Felipe Molina-Burbano1, J Michael Smith2, Michael J Ingargiola1, Saba Motakef3, Paymon Sanati1, Jocelyn Lu1, Peter J Taub1, Michael E Hill3. 1. Drs Molina-Burbano, Ingargiola, Sanati, and Lu are Residents, and Dr Taub is the Program Director, Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY. 2. Dr Smith is a Resident, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Texas Medical Branch, Galveston, TX. 3. Dr Motakef is a Resident and Dr Hill is the Program Director, Department of Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, CA.
Abstract
BACKGROUND: Autologous fat grafting is a helpful supplement to facelift surgery that helps to combat age-related volume loss of facial structures. Despite the widespread prevalence of combined facelift and fat-grafting, there exists significant procedural variation between providers. OBJECTIVE: The primary purpose of this systematic review is to study the efficacy and complication rates of facelift with lipofilling compared with facelift alone. METHODS: A systematic review of the Cochrane Library and MEDLINE databases as completed to identify all clinical reports of fat grafting combined with facelift surgery using the following key terms: ('fat grafting' OR 'lipotransfer' OR 'lipofilling' OR 'fat transfer') AND ('facelift' OR 'rhytidectomy' OR 'SMASectomy' OR 'facial rejuvenation'). Data on techniques, outcomes, complications, and patient satisfaction were collected. RESULTS: The systematic review was performed in April 2017. 248 articles were identified for review. After application of exclusion criteria, a total of 15 primary studies were included in this review. Various facelift techniques were used, including deep-plane or sub-SMAS facelift, SMAS facelift, modified MACS lift, component facelift, midface lift, SMAS plication, SMAS-stacking/SMASectomy, and SMASectomy. The most common locations of fat graft injection included the nasolabial folds, tear troughs, temporal regions, midface/cheek/malar eminence, marionette groove, lips, and ear lobes. The addition of fat grafting to facelift surgery resulted in significant improvement in facial volume and aesthetic assessments. CONCLUSIONS: Combined facelift and fat grafting is a safe and efficacious means to simultaneously address age-related ptosis and volume loss. Further research is required to validate and improve existing treatment modalities.
BACKGROUND: Autologous fat grafting is a helpful supplement to facelift surgery that helps to combat age-related volume loss of facial structures. Despite the widespread prevalence of combined facelift and fat-grafting, there exists significant procedural variation between providers. OBJECTIVE: The primary purpose of this systematic review is to study the efficacy and complication rates of facelift with lipofilling compared with facelift alone. METHODS: A systematic review of the Cochrane Library and MEDLINE databases as completed to identify all clinical reports of fat grafting combined with facelift surgery using the following key terms: ('fat grafting' OR 'lipotransfer' OR 'lipofilling' OR 'fat transfer') AND ('facelift' OR 'rhytidectomy' OR 'SMASectomy' OR 'facial rejuvenation'). Data on techniques, outcomes, complications, and patient satisfaction were collected. RESULTS: The systematic review was performed in April 2017. 248 articles were identified for review. After application of exclusion criteria, a total of 15 primary studies were included in this review. Various facelift techniques were used, including deep-plane or sub-SMAS facelift, SMAS facelift, modified MACS lift, component facelift, midface lift, SMAS plication, SMAS-stacking/SMASectomy, and SMASectomy. The most common locations of fat graft injection included the nasolabial folds, tear troughs, temporal regions, midface/cheek/malar eminence, marionette groove, lips, and ear lobes. The addition of fat grafting to facelift surgery resulted in significant improvement in facial volume and aesthetic assessments. CONCLUSIONS: Combined facelift and fat grafting is a safe and efficacious means to simultaneously address age-related ptosis and volume loss. Further research is required to validate and improve existing treatment modalities.