As a resident in the early 1990s, I was fortunate to have been involved in the initial experiments with fat grafting.  Since then, I have literally helped “shape” the field of autologous fat grafting, despite the doubts of many of my colleagues.  With proper technique, fat does survive; it is Mother Nature’s sculpting material of choice.  In addition, it acts as a stem cell with powerful rejuvenative and anti-aging properties. Fat is the most powerful tool that I have in addition to my surgical techniques, to provide my patients with their desire to retain or regain that youthful look.. 

I have proven the efficacy of my fat techniques in  thousands of patients over  more than twenty years of practice. These experiences have solidified my position as a  recognized and published  leader in the field of fat grafting. My aesthetic is known to be natural..  Below is a summary of the ground breaking article that was recently published in the well-respected, peer reviewed journal, Plastic and Reconstructive Surgery; finally, there is scientific affirmation of  my experience and those of my patients.

In the article, “Antiaging Treatment of the Facial Skin by Fat Graft and Adipose-Derived Stem Cells,” by Luiz Charles-de-Sa, MD, et al the authors concluded that treatment with fat modifies the pattern of the dermis leading to a skin rejuvenating effect.  What does this mean?  Aged skin includes several clinical aspects that are typically present.  These include: (1) degradation of the extracellular matrix fibers which impairs the ability of the dermis to retain water (2) the reduction in the number of collagen producing fibroblasts and (3) the disorganized distribution pattern of elastic fibers that lead to loss of elasticity and tonus of the skin.

Within the deep layer of the skin, tissue atrophy is observed, leading to volumetric loss of contour and angularity in the face.  After successful fat grafting, the skin appeared more hydrated, with an increase in collagen network in the superficial dermis and a decrease in the area of damaged elastin fibers in the deep dermis.  At the junction between the deep and superficial dermis, the treatment with fat led to the formation of a richer microvascular bed.

Harvested fat cells contain multipotent elements that can be easily accessed.  Fat cells have a high potential for self-renewal and the capacity to differentiate into multiple cell lines, giving them an important role in regenerative medicine.  They also have important paracrine (hormonal) actions, stimulate angiogenesis (new blood vessels), have antioxidant properties and can modulate immune tolerance and inflammation.  The ability of fat cells to perform these multiple functions are attributed to the action of several growth factors released under specific conditions.

The article suggests that the skin is rejuvenated after skin grafting due to the formation of blood vessels (angiogenesis) at the junction between the dermis and the subcutaneous tissue.  More studies have to be done to prove this hypotheses, but in my experience the fact that patients’ fat grafted skin looks better almost immediately and continues to improve over years, is evidence that new blood vessels are forming and continue to nourish the skin.

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