Various materials have been used for tissue augmentation and for the treatment of rhytids. Autologous fat transfer (AFT) is considered ideal regarding biocompatibility and patient concerns. This study was performed on a series of 215 female patients for face rejuvenation with tumescent technique fat harvesting and saline washing. The study was based on two AFT procedures for each patient. Second treatment was performed at least 1 month after the first operation. Their mean age was 55.5 ± 2.1 years. High-definition photographs in five standard views, front (n = 1), side (n = 2) and oblique of 3/4 (n = 2), were taken for the preoperative morphological study. Aesthetic outcomes were evaluated by the operating surgeon, the patient and an independent dermatologist. Outcomes were evaluated by comparing the preoperative photographs with those taken 1 month after the first procedure and at the end of the 1-year follow-up period. At 12 months all the patients except one noted an improvement. Of these 85.6% (184 patients) were satisfied with the treatment. The operating surgeon and the independent observer noted respectively a sufficient correction in 88.8 and 95.3%. AFT was considered painless by 94.9% and slightly painful by 5.1% of subjects. Fat tissue harvesting by tumescent anesthesia and purification with saline washing enable adipocyte viability to be preserved throughout the procedure and to perform the treatment under local anesthesia.

1.
Dallara JM: Subcutaneous tissue: anatomy and aging. Ann Dermatol Venereol 2009;136:S270–S272.
2.
Stuzin J, Baker T, Gordon H: The relationship of the superficial and deep facial fascias. Relevance to rhytidectomy and aging. Plast Reconstr Surg 1992;89:441–449.
3.
Gonzalez-Ulloa M, Flores E: Senelity of the face: basic study to understand its causes and effects. Plast Reconstr Surg 1965;36:239–246.
4.
Foyatier JL, Mojallal A, Vaulliaume D, et al: Clinical evaluation of structural fat tissue graft (Lipostructure®) in volumetric facial restoration with face-lift. About 100 cases. Ann Chir Plast Esthet 2004;49:437–455.
5.
Mandy SH: Satisfying patient expectations with soft-tissue augmentation. Dermatol Online J 2009;15:1.
6.
Carruthers J, Cohen SR, Joseph JH, et al: The science and art of dermal fillers for soft-tissue augmentation. J Drugs Dermatol 2009;8:335–350.
7.
Carruthers J, Fagien S, Matarasso SL; Botox Consensus Group: Consensus recommendations on the use of botulinum toxin type a in facial aesthetics. Plast Reconstr Surg 2004;114:1S–22S.
8.
Binder WJ, Azizzadeh B: Malar and submalar augmentation. Facial Plast Surg Clin North Am 2008;16:11–13.
9.
Stuzin JM: Restoring facial shape in face lifting: the role of skeletal support in facial analysis and midface soft-tissue repositioning. Plast Reconstr Surg 2007;119:362–376; discussion 377–378.
10.
Billings E Jr, May JW Jr: Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg 1989;83:368–381.
11.
Sattler G, Sommer B: Liporecycling: a technique for facial rejuvenation and body contouring. Dermatol Surg 2000;26:1140–1144.
12.
Neuber GA: Fettransplantation. Langenbecks Arch Klin Chir Ver Dtsch Z Chir 1893;22:66.
13.
Serra-Renom JM, Fontdevila J: Treatment of facial fat atrophy related to treatment with protease inhibitors by autologous fat injection in patients with human immunodeficiency virus infection. Plast Reconstr Surg 2004;114:551–555; discussion 556–557.
14.
McCulloch TM, Andrews BT, Hoffman HT, et al: Long-term follow-up of fat injection laryngoplasty for unilateral vocal cord paralysis. Laryngoscope 2002;112:1235–1238.
15.
Kershen RT, Atala A: New advances in injectable therapies for the treatment of incontinence and vesicoureteral reflux. Urol Clin North Am 1999;26:81–94.
16.
Niechajev I, Sevćuk O: Long-term results of fat transplantation: clinical and histologic studies. Plast Reconstr Surg 1994;94:496–506.
17.
Shiffman MA, Mirrafati S: Fat transfer techniques: the effect of harvest and transfer methods on adipocyte viability and review of the literature. Dermatol Surg 2001;27:819–826.
18.
Guerrerosantos J: Autologous fat grafting for body contouring. Clin Plast Surg 1996;23:619–631.
19.
Ersek RA, Chang P, Salisbury MA: Lipo layering of autologous fat: an improved technique with promising results. Plast Reconstr Surg 1998;101:820–826.
20.
Boschert MT, Beckert BW, Puckett CL, et al: Analysis of lipocyte viability after liposuction. Plast Reconstr Surg 2002;109:761–765; discussion 766–767.
21.
Butterwick KJ, Lack EA: Facial volume restoration with the fat autograft muscle injection technique. Dermatol Surg 2003;29:1019–1026.
22.
Sommer B, Sattler G: Current concepts of fat graft survival: histology of aspirated adipose tissue and review of literature. Dermatol Surg 2000;26:1159–1166.
23.
Kaya G, Saurat JH: Dermatoporosis: a chronic cutaneous insufficiency/fragility syndrome. Clinicopathological features, mechanisms, prevention and potential treatments. Dermatology 2007;215:284–294.
24.
Von Heimburg D, Zachariah S, Low A, et al: Influence of different biodegradable carriers on the in vivo behavior of human adipose precursor cells. Plast Reconstr Surg 2001;108:411–420; discussion 421–422.
25.
Manaloto RM, Alster TS: Periorbital rejuvenation: a review of dermatologic treatments. Dermatol Surg 1999;25:1–9.
26.
Olenius M: The first clinical study using a new biodegradable implant for the treatment of lips, wrinkles, and folds. Aesthetic Plast Surg 1998;22:97–101.
27.
Onesti M, Toscani M, Curinga G, et al: Assessment of a new hyaluronic acid filler. Double-blind, randomized, comparative study between Puragen and Captique in the treatment of nasolabial folds. In Vivo 2009;23:479–486.
28.
Bertossi D, Zancanaro C, Trevisiol L, et al: Lipofilling of the lips: ultrastructural evaluation by transmission electron microscopy of injected adipose tissue. Arch Facial Plast Surg 2003;5:392–398.
29.
Tzikas TL: Lipografting: autologous fat grafting for total facial rejuvenation. Facial Plast Surg 2004;20:135–143.
30.
Lidagoster MI, Cinelli PB, Levee EM: Comparison of autologous fat transfer in fresh, refrigerated, and frozen specimens: an animal model. Ann Plast Surg 2000;44:512–515.
31.
Condé-Green A, de Amorim NF, Pitanguy I: Influence of decantation, washing and centrifugation on adipocyte and mesenchymal stem cell content of aspirated adipose tissue: a comparative study. J Plast Reconstr Aesthet Surg 2010;63:1375–1381.
32.
Khater R, Atanassova P, Anastassov Y, et al: Clinical and experimental study of autologous fat grafting after processing by centrifugation and serum lavage. Aesthetic Plast Surg 2009;33:37–43.
33.
Klein JA: Anesthesia for liposuction in dermatologic surgery. J Dermatol Surg Oncol 1988;14:1124–1132.
34.
Böni R: Tumescent liposuction: efficacy of a lower lidocaine dose (400 mg/l). Dermatology 2010;220:223–225.
35.
Boeni R: Safety of tumescent liposuction under local anesthesia in a series of 4,380 patients. Dermatology 2011;222:278–281.
36.
Augustin M, Maier K, Sommer B, et al: Double-blind, randomized, intraindividual comparison study of the efficacy of prilocaine and lidocaine in tumescent local anesthesia. Dermatology 2010;221:248–252.
37.
Rigotti G, Marchi A, Galiè M, et al: Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 2007;119:1409–1422; discussion 1423–1424.
38.
De Ugarte DA, Ashjian PH, Elbarbary A, et al: Future of fat as raw material for tissue regeneration. Ann Plast Surg 2003;50:215–219.
39.
Coleman SR: Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 2006;118:108S–120S.
40.
Ersek RA: Transplantation of purified autologous fat: a 3-year follow-up is disappointing. Plast Reconstr Surg 1991;87:219–227.
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