This month’s issue January 2017 of the Aesthetic Surgery Journal had another article about fat grafting to the areas around the mouth and eye. And ready for this? drumroll….. It makes it all better. I am so thrilled the rest of the world is jumping on my love of fat transfer to the face. I love it. It works. Everyone is doing a slightly different twist on how they harvest the fat, how they process, if they add something to it (like more stem cells or protein rich plasma). Please don’t get caught up in all the different terms people use- everyone is trying to “brand” their technique as superior. When meta analysis of many of these studies are done, they show there is not a clear winner yet on how to harvest/process/inject for ideal results. (I have blogs on these studies as well.)
Article: “Skin Rejuvenation and Volume Enhancement with the Micro Superficial Enhanced Fluid Fat Injection (MSEFFI) for Skin Aging of the Periocular and Perioral Regions.” In English, it means they are injecting fat near the eye and face. They are looking at injecting fat superficially- into the dermis layer- not deep in the face. In many articles you will hear this referred to as “nanofat” injecting, where we break up the fat to use the stem cells to inject.
What did they do?
- They harvest with tiny cannulas (so small fat globule size) by hand
- They rinse the fat
- They use PRP (protein rich plasma), centrifuge the PRP, and mix it with the rinsed fat.
- They inject into the skin using a 27 gauge needle (which is tiny)
- They use this for perioral lines and crows feet.
- They scored results by looking at photos. They looked at 1 month, 3 months, and 6 months.
Findings:
- Average patient age was 49
- The PRP in their study increased the cell growth of the tissues harvested
- (*note: another study which looked at the in vivo histologic biopsies of skin did not find PRP changed the efficacy of the stem cells)
- Results: per patients and surgeons : Good at 3 months, Fair at 6 months.
- No visible lumps or cysts.
What do I think?
Fat works. Nanofat works to inject superficially. This study uses PRP and really small cannulas to harvest. Again, it is a variation on the theme of fat grafting- this one focused on the stem cells, with injections superficially into the skin to get the pesky lines around the eyes and mouth.
Photos I find to be a hard way to assess how well something works. I like the studies which did biopsies and can catalog the histologic changes.
I have already embraced nanofat (superficial injection into the skin) and microfat (deeper injections into the face).