LAUSR

Background Although many facelift techniques incorporate fat grafting with tissue repositioning and removal, the intermediate and long-term changes in facial volume after these techniques is unknown. Whereas fillers for facial volume have predictable life spans, we know little about the facial volume changes following fat grafting with facelift surgery. Objectives To track the short-term and long-term effects on midfacial volume change. Methods We evaluated a subset of patients who were followed by 3D photometric imaging 18-24 months after facelift with fat grafting to the deep midfacial fat compartments and the buccal fat pads. Volume changes were measured preoperatively and postoperatively every 1, 3, 6, 12, 18, and 24 months using the 3D photometry. Results At the 1-2 month follow-up period, average facial volume was 49.60% of the initial fat injected. At the 18-24 month follow-up period, average facial volume was 73.64% of the initial fat injected, indicating an increase in midfacial volume. Upon graphing available photometric data, dynamic changes in facial volume were observed. In five midfacial zones, facial volume appeared to initially decline (average decline, 49.0% of original fat injection) troughing at 10 months (range, 2-15 months), but later inclined, (average increase in volume, 95.9% of original fat injection) peaking around 16 months (range, 4 to 24 months). Conclusions Progressive improvement in midfacial volume in part may be explained by the graft replacement theory of Suga and Yoshimura, which suggests that grafted adipose tissue immediately dies after transplantation and is replaced by adipose-derived stem or progenitor cells.