Autologous Fat Transfer for Face Rejuvenation with Tumescent Technique Fat Harvesting and Saline Washing: A Report of 215 Cases

Abstract

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.

Autologous Fat Transfer for Facial Rejuvenation: A Systematic Review on Technique, Efficacy, and Satisfaction

“…The number of AFT sessions was reported in 11 studies 9 , 36 , 39 – 41 , 45 – 47 , 49 , 51 , 52 and varied from 1 to 4 with an mean interval of 4.25 months. 39 – 41 , 47 , 49 , 52 Postoperative management varied greatly among the 9 reporting studies 35 , 39 , 41 , 43 – 46 , 48 , 52 and was even contradictory with Ibrahiem et al 52 recommending massage, as opposed to other studies.…”

“…All articles described, to some extent, the methods of preparing and grafting the adipose tissue (Table 2 ). 9 , 35 , 36 , 38 – 52 Eleven out of 14 studies used a local form of anesthesia, 9 , 36 , 38 – 42 , 44 – 46 , 48 , 49 , 51 , 52 and 3 authors preferred general anesthesia. 35 , 47 , 50 The abdomen was the primary donor site in most studies with fat from the thigh and flank area used in cases of insufficient supply.…”

“… 35 , 47 , 50 The abdomen was the primary donor site in most studies with fat from the thigh and flank area used in cases of insufficient supply. The infiltration cannula size was poorly reported, with 3 studies 35 , 40 , 46 reporting using 1-, 2-, or 3-mm cannulas, respectively, and the infiltration solution varied widely among studies. Ten studies 9 , 35 , 40 , 41 , 45 – 50 (additionally) used some form of local anesthetic in combination with different solutions of epinephrine and saline before harvesting by way of manual aspiration in 16 of the 18 reporting studies.…”

“… 36 , 45 The injection cannula sizes ranged from 1 to 3 mm (14–23 gauge) and were mostly blunt with 2 studies reporting using lateral openings 35 , 48 and 1 study using a ratchet gun for precise fat distribution. 46 For the injections, most studies described a retrograde injection technique. The primary site of injection was the subcutaneous space with additional injections most often performed above or just beneath the superficial muscular aponeurotic system (SMAS).…”

“…A total of 9 studies 9 , 35 , 36 , 39 , 41 , 44 , 46 , 48 , 52 reported on patient and/or surgeon satisfaction either on a visual analog scale (VAS) or a 2-4 point Likert scale (Table 5 ). Meta-analysis for patient satisfaction was performed after conversion to a dichotomous scale (see Tables, Supplemental Digital Content 3, which displays patient satisfaction results, http://links.lww.com/PRSGO/A630 ).…”