The process of aging is the result of subcutaneous loss of volume, in addition to vertical tissue descent. Surgeons are therefore emphasizing soft tissue augmentation to achieve a natural, rejuvenated appearance in patients. Autologous fat grafting is now a commonly performed aesthetic procedure. Autologous fat grafting is a challenging procedure, due to the fragile characteristic of adipose tissue. Viability of transplanted fat is a main consideration when fat grafting is performed. Poor fat viability produces an inadequate result and thus can be considered as a complication of this procedure. Many studies have demonstrated that fat longevity is dependent upon handling and preparation of fat. This article outlines the history of autologous fat grafting. The technique of fat grafting is described, along with review of the evidence of fat viability according to the technique used. The specific technique for autologous fat grafting in the lower third of the face is described including augmentation of the labiomandibular fold, lips, chin, and the jaw.
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