Micro and Nano Fat Grafting

Natural Choices for Facial Rejuvenation

By: Beth Phillips, RPAC

Working in a plastic surgery office, I frequently have patients coming in begging for “HELP”! I think this time of year, when our skin is a little drier and less sun-kissed, many patients feel that their skin just looks “OLD.”

The good news is that there are many new modalities for rejuvenation of the skin and face. While much of my day consists of placing Botox (or Xeomin or Dysport) and/or fillers (ie. Juvederm, Restylane, Radiesse) there continue to be many patients looking for a more permanent option. In those cases, I would say, “Fat is where it’s at!!”

In previous articles, I have discussed structural fat grafting and its uses in reconstruction. Over the past several years, techniques have been continually improving for its uses for facial rejuvenation.

As we age, the fat volume in our faces decreases, which can result in a sunken appearance around the eyes and in the cheeks, as well as contribute to formation of nasolabial folds (laugh lines or “parentheses”) and marionette lines. Volume is also lost in the lips and superficial wrinkles from in the skin. Although these areas are commonly treated with injectable fillers, fat is an exciting option that can provide natural and more permanent results.

Facial fat grafting, also known as fat transfer or stem cell grafting, is a procedure that uses the patient’s own fat to rejuvenate and augment certain areas of the face. The fat is harvested from a donor site (usually the abdomen) via liposuction and then processed and injected into areas of the face to replace lost volume. The fat cells will develop blood supply from the surrounding tissue and “take,” meaning that the volume added will not be lost. Typically, about 50-80% of the injected fat takes, with the remaining fat being absorbed. Because of this, sometimes a few treatments are needed to achieve the desired volume.

In addition, the fat cells that are injected contain stem cells. Stem cells are special cells in our bodies that have the ability to change into any other cell type to replace aging or damaged cells.

In the face, these cells can aid with adding volume, but also rejuvenate the skin and secrete hormones that repair damaged skin. After fat grafting, patients typically notice improved skin quality as well as volume.

Although fat grafting to the face has been done for many years, recent advances have resulted in much better results. It has been found that survival of fat is very dependent on the particle size and how it is harvested. These techniques are referred to as Microfat grafting and Nano-fat grafting.

Microfat grafting, or droplet grafting, uses a very fine cannula with very small holes to obtain the fat. The fat is then rinsed and handled very gently, to minimize damage to the cells. It is then injected using very fine blunt needles, also called cannulas. It must be injected very precisely to obtain the best results. This is a technique where experience makes a dramatic difference in results.

Typical areas injected include the cheeks, lower and upper eyelids, nasal grooves, lips, and temple hollows. The injections tend to take longer than filler injections as the fat needs to be obtained and processed before being injected. The injections themselves are a bit more involved, and the recovery is a bit longer than with typical fillers. Most patients will be a bit bruised and swollen for several days. The results, however, are long-lasting and very natural.

Nanofat grafting is a technique that utilizes the growth factors in fat to the maximum degree.

Fat calls are harvested and them broken down or “emulsified.” This results in the growth factors being released and the fat to be very liquid. Using very fine needles, the fat in injected just beneath the skin surface. This does not add volume, but delivers the growth factors which have been shown to improve skin texture. There have been some promising results with using nanofat to treat dark under eye circles.

Another new technique is called Sharp Needle Intradermal Fat grafting, or SNIF. This treats very superficial lines of the face. Micro fat is injected with a sharp needle just below the skin, treating very fine skin wrinkles. This was not possible with the larger fat particles used in the past. This works particularly well with fine wrinkles along the upper and lower lips and around the mouth. Acne scars can be treated by this technique as well.

So it appears that help is on the way!! Facial rejuvenation has evolved dramatically over recent years. Achieving a natural result is less about removing skin than about adding back lost volume. Facial fat grafting is the next frontier and can provide natural, more permanent results. Learn more by visiting www.plasticsurgeryofsyracuse.com or schedule a consultation at 315-663-0112