The clinical outcome after fat grafting for facial rejuvenation and contouring can be less optimal because lack of standardized techniques is performed by the surgeon for the procedure. In this review, the author has tried to provide a rationalized approach to fat grafting for facial rejuvenation and contouring. The preferred donor sites include low abdomen and inner thigh especially in younger patients. Fat grafts should be harvested with low negative pressure via syringe liposuction technique to ensure the integrity as well as the optimal level of cellular function. Fat grafts should be processed with proper centrifugation that can reliably produce purified fat and concentrated growth factors and adipose-derived stem cells, all of which are beneficial to improve graft survival. Fat grafts should be placed after certain principles with gentle injection of small amount during the withdraw phase of each pass in multiple tissue planes and levels with multiple passes to ensure maximal contact of graft with vascularized tissue in the recipient site. The approach described in this review is supported by the most recent scientific studies and thus can likely provide a more predictable long-lasting result if performed properly.
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