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Lipofilling
“Lipostructure” is a fat autograft.
The American Coleman performed the procedure.
Aging means : sliding, deflation between fixed points.
Face lift treats sliding and lipostructure volumes.
Our theory is “up for down and out for in”.
A young face is full ; with aging, many sectors appear, separated by deep folds.
Lipostructure can be done alone, but is today an important component of a multiprocedure strategy, in association with face lift :
- limiting face lift,
- completing mediofacial lifting
we can speak about volumetric or reshaping face lift.
Fundamental considerations and refinements :
- Material : use little canula (1 and 2mm holes)
- Volumes :
- appreciate the efficient volume
- adapt to the localisation and the quality of the skin
- don’t exagerate in easy localisations (chin, cheekbones)
- good balance between quantity host tissue and graft tissue,
- don’t be timid in delicate areas (eyelids, folds)
- Future of cells graft
- one minute centrifugation doesn’t damage stems cells,
- stems cells are important for the take of the falling tissue
- the rate of the take of graft is technique and area dependant,
- the rate of the take of graft is improved by P.R.F. (Platelet Rich Fibrin) use
- the fat doesn’t migrate
- be able to calculate the fat amount x on an area y to plan the projection
- The different areas
- Except lateral areas of neck and jaw, aging is caracterized by deflation elsewhere : cheekbones, chin, orbitary area, temporal area, folds, lips- cheekbone and chin
- favourite stable areas
- the reshaping of structure fat grafting restores youthful projection
- big volumes from 10 to 15cc, even more
- orbitary and periorbitary areas
- eyelids : - delicate / thin canula / fat from the inner aspect of the knee with initial local anaesthetic / micrograft deep to the muscular layer / volume 0,5 to 1cc (tear trough) 1 or 2cc (palpebromalar fold and lower eyelids)
- periorbitary area : graft above the bone from the upper eyelids fold to 1cm above the eyebrow
- temporal area :
- big quantities necessary if intramuscular graft (10 to 15cc)
- little quantities enough if graft below the skin (3 to 5cc) / possibility of haematoma
- nasolabial folds : non stable area / relative efficiency
- mandibular border : 2 or 3cc, in association with chin graft
- lips : 2 to 4cc in each lip
- parotid region : to correct sequelae of face lift
- cheekbone and chin
CONCLUSION :
Lipostructure restores the fullness of youth It doesn’t remplace Face Lift It is a key point of a multiprocedures reflexion and strategy for subtle, natural and long lasting result.