J Cosmet Med 2020; 4(2): 57-63  https://doi.org/10.25056/JCM.2020.4.2.57
Sequential autologous fat injection techniques for volumetric face lifting in young Korean females
Kyoungjin Kang, MD, PhD
Seoul Cosmetic Surgery Clinic, Busan, Rep. of Korea
Kyoungjin Kang
E-mail: safikccs@pascal-world.com
Received: August 25, 2020; Revised: October 5, 2020; Accepted: October 6, 2020; Published online: December 31, 2020.
© Korean Society of Korean Cosmetic Surgery. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Various fat grafting techniques have been preferentially performed to restore facial volume deficiency. However, no reports have focused on simultaneous volume deficiency and sagging appearance improvements, barring the sequential autologous fat injection (SAFI) technique.
Objective: This study aimed to show real evidence of volumetric lifting using the SAFI technique.
Methods: From 2007 to 2009, we performed the SAFI technique on 10 patients in their 20s. Fat was purified using Coleman’s method and sequentially injected into each defective region from the superolateral to the anteroinferior direction. The fat was placed subsequently in the supra-periosteal, deep, and superficial layers (approximately 60%, 30%, and 10% of the injected volume, respectively) of each region to increase the skeletal support for the soft tissue. Morphological changes were evaluated by comparing pre- and postoperative photographs. The effects were monitored from 3 months to 1.5 years.
Results: We included 10 patients with an average age of 25.4±2.56 years, having relatively small and flat malar bones with negative globe-to-skeletal rim relations; moreover, they were injected averagely with 38.8±4.89 ml of fat. In most of the cases, the facial contour changed from a rectangular to an oval shape. Furthermore, the appearance was lifted through great volume restoration in the midface and volume reduction in the deep nasolabial folds (NLFs) and jowls. The wrinkle severity rating scale (WSRS) grade decreased in 7 patients (3 on both sides and 4 on either side) and increased in 3 patients. The WSRS improvement was not statistically significant; however, NLFs showed a younger, more natural, and lifted look in all cases. Patient satisfaction was relatively high (4.4±0.5).
Conclusion: The results indicated that the SAFI technique could be used for both volume deficiency and sagging appearance improvements because it preferentially focused on both skeletal deformity and soft tissue defect corrections.
Keywords: face lifting; face sagging; fat grafting; skeletal deformity; volume deficiency
References
  1. Coleman SR. Structural fat grafting. Aesthet Surg J 1998;18:386, 388.
    CrossRef
  2. Donofrio LM. Fat rebalancing: the new “facelift”. Skin Therapy Lett 2002;7:7-9.
  3. Amar RE, Fox DM. The facial autologous muscular injection (FAMI) procedure: an anatomically targeted deep multiplane autologous fat-grafting technique using principles of facial fat injection. Aesthetic Plast Surg 2011;35:502-10.
    Pubmed CrossRef
  4. Lam SM, Glasgold MJ, Glasgold RA. Complementary fat grafting. Philadelphia, PA: Lippincott, Williams, & Wilkins; 2007.
    CrossRef
  5. Kang K. Lifting effect of sequential autologous fat injection (SAFI) in three patients with small and flat malar bones. J Cosmet Med 2019;3:120-4.
    CrossRef
  6. Prager W, Wissmueller E, Havermann I, Bee EK, Howell DJ, Zschocke I, et al. A prospective, split-face, randomized, comparative study of safety and 12-month longevity of three formulations of hyaluronic acid dermal filler for treatment of nasolabial folds. Dermatol Surg 2012;38(7 Pt 2):1143-50.
    Pubmed CrossRef
  7. Pessa JE, Zadoo VP, Mutimer KL, Haffner C, Yuan C, DeWitt AI, et al. Relative maxillary retrusion as a natural consequence of aging: combining skeletal and soft-tissue changes into an integrated model of midfacial aging. Plast Reconstr Surg 1998;102:205-12.
    Pubmed CrossRef
  8. Kang KJ, Yang HH, Chai CY. Assessment of rejuvenation by change of lid-cheek junction after transconjunctival and traditional subciliary incision blepharoplasty. J Cosmet Med 2017;1:30-8.
    CrossRef
  9. Day DJ, Littler CM, Swift RW, Gottlieb S. The wrinkle severity rating scale: a validation study. Am J Clin Dermatol 2004;5:4952.
    Pubmed CrossRef
  10. Davis A, Augenstein A. Amniotic allograft implantation for midface aging correction: a retrospective comparative study with platelet-rich plasma. Aesthetic Plast Surg 2019;43:134552.
    Pubmed KoreaMed CrossRef
  11. Kang KJ. SAFI: a novel facial fat grafting technique with a concept of volumetric lifting. Paju: Koonja Publishing Inc.; 2016. p. 1-351.
  12. El-Mesidy MS, Alaklouk WT, Azzam OA. Nasolabial fold correction through cheek volume loss restoration versus thread lifting: a comparative study. Arch Dermatol Res 2020;312:47380.
    Pubmed CrossRef


This Article


Cited By Articles
  • CrossRef (0)

Author ORCID Information

Services
Social Network Service

e-submission

Archives