Facial recontouring with lipostructure.

Abstract

Lipostructure is a natural, long-lasting method of filling and supporting the face using intricate layering of infiltrated autologous tissue. This method allows the tissues to be sculpted to enact three-dimensional augmentation of facial elements. Because the grafted fat becomes integrated into the host tissues, it is almost undetectable after transplantation, except by photography. To successfully use fatty tissue as such a graft, attention must be paid to the nature of fatty tissue; to the methods of harvesting, transfer, and placement; and to the preparation of the patient. Fatty tissue is a complex, delicate structure that is easily damaged by mechanical and chemical insults. Successful fat transplantation demands that every step be practiced with attention to this fragile nature of fatty tissue. Precision is an important consideration in the augmentation of millimeters of facial elements. The true volume of infiltration is difficult to judge if too much blood, lidocaine, or oil is present in the tissue being placed. Fat is living tissue that must be in close proximity to a nutritional and respiratory source to survive. Therefore, placement of small amounts of fatty tissue in multiple tunnels assumes the utmost importance in the quest for both survival of fatty tissue and an aesthetically appropriate correction. Successful, three-dimensional sculpting requires attention to patient preparation, meticulous planning, and fastidious photographic evaluation. The potential applications in aesthetic and reconstructive surgeries of this new tool are profound. Lipostructure represents an important advance in plastic surgery: a safe, long-lasting method of recontouring the face with autologous tissue.