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Combining High-Density Fat and Condensed Low-Density Fat Injections for Precise Facial Rejuvenation

  • Original Articles
  • Fat Grafting/Regenerative Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Facial aging involves ptosis, adipose atrophy, and skeletal resorption. Depletion of adipose tissue primarily affects the deep facial fat compartment, leading to facial depression or ptosis, accompanied by atrophy of the superficial compartment. Restoring volume in the deep fat compartment is crucial for facial rejuvenation, while enhancing its supportive properties is also important. The superficial fat compartment contains small-sized adipocytes, and autologous fat grafting is a popular approach. However, variability in fat retention, homogeneity, and processing methods can impact outcomes, necessitating careful selection of a suitable fat processing material for precise facial fat grafting.

Method

A retrospective study was conducted on 50 patients who underwent facial augmentation using combined transplantation of high-density fat (HDF) and condensed low-density fat (CLDF) and 25 patients who underwent conventional Coleman fat grafting. Coleman fat was harvested by standard technique and the adipose tissue was divided into HDF and CLDF fractions through centrifugation. Subsequently, the low-density fat fraction was subjected to a process involving physical disruption followed by additional centrifugation to obtain CLDF. The CLDF fraction was consequently injected into the pre-SMAS subcutaneous layer of the superficial fat compartments. Patient satisfaction was evaluated using a typical Likert scale. Photographs were taken and imageological examinations were performed before and after treatment.

Result

The CLDF+HDF grafting group demonstrated a significantly shorter duration of swelling (6.0 ± 1.2 to 12.6 ± 3.3 days) and higher level of patient satisfaction when compared to the Coleman fat group. No serious complications were observed among all the patients who received the injections.

Conclusion

The use of this new treatment approach allows for precise fat transplantation in facial regions. The use of high-concentration fat filling for deep facial layers and CLDF filling for superficial layers is a safe and effective treatment plan for facial rejuvenation.

Level of Evidence IV

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Data Availability

The original data of this article can be obtained from the corresponding author upon reasonable request.

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Funding

This work was supported by the National Nature Science Foundation of China (81801932, 81901976, 81971852, 81772101, 81901975).

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Author notes

  1. Huidong Zhu, Hui Shi and Jian Li have contributed equally to this article and should be considered as co-first authors.

  2. Yuping Quan and Feng Lu have contributed equally to this article and should be considered as co-corresponding authors.

Authors and Affiliations

  1. Department of Plastic Surgery and Regenerative Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian, China

    Yuping Quan

  2. Chengdu Tongquetai Aesthetic and Plastic Hospital, Chengdu, Sichuan, China

    Huidong Zhu

  3. Department of Cosmetic Surgery, One and Only Cosmetic Hospital Dongguan, Dongguan, Guangdong, China

    Hui Shi

  4. Department of Plastic and Cosmetic Surgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China

    Huidong Zhu, Jian Li, Yunjun Liao, Junrong Cai, Feng Lu & Yuping Quan

Authors
  1. Huidong Zhu
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  2. Hui Shi
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Corresponding author

Correspondence to Yuping Quan.

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The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Tongquetai hospital for studies involving humans.

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Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper.

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Zhu, H., Shi, H., Li, J. et al. Combining High-Density Fat and Condensed Low-Density Fat Injections for Precise Facial Rejuvenation. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03953-y

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  • DOI: https://doi.org/10.1007/s00266-024-03953-y

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