Facial Rejuvenation With Fat Grafting and Fillers

Abstract

Facial rejuvenation requires a multi-modality approach to address the sun damage, volume loss, and thinning of skin that occurs with aging. With age, the collagen fibrils that provide strength become fragmented and fibroblasts connections become weak, leading to skin laxity and loss of youthful skin. Fillers can lead to a more youthful appearance by providing volumetric support. Synthetic fillers such as hyaluronic acid products, calcium hydroxyapatite, polylactic acid, and polymethylmethacralate have bio-stimulatory affects, ranging from small effects on fibroblast production to prolonged stimulatory effects on dermal thickness and blood supply. Fat grafting is also an ideal technique for facial rejuvenation because it is readily available, natural, and has regenerative effects. This review describes a new technique of fat grafting for the face called Injectable Tissue Replacement and Regeneration that specifically addresses the different anatomic compartments of the face with volume loss. With this brief review, we aim to evaluate the currents trends of fat grafting and fillers in the management of facial rejuvenation, including the cellular changes that occur with facial aging, the bio-stimulatory effects of fillers, and the anatomic replacement of tissue with fat grafting. >Level of Evidence: 4

Contouring and augmentation of the temple using stromal vascular fraction gel grafting

“…Fat grafting and other filler injections have been widely applied in facial contouring for decades. However, the selected techniques are based on surgeons' clinical experiences, and the injection plane for filler placement varies between surgeons ( 12 ). An anatomical study of the temple ( 13 ) showed that the temporal region is comprised of two compartments, the UTC and the LTC, which are separated by the ITC.…”

Benefit of Hyaluronic Acid to Treat Facial Aging in Completely Edentulous Patients

“…Animal collagen and synthetic fillers (hyaluronic acid, calcium hydroxyapatite, polylactic acid, and polymethylmethacrylate) have volumetric and biological effects, such as effects on fibroblast production and angiogenesis. Fat grafting and autologous platelet-derived preparations are also interesting techniques for facial rejuvenation because they are autologous and have regenerative effects [ 38 ].…”

Ultrasound Imaging of Facial Vascular Neural Structures and Relevance to Aesthetic Injections: A Pictorial Essay

“…The forehead and glabella represent the most common sites for filler injections [ 11 ]. The injectables should be introduced within the loose connective tissue above the periosteum for wrinkle reduction and volume expansion.…”

“…Filler injections into the temporal area are useful to correct atrophy secondary to age-induced fat loss [ 11 ]. Medial infraorbital region injections are used to trim the tear trough, which is a deep crease between the lower eyelid and upper cheek.…”

“…Filler injections administered medial to the depressor anguli oris muscle can reduce prominent marionette lines. Injections over the mental region improve the appearance of an under-projected chin [ 11 ].…”