, Autologous
D036341:Intercellular Signaling Peptides and Proteins