Adipose component transplantation – an advanced fat grafting strategy based on adipose tissue component selection for facial rejuvenation

Background: Autologous fat grafting is frequently used for volume augmentation and tissue regeneration. The uniform physical and biological characteristics of fat grafts, however, limit their optimal effects in various situations. Subjecting fat tissue to different mechanical processes results in adipose-derived products with distinct biological components and physical features. The present study describes a novel facial fat grafting strategy, adipose component transplantation (ACT), which yields different adipose products that can be applied to specific injection sites. Methods: All patients who underwent ACT were retrospectively evaluated. Fat tissue samples were fractionated into high density fat (HDF), adipose matrix complex (AMC), stromal vascular fraction (SVF)-gel, and adipose collagen fragment (ACF), as described. Each of these fractions was processed and injected into indicated recipient sites. Additional SVF-gel was cryopreserved and, if necessary, injected during the following 3 months. Patients were followed-up after 1, 2, 3, and 6 months, and annually thereafter. Results: From March 2020 to September 2021, 78 patients have undergone whole face fat grafting using the ACT strategy. All operations and secondary injections of cryopreserved SVF-gel were uneventful. There were no major complications, and final aesthetic results were satisfactory in 91% patients. Conclusion: The ACT strategy allows specific adipose products to be applied to specific injection sites, as warranted. AMC is indicated for sufficient rigid support, HDF when large volumes are required, SVF-gel for precise injection and cryopreservation, and ACF as mesotherapy for skin rejuvenation. The ACT strategy optimizes the biological functions and physical features of different adipose-derived products.