Steven R Cohen1, Sierra Hewett2, Lauren Ross3, Michele Fischer4, Ahmad Saad5, Savanna Teubel4, Flore Delaunay6. 1. Clinical Professor, Division of Plastic Surgery, University of California, San Diego, CA. 2. Research Assistant, University of California, San Diego, CA. 3. Research Intern, Chapman University, Orange, CA. 4. Research coordinators at a private plastic surgery practice in San Diego, CA. 5. Plastic Surgeon, Division of Plastic Surgery, Clemenceu Medical Center, John Hopkins Medicine International, Beirut, Lebanon. 6. Plastic Surgeon, Division of Plastic Surgery, Hospital Le Belvedere, Mont Saint Aignan, France.
Abstract
BACKGROUND: Although many facelift techniques incorporate fat grafting with tissue repositioning and removal, the intermediate and long-term changes in facial volume after these techniques is unknown. Whereas fillers for facial volume have predictable life spans, we know little about the facial volume changes following fat grafting with facelift surgery. OBJECTIVES: The authors sought to track the short-term and long-term effects on midfacial volume change. METHODS: We evaluated a subset of patients who were followed by 3-dimensional (3D) photometric imaging 18 to 24 months after facelift with fat grafting to the deep midfacial fat compartments and buccal fat pads. Volume changes were measured preoperatively and postoperatively every 1, 3, 6, 12, 18, and 24 months using the 3D photometry. RESULTS: At the 1- to 2-month follow-up period, average facial volume was 49.60% of the initial fat injected. At the 18- to 24-month follow-up period, average facial volume was 73.64% of the initial fat injected, indicating an increase in midfacial volume. Upon graphing available photometric data, dynamic changes in facial volume were observed. In 5 midfacial zones, facial volume appeared to initially decline (average decline, 49.0% of original fat injection), troughing at 10 months (range, 2-15 months), but later inclined (average increase in volume, 95.9% of original fat injection), peaking around 16 months (range, 4-24 months). CONCLUSIONS: Progressive improvement in midfacial volume in part may be explained by the graft replacement theory of Suga and Yoshimura, which suggests that grafted adipose tissue immediately dies after transplantation and is replaced by adipose-derived stem or progenitor cells. Published by Oxford University Press on behalf of The American Society for Aesthetic Plastic Surgery 2018.
BACKGROUND: Although many facelift techniques incorporate fat grafting with tissue repositioning and removal, the intermediate and long-term changes in facial volume after these techniques is unknown. Whereas fillers for facial volume have predictable life spans, we know little about the facial volume changes following fat grafting with facelift surgery. OBJECTIVES: The authors sought to track the short-term and long-term effects on midfacial volume change. METHODS: We evaluated a subset of patients who were followed by 3-dimensional (3D) photometric imaging 18 to 24 months after facelift with fat grafting to the deep midfacial fat compartments and buccal fat pads. Volume changes were measured preoperatively and postoperatively every 1, 3, 6, 12, 18, and 24 months using the 3D photometry. RESULTS: At the 1- to 2-month follow-up period, average facial volume was 49.60% of the initial fat injected. At the 18- to 24-month follow-up period, average facial volume was 73.64% of the initial fat injected, indicating an increase in midfacial volume. Upon graphing available photometric data, dynamic changes in facial volume were observed. In 5 midfacial zones, facial volume appeared to initially decline (average decline, 49.0% of original fat injection), troughing at 10 months (range, 2-15 months), but later inclined (average increase in volume, 95.9% of original fat injection), peaking around 16 months (range, 4-24 months). CONCLUSIONS: Progressive improvement in midfacial volume in part may be explained by the graft replacement theory of Suga and Yoshimura, which suggests that grafted adipose tissue immediately dies after transplantation and is replaced by adipose-derived stem or progenitor cells. Published by Oxford University Press on behalf of The American Society for Aesthetic Plastic Surgery 2018.
Authors: Angelo Trivisonno; Robert W Alexander; Silvia Baldari; Steven R Cohen; Giuliana Di Rocco; Pietro Gentile; Guy Magalon; Jérémy Magalon; Randy B Miller; Hayley Womack; Gabriele Toietta Journal: Stem Cells Transl Med Date: 2019-10-10 Impact factor: 6.940
Authors: Steven R Cohen; Tunç Tiryaki; Hayley A Womack; Serli Canikyan; Kai Uwe Schlaudraff; Michael Scheflan Journal: Aesthet Surg J Open Forum Date: 2019-09-29