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Erschienen in: Aesthetic Plastic Surgery 5/2018

08.08.2017 | Review

Fat Injection: A Systematic Review of Injection Volumes by Facial Subunit

verfasst von: Shirley Shue, David E. Kurlander, Bahman Guyuron

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 5/2018

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Abstract

Background

Fat grafting to the aging face has become an integral component of esthetic surgery. However, the amount of fat to inject to each area of the face is not standardized and has been based mainly on the surgeon’s experience. The purpose of this study was to perform a systematic review of injected fat volume to different facial zones.

Methods

A systematic review of the literature was performed through a MEDLINE search using keywords “facial,” “fat grafting,” “lipofilling,” “Coleman technique,” “autologous fat transfer,” and “structural fat grafting.” Articles were then sorted by facial subunit and analyzed for: author(s), year of publication, study design, sample size, donor site, fat preparation technique, average and range of volume injected, time to follow-up, percentage of volume retention, and complications. Descriptive statistics were performed.

Results

Nineteen articles involving a total of 510 patients were included. Rhytidectomy was the most common procedure performed concurrently with fat injection. The mean volume of fat injected to the forehead is 6.5 mL (range 4.0–10.0 mL); to the glabellar region 1.4 mL (range 1.0–4.0 mL); to the temple 5.9 mL per side (range 2.0–10.0 mL); to the eyebrow 5.5 mL per side; to the upper eyelid 1.7 mL per side (range 1.5–2.5 mL); to the tear trough 0.65 mL per side (range 0.3–1.0 mL); to the infraorbital area (infraorbital rim to lower lid/cheek junction) 1.4 mL per side (range 0.9–3.0 mL); to the midface 1.4 mL per side (range 1.0–4.0 mL); to the nasolabial fold 2.8 mL per side (range 1.0–7.5 mL); to the mandibular area 11.5 mL per side (range 4.0–27.0 mL); and to the chin 6.7 mL (range 1.0–20.0 mL).

Conclusions

Data on exactly how much fat to inject to each area of the face in facial fat grafting are currently limited and vary widely based on different methods and anatomical terms used. This review offers the ranges and the averages for the injected volume in each zone.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Coleman SR (1995) Long-term survival of fat transplants: controlled demonstrations. Aesthetic Plast Surg 19:421–425CrossRef Coleman SR (1995) Long-term survival of fat transplants: controlled demonstrations. Aesthetic Plast Surg 19:421–425CrossRef
2.
Zurück zum Zitat Meier JD, Glasgold RA, Glasgold MJ (2009) Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg 11:24–28CrossRef Meier JD, Glasgold RA, Glasgold MJ (2009) Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg 11:24–28CrossRef
3.
Zurück zum Zitat Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118:108S–120SCrossRef Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118:108S–120SCrossRef
4.
Zurück zum Zitat Coleman SR (2006) Facial augmentation with structural fat grafting. Clin Plastic Surg 36:567–577CrossRef Coleman SR (2006) Facial augmentation with structural fat grafting. Clin Plastic Surg 36:567–577CrossRef
5.
Zurück zum Zitat Coleman SR, Katzel EB (2015) Fat grafting for facial filling and regeneration. Clin Plastic Surg 42:289–300CrossRef Coleman SR, Katzel EB (2015) Fat grafting for facial filling and regeneration. Clin Plastic Surg 42:289–300CrossRef
6.
Zurück zum Zitat Boneti C, Anakwenze CP, Torre J, Weaver TL, Collawn SS (2016) Two-year follow-up of autologous fat grafting with laser-assisted facelifts. Ann Plast Surg 76:S260–S263CrossRef Boneti C, Anakwenze CP, Torre J, Weaver TL, Collawn SS (2016) Two-year follow-up of autologous fat grafting with laser-assisted facelifts. Ann Plast Surg 76:S260–S263CrossRef
7.
Zurück zum Zitat Gerth DJ, King B, Rabach L, Glasgold RA, Glasgold MJ (2014) Long-term volumetric retention of autologous fat grafting processed with closed-membrane filtration. Aesth Surg 34:985–994CrossRef Gerth DJ, King B, Rabach L, Glasgold RA, Glasgold MJ (2014) Long-term volumetric retention of autologous fat grafting processed with closed-membrane filtration. Aesth Surg 34:985–994CrossRef
8.
Zurück zum Zitat Hendy A (2010) Facial re-contouring using autologous fat transfer. J Plast Reconstr Surg 34:65–69 Hendy A (2010) Facial re-contouring using autologous fat transfer. J Plast Reconstr Surg 34:65–69
9.
Zurück zum Zitat Isik S, Sahin I (2012) Contour restoration of the forehead by lipofilling: our experience. Aesth Plast Surg 36:761–766CrossRef Isik S, Sahin I (2012) Contour restoration of the forehead by lipofilling: our experience. Aesth Plast Surg 36:761–766CrossRef
10.
Zurück zum Zitat Lawrence CY (2000) Rejuvenative facial lipomorphoblasty. Aesth Plast Surg 24:22–27 Lawrence CY (2000) Rejuvenative facial lipomorphoblasty. Aesth Plast Surg 24:22–27
11.
Zurück zum Zitat Niechajev I, Sevcuk O (1994) Long-term results of fat transplantation: clinical and histologic studies. Plast Reconstr Surg 94:496–506CrossRef Niechajev I, Sevcuk O (1994) Long-term results of fat transplantation: clinical and histologic studies. Plast Reconstr Surg 94:496–506CrossRef
12.
Zurück zum Zitat Wang W, Xie Y, Huang RL, Zhou J, Tanja H, Zhao P, Cheng C, Zhou S, Pu LLQ, Li Q (2017) Facial contouring by targeted restoration of facial fat compartment volume: the mid-face. Plast Reconstr Surg 139:563–572CrossRef Wang W, Xie Y, Huang RL, Zhou J, Tanja H, Zhao P, Cheng C, Zhou S, Pu LLQ, Li Q (2017) Facial contouring by targeted restoration of facial fat compartment volume: the mid-face. Plast Reconstr Surg 139:563–572CrossRef
13.
Zurück zum Zitat Xie Y, Zheng DN, Li QF, Gu B, Liu K, Shen GX, Pu LLQ (2010) An integrated fat grafting technique for cosmetic facial contouring. J Plast Reconstr Aesth Surg 63:270–276CrossRef Xie Y, Zheng DN, Li QF, Gu B, Liu K, Shen GX, Pu LLQ (2010) An integrated fat grafting technique for cosmetic facial contouring. J Plast Reconstr Aesth Surg 63:270–276CrossRef
14.
Zurück zum Zitat Gamboa GM, Ross WA (2013) Autologous fat transfer in aesthetic facial recontouring. Ann Plast Surg 70:513–516CrossRef Gamboa GM, Ross WA (2013) Autologous fat transfer in aesthetic facial recontouring. Ann Plast Surg 70:513–516CrossRef
15.
Zurück zum Zitat Le TP, Peckinpaugh J, Naficy S, Amadi AJ (2014) Effect of autologous fat injection on lower eyelid position. Ophthal Plast Reconstr Surg 30:504–507CrossRef Le TP, Peckinpaugh J, Naficy S, Amadi AJ (2014) Effect of autologous fat injection on lower eyelid position. Ophthal Plast Reconstr Surg 30:504–507CrossRef
16.
Zurück zum Zitat Mailey B, Baker JL, Hosseini A, Collins J, Suliman A, Wallace AM, Cohen SR (2016) Evaluation of facial volume changes after rejuvenation surgery using a 3-dimensional camera. Aesth Surg 36:379–387CrossRef Mailey B, Baker JL, Hosseini A, Collins J, Suliman A, Wallace AM, Cohen SR (2016) Evaluation of facial volume changes after rejuvenation surgery using a 3-dimensional camera. Aesth Surg 36:379–387CrossRef
17.
Zurück zum Zitat Pezeshk RA, Stark RY, Small KH, Unger JG, Rohrich RJ (2015) Role of autologous fat transfer to the superficial fat compartments for perioral rejuvenation. Plast Reconstr Surg 136:301e–309eCrossRef Pezeshk RA, Stark RY, Small KH, Unger JG, Rohrich RJ (2015) Role of autologous fat transfer to the superficial fat compartments for perioral rejuvenation. Plast Reconstr Surg 136:301e–309eCrossRef
18.
Zurück zum Zitat Roh MR, Kim TK, Chung KY (2009) Treatment of infraorbital dark circles by autologous fat transplantation: a pilot study. Br J Dermatol 160:1022–1025CrossRef Roh MR, Kim TK, Chung KY (2009) Treatment of infraorbital dark circles by autologous fat transplantation: a pilot study. Br J Dermatol 160:1022–1025CrossRef
19.
Zurück zum Zitat Pallua N, Wolter T (2013) The lipo-facelift: merging the face-lift and liposculpture: eight years experience and a preliminary observational study. Aesth Plast Surg 37:1107–1113CrossRef Pallua N, Wolter T (2013) The lipo-facelift: merging the face-lift and liposculpture: eight years experience and a preliminary observational study. Aesth Plast Surg 37:1107–1113CrossRef
20.
Zurück zum Zitat Billings E Jr, May JW Jr (1989) Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg 83:368–381CrossRef Billings E Jr, May JW Jr (1989) Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg 83:368–381CrossRef
21.
Zurück zum Zitat Rohrich RJ, Pessa JE (2007) The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg 119:2219–2227CrossRef Rohrich RJ, Pessa JE (2007) The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg 119:2219–2227CrossRef
22.
Zurück zum Zitat Buckingham ED, Bader B, Smith SP (2010) Autologous fat and fillers in periocular rejuvenation. Facial Plast Surg Clin N Am 18:385–398CrossRef Buckingham ED, Bader B, Smith SP (2010) Autologous fat and fillers in periocular rejuvenation. Facial Plast Surg Clin N Am 18:385–398CrossRef
23.
Zurück zum Zitat Glasgold M (2015) Introduction to volumetric facial rejuvenation. Facial Plast Surg 31:10–14CrossRef Glasgold M (2015) Introduction to volumetric facial rejuvenation. Facial Plast Surg 31:10–14CrossRef
24.
Zurück zum Zitat Donofrio LM (2005) Panfacial volume restoration with fat. Dermatol Surg 31:1496–1505CrossRef Donofrio LM (2005) Panfacial volume restoration with fat. Dermatol Surg 31:1496–1505CrossRef
25.
Zurück zum Zitat Sadick NS, Manhas-Bhutani S, Kreuger N (2013) A novel approach to structural facial volume replacement. Aesth Plast Surg 37:266–276CrossRef Sadick NS, Manhas-Bhutani S, Kreuger N (2013) A novel approach to structural facial volume replacement. Aesth Plast Surg 37:266–276CrossRef
26.
Zurück zum Zitat Reuther M, Watson D (2016) Tissue engineering and the future of facial volumization. Facial Plast Surg 32:565–568CrossRef Reuther M, Watson D (2016) Tissue engineering and the future of facial volumization. Facial Plast Surg 32:565–568CrossRef
27.
Zurück zum Zitat Kim IA, Keller GK, Groth MJ, Nabili V (2016) The downside of fat: avoiding and treating complications. Facial Plast Surg 32:556–559CrossRef Kim IA, Keller GK, Groth MJ, Nabili V (2016) The downside of fat: avoiding and treating complications. Facial Plast Surg 32:556–559CrossRef
28.
Zurück zum Zitat Sinno S, Mehta K, Reavey PL, Simmons C, Stuzin JM (2015) Current trends in facial rejuvenation: an assessment of ASPS members’ use of fat grafting during face lifting. Plast Reconstr Surg 136:20e–30eCrossRef Sinno S, Mehta K, Reavey PL, Simmons C, Stuzin JM (2015) Current trends in facial rejuvenation: an assessment of ASPS members’ use of fat grafting during face lifting. Plast Reconstr Surg 136:20e–30eCrossRef
29.
Zurück zum Zitat Del Vecchio D, Rohrich RJ (2012) A classification of clinical fat grafting: different problems, different solutions. Plast Reconstr Surg 130:511–522CrossRef Del Vecchio D, Rohrich RJ (2012) A classification of clinical fat grafting: different problems, different solutions. Plast Reconstr Surg 130:511–522CrossRef
30.
Zurück zum Zitat Gause TM II, Kling RE, Sivak WN, Marra KG, Rubin PJ, Kokai LE (2014) Particle size in fat graft retention: a review on the impact of harvesting technique in lipofilling surgical outcomes. Adipocyte 3:273–279CrossRef Gause TM II, Kling RE, Sivak WN, Marra KG, Rubin PJ, Kokai LE (2014) Particle size in fat graft retention: a review on the impact of harvesting technique in lipofilling surgical outcomes. Adipocyte 3:273–279CrossRef
31.
Zurück zum Zitat Khouri RK, Rigotti G, Cardoso E, Khouri RK Jr, Biggs TM (2014) Megavolume autologous fat transfer: part I. Theory and principles. Plast Reconstr Surg 133:550–557CrossRef Khouri RK, Rigotti G, Cardoso E, Khouri RK Jr, Biggs TM (2014) Megavolume autologous fat transfer: part I. Theory and principles. Plast Reconstr Surg 133:550–557CrossRef
32.
Zurück zum Zitat Bourne DA, James IB, Wang SS, Marra KG, Rubin PJ (2016) The architecture of fat grafting: what lies beneath the surface. Plast Reconstr Surg 137:1072–1079CrossRef Bourne DA, James IB, Wang SS, Marra KG, Rubin PJ (2016) The architecture of fat grafting: what lies beneath the surface. Plast Reconstr Surg 137:1072–1079CrossRef
33.
Zurück zum Zitat James IB, Coleman SR, Rubin PJ (2016) Fat, stem cells, and platelet-rich plasma. Clin Plastic Surg 43:473–488CrossRef James IB, Coleman SR, Rubin PJ (2016) Fat, stem cells, and platelet-rich plasma. Clin Plastic Surg 43:473–488CrossRef
34.
Zurück zum Zitat Fontdevila J, Guisantes E, Martinez E, Prades E, Berenguer J (2014) Double-blind clinical trial to compare autologous fat grafts versus autologous fat grafts with PDGF: no effect of PDGF. Plast Reconstr Surg 134:219e–230eCrossRef Fontdevila J, Guisantes E, Martinez E, Prades E, Berenguer J (2014) Double-blind clinical trial to compare autologous fat grafts versus autologous fat grafts with PDGF: no effect of PDGF. Plast Reconstr Surg 134:219e–230eCrossRef
35.
Zurück zum Zitat Fontdevila J, Serra-Renom JM, Raigosa M, Berenguer J, Guisantes E, Prades E, Benito-Ruiz J, Martinez E (2008) Assessing the long-term viability of facial fat grafts: an objective measure using computed tomography. Aesthet Surg J 28:380–386CrossRef Fontdevila J, Serra-Renom JM, Raigosa M, Berenguer J, Guisantes E, Prades E, Benito-Ruiz J, Martinez E (2008) Assessing the long-term viability of facial fat grafts: an objective measure using computed tomography. Aesthet Surg J 28:380–386CrossRef
36.
Zurück zum Zitat Horl HW, Feller AM, Biemer E (1991) Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging. Ann Plast Surg 26:248–258CrossRef Horl HW, Feller AM, Biemer E (1991) Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging. Ann Plast Surg 26:248–258CrossRef
37.
Zurück zum Zitat Gosain AK, Klein MH, Sudhakar PV, Prost RW (2005) A volumetric analysis of soft-tissue changes in the aging midface using high-resolution MRI: implications for facial rejuvenation. Plast Reconstr Surg 115:1143–1155CrossRef Gosain AK, Klein MH, Sudhakar PV, Prost RW (2005) A volumetric analysis of soft-tissue changes in the aging midface using high-resolution MRI: implications for facial rejuvenation. Plast Reconstr Surg 115:1143–1155CrossRef
38.
Zurück zum Zitat Darcy SJ, Miller TA, Goldberg RA, Villablanca JP, Demer JL, Rudkin GH (2008) Magnetic resonance imaging characterization of orbital changes with age and associated contributions to lower eyelid prominence. Plast Reconstr Surg 122:921–931CrossRef Darcy SJ, Miller TA, Goldberg RA, Villablanca JP, Demer JL, Rudkin GH (2008) Magnetic resonance imaging characterization of orbital changes with age and associated contributions to lower eyelid prominence. Plast Reconstr Surg 122:921–931CrossRef
39.
Zurück zum Zitat Wysong A, Joseph T, Kim D, Tang JY, Gladstone HB (2013) Quantifying soft tissue loss in facial aging: a study in women using magnetic resonance imaging. Dermatol Surg 39:1895–1902CrossRef Wysong A, Joseph T, Kim D, Tang JY, Gladstone HB (2013) Quantifying soft tissue loss in facial aging: a study in women using magnetic resonance imaging. Dermatol Surg 39:1895–1902CrossRef
40.
Zurück zum Zitat Del Vecchio DA, Bucky LP (2011) Breast augmentation using preexpansion and autologous fat transplantation: a clinical radiographic study. Plast Reconstr Surg 127:2441–2450CrossRef Del Vecchio DA, Bucky LP (2011) Breast augmentation using preexpansion and autologous fat transplantation: a clinical radiographic study. Plast Reconstr Surg 127:2441–2450CrossRef
Metadaten
Titel
Fat Injection: A Systematic Review of Injection Volumes by Facial Subunit
verfasst von
Shirley Shue
David E. Kurlander
Bahman Guyuron
Publikationsdatum
08.08.2017
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 5/2018
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-017-0936-6

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