Concurrent structural fat grafting and carbon dioxide laser resurfacing for perioral and lower face rejuvenation.
OBJECTIVE
To quantitatively evaluate a dual-modality treatment that combines autologous structural fat grafting and carbon dioxide (CO(2)) laser resurfacing for perioral and lower face rejuvenation.


METHODS
Retrospective review of patients undergoing rejuvenation by a single surgeon between 2005 and 2009. A blinded expert rated photographs on three scales, each with a range of 1 (no abnormality) to 5 (severe abnormality): (i) perioral fine rhytids; (ii) deep folds; and (iii) pigmentary or cutaneous abnormalities. Within-subject comparisons were generated. Results were correlated with skin type (Fitzpatrick) and baseline photodamage (Glogau). A test for effect of adjunctive procedures was performed.


RESULTS
Seventeen patients were included (all female, mean age 61 years). Significant postoperative improvement was noted for perioral fine rhytids (3.1 to 1.7, p < 0.0001); deep folds (3.4 to 2.0, p < 0.00001); and pigmentation (2.5 to 1.9, p = 0.02). Fitzpatrick skin type was inversely correlated with improvement in pigmentation scores (r = -0.78), while the Glogau score correlated with improvement of fine rhytids (r = 0.76). No significant effect of adjunctive procedures was found. No complications occurred, though fat grafts resorbed in one patient.


CONCLUSIONS
Concurrent structural fat grafting and CO(2) resurfacing result in quantifiable improvement of perioral and lower face aesthetics in relation to baseline characteristics and independent of adjunctive surgical procedures.
Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19103, USA. evan.ransom@uphs.upenn.edu
Evan R
ER
Ransom
Marcelo B
MB
Antunes
Jason D
JD
Bloom
Timothy
T
Greco
D000273:Adipose Tissue / Q000637:transplantation*; D000368:Aged; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D058629:Plasma Skin Regeneration; D012060:Rejuvenation; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging; D019737:Transplants; D016896:Treatment Outcome