Superficial Enhanced Fluid Fat Injection (SEFFI) to Correct Volume Defects and Skin Aging of the Face and Periocular Region.
BACKGROUND
Although recent research on micro fat has shown the potential advantages of superficial implantation and high stem cell content, clinical applications thus far have been limited.


OBJECTIVE
The authors report their experience with superficial enhanced fluid fat injection (SEFFI) for the correction of volume loss and skin aging of the face in general and in the periocular region.


METHODS
The finer SEFFI preparation (0.5 mL) was injected into the orbicularis in the periorbital and perioral areas, and the 0.8-mL preparation was injected subdermally elsewhere in the face.


RESULTS
The records of 98 consecutive patients were reviewed. Average follow-up time was 6 months, and average volume of implanted fat was 20 mL and 51.4 mL for the 0.5-mL and 0.8-mL preparations, respectively. Good or excellent results were achieved for volume restoration and skin improvement in all patients. Complications were minor and included an oil cyst in 3 patients. The smaller SEFFI quantity (0.5 mL) was well suited to correct volume loss in the eyelids, especially the deep upper sulcus and tear trough, whereas the larger SEFFI content was effective for larger volume deficits in other areas of the face, including the brow, temporal fossa, zygomatic-malar region, nasolabial folds, marionette lines, chin, and lips.


CONCLUSIONS
The fat administered by SEFFI is easily harvested via small side-port cannulae, yielding micro fat that is rich in viable adipocytes and stem cells. Both volumes of fat (0.5 mL and 0.8 mL) were effective for treating age-related lipoatrophy, reducing facial rhytids, and improving skin quality.


METHODS
4 Therapeutic.
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Francesco P
FP
Bernardini
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Alessandro
A
Gennai
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Luigi
L
Izzo
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Alessandra
A
Zambelli
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Erica
E
Repaci
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Ilaria
I
Baldelli
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
G
G
Fraternali-Orcioni
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Morris E
ME
Hartstein
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Pier Luigi
PL
Santi
Drs Bernardini and Zambelli are oculofacial plastic surgeons in private practice in Genova, Milano, and Torino, Italy. Drs Gennai and Izzo are plastic surgeons in private practice in Bologna, Italy. Dr Repaci and Prof Dr Quarto are Researchers in the Department of Experimental Medicine, University of Genova, Italy. Dr Baldelli and Prof Dr Santi are Plastic Surgeons in the Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Italy. Dr Fraternali-Orcioni is a Pathologist in the Department of Pathology, University of Genova, Italy. Dr Hartstein is an Oculofacial Plastic Surgeon at Assaf Harofhe Medical Center in Zerifin, Israel.
Rodolfo
R
Quarto
D017667:Adipocytes / Q000637:transplantation*; D000273:Adipose Tissue / Q000166:cytology / Q000637:transplantation*; D000328:Adult; D000367:Age Factors; D000368:Aged; D064592:Autografts; D002454:Cell Differentiation; D002478:Cells, Cultured; D003357:Cosmetic Techniques; D004954:Esthetics; D005123:Eye; D005145:Face; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D008066:Lipolysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012060:Rejuvenation; D015595:Skin Aging; D033581:Stem Cell Transplantation; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome
enhanced fat implant; eyelid fat grafting; micro-grafting; periocular region; superficial fat implant; tissue regeneration with fat