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Commentary
November 17, 2008

Facial Fat GraftingThe New Paradigm

Arch Facial Plast Surg. 2008;10(6):417-418. doi:10.1001/archfaci.10.6.417

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.

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