From the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan.
Dallas Plastic Surgery Institute.
Plast Reconstr Surg. 2024 Feb 1;153(2):360-377. doi: 10.1097/PRS.0000000000010643. Epub 2023 May 9.
The scientific study of facial aging has transformed modern facial rejuvenation. As people age, fat loss in specific fat compartments is a major contributor to 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 aging face a more youthful, healthy, and aesthetic appearance. Harvesting and preparation with different cannula sizes 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 have the benefit of providing volume to restore areas of facial deflation and atrophy in addition to improving skin quality; nanofat has been shown to improve skin texture and pigmentation. In this article, the authors discuss 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. The opportunity exists 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 powerful tool that has revolutionized facial rejuvenation, and developing precise, individualized plans for autologous fat grafting for each patient is an important advancement in the evolution of facial rejuvenation.
面部衰老的科学研究改变了现代面部年轻化。随着人们年龄的增长，特定脂肪隔室中的脂肪流失是导致面部结构老化的主要原因。自体脂肪移植安全、丰富、易于获得且完全生物相容，这使其成为纠正面部萎缩的首选软组织填充剂。通过脂肪移植增加体积可使衰老的面部呈现出更年轻、健康和美观的外观。不同套管尺寸和过滤筒技术的采集和准备，使得脂肪移植可以根据包裹大小和细胞类型分为三大亚型：大脂肪、小脂肪和纳米脂肪。大脂肪和小脂肪除了改善皮肤质量外，还具有提供体积以恢复面部凹陷和萎缩区域的益处；纳米脂肪已被证明可改善皮肤质地和色素沉着。本文作者讨论了目前关于脂肪移植的观点，以及脂肪移植的不断发展的科学如何导致每种类型的脂肪在优化面部年轻化方面的临床应用。现在有机会根据不同的脂肪亚型，针对面部不同解剖区域的衰老，个体化地使用自体脂肪移植。脂肪移植已成为一种强大的工具，彻底改变了面部年轻化，为每位患者制定精确、个体化的自体脂肪移植计划是面部年轻化发展的重要进步。
