A new paradigm has arisen to supplant the traditional excision-based techniques of surgically treating the aging face. Volume loss has become recognized as a vital if not primary component to the aging process. Lambros1 has carefully examined photographs of patients as they age and has demonstrated that the aging process is more a result of concentric contraction of the facial volume rather than tissue descent. Pessa2 has radiologically shown that bony changes contribute to this volume loss, most interestingly documenting a posterior cephalad rotation of the maxilla. Coleman3 has proposed that a significant amount of volume loss is due to loss of colloidal volume in aging tissues. Donath et al4 extensively reviewed the literature on age-related volume loss in the face and proposed a volumetric mechanism for deepening of the nasolabial fold with age. While a precise explanation of the age-related volumetric changes is still being developed, the role of volume replacement for facial rejuvenation is well accepted.
Glasgold RA, Lam SM, Glasgold MJ. Facial Fat GraftingThe New Paradigm. Arch Facial Plast Surg. 2008;10(6):417-418. doi:10.1001/archfaci.10.6.417