Autologous Granular Fat Grafting In Facial Plastic And Aesthetic Surgery

Objective: The Long-term follow-up of the clinical outcome and experience of autologous granular fat grafting in facial plastic and aesthetic surgery.Methods: 1. Preparation of Granular Fat:Donor sites may include low abdomen, hips, thighs etc.. The harvest of adipose tissue via the harvesting cannula connected to a 20-m L disposable sterile syringe to liposuction under local tumescent anesthesia. After the harvesting phase, leave to the syringes with fat granules stand vertically for few minutes, and then separate out the bottom layer composed of debris, anesthetic solutions and small amounts of red blood cells, rinse with normal saline repeatedly. In addition, pick out fibrous bundles and cellulite with a blunt tip as possible. Finally get the fraction of pure fat granules in the syringes. 2. Fat Injection Technique: The entry point set from about 1 cm of the edge of the recipient sites infiltrated 2% Lidocaine for local anesthesia. Fat granules are injected radially from distal to proximal into the affected areas of the face with low volume for each pass via multi-tunnels, multi-planes and multi-points. Adipose tissue should be injected only as the cannula is withdrawn. Routinely inject more than required volume of fat granules for overcorrection. Gentle massage is done to ensure a smooth correction.Results: 145 patients were treated using the described technique during the period between 1997 and 2014.The indications for autologous granular fat grafting consisted of hemifacial atrophy(30 cases), periocular hollowing(20 cases), nasolabial groove(15 cases), temples(10 cases), cheek(30 cases), frontal(10cases) and chin(10 cases). Postoperatively, all cases were followed up for 3 months to 12 years. The satisfaction was comprehensively evaluated by facial symmetry; the outcomes of recipient sites and the perceptions of patients. Except for 5 cases of hemifacial atrophy were assessed as unsatisfactory and repaired by additional fat grafting. The rest of cases were assessed as satisfactory. The satisfied result has been obtained.Conclusion: The result from autologous granular fat grafting by using a small quantity of adipose tissue in facial plastic and aesthetic surgery seems stable, efficient and well-survived.