Biofilling and Biocontouring with Milli, Micro & Nano Fat

Facial aging is complex. To deliver the best anti-ageing result in the face, a surgeon has to address and treat photo-damage, volume loss, and soft tissue laxity simultaneously.

By improving volume at earlier ages with biomaterials such as with a patient’s own fat, it is possible for a surgeon to stimulate angiogenesis as well as sustain volume augmentation to help tissue regeneration and possibly prevent/decelerate ageing at cellular level.

This week, IFAAS faculty, Dr. Steven R. Cohen shares his findings in Regenerative Cells For Facial Surgery: Biofilling and Biocontouring with Milli Fat, Micro Fat & Nano Fat.

Regenerative Cells - Stromal Vascul Fraction (SVF)

Regenerative cells found in human fats are a mixed population of stromal and vascular cells found around blood vessels and between adipocytes in the matrix of fat. Most of these cells are covalently bound to small blood vessels in the matrices of fat which surround adipocytes. By definition, Stormal Vascular Fraction (SVF) is composed of stromal and vascular cells. A small proportion of the stromal cells are stem cells, which have been shown to be capable of differentiating into different structures (pluripotentency).

Mini-Fellowship (Observation): Korean Advanced Body Contouring Surgeries: Advanced Breast Augmentation, Breast Lifting & Buttocks Augmentation | 28 - 30 March, 2019 : Seoul, South Korea

SVF cells have also been shown to have beneficial effects in wound remodeling, blood supply, differentiation, and wound immune modulation. They are also often associated with numerous trophic factors, growth factors, cytokines, cell signaling molecules, etc. and represent an orchestra of regenerative cells that can be found in human fat.

Bio-Fillers: Fat Grafts - Milli vs Micro vs Nano

Fat grafts in general, can be modified into different shapes and sizes for different anatomic indications.

Milli-fat is large parcel sized (2.4 mm and <) fat that is used when structural fat grafts are performed for deep fat compartment filling, filling of the lips, temporal regions, brows, chin, nose, and pyriform.

Micro-fat is used for superficial fat grafting, for instance, in the forehead, the hands, the perioral tissues (upper and lower lip and chin), and at times, the nose and deep in the tear trough.

Nano-fat is used for patients with thinner tissues in substitution for microfat. These are used more specifically for intradermal injection in the radial wrinkle lines of the lips, in acne scars, in the upper and lower eye- lid in the subcutaneous fat superficial to the muscle. Nanofat can also used as a mesotherapeutic agent delivered by microneedling into the dermis throughout the face, and also alone or in combination with PRP in the scalp at the level of the hair bulge.

Bio-Contouring

Modifying the characteristics of fat can help address anatomic needs and provide modest regenerative effects. However, for best results, it is crucial to place modified fats in the correct areas.

These fats should not be used for overcorrection to account for loss of fluid in any fat graft procedure during surgery or grafting, as some of these fluids will disperse - although one can add a bit more fat to improve aesthetics, never should one overcorrect.

Ultimately, bio-contouring through simple injections of bio-fillers is possible. This allows a surgeon to perform in situ tissue engineering to construct, correct and improve areas such as the face, chin, neck and bony contours to certain extent without the need for complex surgery procedures.

Resources:

https://academic.oup.com/asj/article/37/suppl_3/S16/3868348?searchresult=1

Learn more about advanced cutting-edge techniques in Biofilling and Biocontouring through Dr Cohen's Mini Fellowship in his own Operation Room:

IFAAS Mini Fellowship (Observation)

San Diego - Dr Steve Cohen's Injectable Tissue Replacement and Regeneration & ABC Face Lift

June 28-29, 2019: San Diego, CA, United States