The Development of Facial Lipofilling from a Historical Point of View

Abstract

Lipofilling, the transplantation of adipose tissue, has already been used since the end of the 19th century. For decades, lipofilling was used to restore loss of volume due to aging, trauma, or congenital defects. Later on, the indications for the use of lipofilling expanded by treating aged skin, scars, and improving wound healing. The expansion was caused by the discovery of adipose derived stromal cells (ASCs) in adipose tissue and the development of very fine harvesting and injection cannulas which made it possible to inject small adipose tissue particles in small volume areas, such as the face. ASCs are multipotent stromal cells which reside in the stromal vascular fraction (SVF) of adipose tissue and are able to differentiate in multiple cell lineages and secrete a plurality of growth factors with regenerative potentials. The discovery of ASCs led toward more experimental cell-based therapies, that is, ASCs or SVF isolated by means of enzymatic isolation procedures. Later on, enzymatic isolation procedures were forbidden in many countries by legislation and were replaced by mechanical isolation procedures, such as the Nanofat and Fractionation of Adipose Tissue (FAT) procedures. The Nanofat procedure has been extensively investigated, especially as treatment for skin rejuvenation in the face. Though, substantial evidence is lacking for using facial lipofilling or any therapeutic component, that is, ASCs or SVF for skin rejuvenation to date. In contrast, facial lipofilling to restore loss of volume seems to be promising.

Mechanically Derived Tissue Stromal Vascular Fraction Acts Anti-inflammatory on TNF Alpha-Stimulated Chondrocytes In Vitro

“…In these studies, however, cSVF is obtained enzymatically by time-consuming isolation procedures. These enzymatic procedures disrupt all cell–cell interactions including ECM [ 48 ]. Although several studies reported on the therapeutic effect of cSVF on osteoarthritis, the regenerative role of ECM is often underestimated.…”

Our experience with lipofilling in secondary rhinoplasty, into a new era

“…However it is not always feasible. 18 Moreover, there is an increased risk of patient dissatisfaction in revision surgeries. This may be due to a change in the nasal anatomy, the development of scar tissue, the loss of cartilaginous support, the altered blood supply, and the compromised soft tissue envelope.…”

“…These results are ensured by ADCSs that promote angiogenesis and improve scar healing 17 . However, there is a controversy whether the effect of ADSCs is assured by their multi‐lineage differentiation ability or by the secretions of paracrine factors, exosomes, and cytokines that stimulate skin regeneration 18 . As a result, this treatment can be geared for cosmetic purposes and skin disorders such as radiation dermatitis and chronic ulceration.…”

“…Imperfections post rhinoplasty are common and a revision rhinoplasty is indicated in certain cases. However it is not always feasible 18 . Moreover, there is an increased risk of patient dissatisfaction in revision surgeries.…”

Insights into the role of adipose‐derived stem cells: Wound healing and clinical regenerative potential

“…Fat grafting, also called lipofilling, has been applied for over 100 years since Neuber reported the first successful fat grafting procedure in 1893 (van Dongen, van Boxtel, Harmsen, & Stevens, 2019).…”