Facial fat grafting: the search for predictable results.

Since the majority of volume loss to the face is due to fat atrophy, autologous fat grafting with living fat cells represents the ideal tissue replacement. Recent technical improvements have led to excellent results utilizing fat grafting for cosmetic and reconstructive indications. The purpose of this article is to describe our clinical and laboratory experience with successful facial fat grafting for volume augmentation. Our laboratory experience with facial fat grafting centers around the results of multiple studies utilizing a nude mouse model of facial fat transplantation. Armed with the knowledge gained from our laboratory experience we present modified techniques to optimize fat grafting in the clinical setting. Furthermore, we present the results of several clinical studies examining a variety of recipient sites including nasolabial folds, glabella, lips, and lower eyelids. Lastly we describe our experience utilizing fat grafting to treat patients with hemifacial atrophy. When utilized in the appropriate areas, facial fat grafting can provide long-lasting aesthetically superior replacement for the soft tissues lost through aging or disease.