Objective Evaluation of Eyebrow Position After Autologous Fat Grafting to the Temple and Forehead

Ophthalmic Complications Following Facial Autologous Fat Graft Injection: A Systematic Review and Meta-Analysis

INTRODUCTION

With the recent increase in interest in using autologous fat (AF) filler injections to enhance aesthetic facial appearance, there is a noticeable increase in the complications such as vascular compromise and blindness. This systematic review and meta-analysis aimed to understand the symptomatology of ophthalmic complications related to AF facial injections for cosmetic purposes, their underlying causes, management options, and the final clinical outcomes.

METHODS

This review was conducted according to the International Prospective Register of Systematic Reviews (PROSPERO) guidelines. In November 2021, we performed a systematic review of available literature using the following electronic databases: Cochrane, MEDLINE, and EMBASE. Our search was limited to the published studies between 2000 and 2021.

RESULTS

A total of 1052 publications and 34 articles published were included. Twenty case reports, two case series, one prospective cohort study, and eleven retrospective studies were evaluated. The forehead was the most common single injection site (n = 196, 55.36%). The most common initial symptom was periorbital swelling (92.7%). The pooled prevalence of ophthalmic artery occlusion was 50.4% out of all AF injection-related complications. Regarding the management, most patients were managed conservatively (n = 278, 51.38%). Complete improvement was observed among 423 patients (80.57%).

CONCLUSION

Autologous facial fat injection is a minimally invasive procedure with a favorable safety profile in cosmetic applications. However, the common use of these injections in aesthetic surgery has resulted in a concomitant increase in devastating consequences, such as blindness. Therefore, a firm understanding of the potential complications of such interventions is essential.

LEVEL OF EVIDENCE III

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Fat Grafting for Facial Rejuvenation

For optimal results, facial rejuvenation procedures should address both the tissue laxity and volume deflation associated with facial aging. The lift-and-fill face lift, in which fat grafting provides volumetric rejuvenation to the face while surgical lift effectively repositions and removes ptotic and redundant tissue, has revolutionized the plastic surgeon's approach to the aged face. An understanding of the intricate anatomy of distinct facial fat compartments and a systematic method to assess areas of fat atrophy and volume depletion are keys to provide patients with a natural and youthful result. Fat grafting may be used to improve contour in any area treatable by nonautologous injectable fillers, including the temples, forehead, upper and lower orbit, cheeks, perioral region, nasolabial fold, jawline, and chin-with the benefit of a more natural contour and integration with native tissue.

Does Stromal Vascular Fraction Ensure a Higher Survival in Autologous Fat Grafting for Breast Augmentation? A Volumetric Study Using 3-Dimensional Laser Scanning

Background

Cell-assisted lipotransfer (CAL) has been considered a promising technique for promoting adipogenesis and angiogenesis in fat grafts.

Objectives

The author sought to objectively analyze the change of breast volume in patients who underwent stromal vascular fraction (SVF)-enriched fat grafting for breast augmentation and compared the clinical results with those who underwent conventional fat grafting without SVF by using 3-dimensional laser scanning.

Methods

From April 2015 to March 2016, 105 patients who underwent traditional fat grafting without SVF enrichment for breast augmentation were assigned to group A and served as the control. The other 101 patients who underwent SVF-enriched fat grafting for breast augmentation were assigned to group B. The charts of these patients were retrospectively reviewed.

Results

The survival rate of the transplanted fat was 67.9% in group A and 68.7% in group B at 12 months after the operation. Postoperative complication rate was 3.8% in group A and 5.9% in group B. The differences were statistically insignificant.

Conclusions

SVF does not ensure a higher survival rate in autologous fat grafting for breast augmentation. Considering the potential drawbacks of adipose-derived stem cells (ADSC) and the extra cost of the consumables, in particular the need for harvesting larger amount of fat which could be reserved for additional fat grafting at a later time to achieve even better improvement, the results of this study do not support the use of SVF in autologous fat grafting for breast augmentation in terms of graft survival and postoperative complications.

Level of Evidence 3