Technical Precision with Autologous Fat Grafting for Facial Rejuvenation: A Review of the Evolving Science

Summary: The scientific study of facial aging has transformed modern facial rejuvenation. As we age, fat loss in specific fat compartments is a major contributor to the structural aging of the face. Autologous fat grafting is safe, abundant, readily available, and completely biocompatible, which makes it the preferred soft tissue filler in the correction of facial atrophy. The addition of volume through fat grafting gives an aged face a more youthful, healthy, and aesthetic appearance. Harvesting and preparation with different cannula size and filter cartridge techniques have allowed for fat grafts to be divided based on parcel size and cell type into three major subtypes - macrofat, microfat, and nanofat. Macrofat and microfat has the benefit of providing volume to restore areas of facial deflation and atrophy in addition to improving skin quality, while nanofat has been shown to improve skin texture and pigmentation. In this article, the current opinions regarding fat grafting and how the evolving science of fat grafting has led to the clinical utility of each type of fat to optimize facial rejuvenation will be discussed. We now have the opportunity to individualize the use of autologous fat grafting with the various subtypes of fat for the targeted correction of aging in different anatomic areas of the face. Fat grafting has become a very powerful tool that has revolutionized facial rejuvenation, and developing precise, individualized plans for autologous fat grafting for each patient is a vertical advancement in the evolution in facial rejuvenation.