The purpose of this paper is to quantify the long term volume retention in the midface of autologous fat grafting and examine the effect of processing technique.
Methods/Technique:
The authors performed autologous fat grafting of the midface utilizing standard techniques described in text book Complementary Fat Grafting (Lam 2007). The midface is defined as the inferior orbital rim and anterior cheek. The volume of autologous fat injected into this area was recorded during surgery. Pre operative and Post operative 3D images were compared using a volume differential model for the Vectra photography system by Canfield Scientific. The change in volume in the area defined as the midface was considered the long term result. The fat was processed by either a standard centrifugation technique or using a closed membrane filtration system (Puregraft). Results were evaluated using a volume differential mode with 3D photography (Vectra) to provide quantitative data.
Results/Complications:
In the membrane filtration processing, 18 patients (36 hemi-midfaces) met inclusion criteria for the study. The mean “take” at the time of followup was 47%, range 14-93%, with a standard deviation of 28%. Average post operative interval was 11 months, range 7 - 18 months In the centrifugation processing, 33 patients (66 hemi-midfaces) met inclusion criteria. The mean take 32%, range 10 - 90% take. Average post operative interval was 16 months, range 12 - 21 months. Statistical analysis using t-test analysis showed a p-value of 0.00217.
Conclusion:
3-D quantitative analysis of fat grafting to the midface demonstrated a statistically significant better volume take when processing the fat with membrane filtration versus standard centrifugation technique evaluating long term (1yr) results.