- A surgeon offers what he calls an effective approach for recontouring the face with autologous fat, based on clinical and laboratory studies
- Surgeon says he chooses the inner thigh for fat harvesting whenever possible, followed by the lateral flank as a secondary site
Research is ongoing to identify how specific approaches for autologous fat grafting affect the results. Until true level 1 or 2 data are available to develop practice-changing, evidence-based recommendations, Rod J. Rohrich, M.D., says he believes it is best to keep it simple and efficient with a focus on minimizing the time between when the fat is extracted and replaced into the patient in order to minimize fat cell death.
He says his technique, which is based on his clinical and laboratory studies published in the Journal of Plastic and Reconstructive Surgery plus a decade of clinical experience, represents a rationale and effective approach for recontouring the face with autologous fat.
In addition to prompt reinjection of the fat, he says the components of his method include preferential fat harvesting from the inner thigh; one minute of centrifuge time; and reinjection of the fat in an anatomically based approach into well-defined deep facial compartments. "When it comes to techniques for autologous fat augmentation, currently there are only data showing the value of minimizing centrifuge time and reinjecting the fat as quickly as possible after harvesting in order to reduce cell loss due to anoxia, and in my opinion, prompt reinjection is a consideration that has not been emphasized enough," he says. "Otherwise, there are no good evidence-based medicine data demonstrating that any specific techniques for fat harvesting, processing or injection improve graft take and survival, and that includes a lack of data to support the use of costly devices that purportedly isolate stem cells for use in augmenting fat injections." Dr. Rohrich is professor of plastic surgery, Crystal Charity Ball Distinguished Chair in Plastic Surgery, and Warren and Betty Woodward Chair in Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas.
"From a personal perspective based on my clinical outcomes of over 350 facelift patients, I can report that the approach I use works well, although I acknowledge it represents level 5 evidence-based medicine." he says.
A 48-year-old female patient before (left images) and two years after face- and necklift and lower blepharoplasty, fat injections to nasolabial and deep and lateral malar compartments. (Photos credit: Rod J. Rohrich, M.D.)